Letter from Chief Medical Officer to NHS Chief Executives - November 2017

Letter from Chief Medical Officer Catherine Calderwood to NHS Chief Executives.

Dear Colleagues

Healthcare and Forensic Medical Services to those who have experienced rape and sexual assault

I am writing to ask that you provide the Scottish Government with an assessment of the existing integrated joint working arrangements that are in place in your locality to deliver trauma informed services to those who have experienced rape and sexual assault.


Earlier this year, Her Majesty's Inspectorate of Constabulary in Scotland published a report (HM inspectorate of Constabulary in Scotland: Strategic Overview of the Provision of Forensic medical Services to Victims of Sexual Crime, March 2017) which provides an overview of the provision of forensic medical services to victims of sexual crime and made a number of recommendations to improve this. There has also been notable Parliamentary interest in this issue, particularly in relation to the services provided by some of the Health Boards.

In March 2017, I was asked by the Cabinet Secretary for Justice, Michael Matheson MSP and the Cabinet Secretary for Health and Sport, Shona Robison MSP, to lead a Taskforce with a remit to improve services for forensic medical examination and general healthcare for those who have experienced rape and sexual assault. On 6 October 2017, I published a high level work plan (/groups/taskforce-to-improve-services-for-rape-and-sexual-assault-victims) which sets out a clear vision of how the Taskforce and its sub groups, will drive forward improvements over the next five years. As set out in the Programme for Government (http://www.gov.scot/Resource/0052/00524214.pdf) published in September, progressing this work is a key priority for the Scottish Government.

The SG has recently established a multi-agency Health and Justice Collaboration Board, attended by senior leaders from organisations responsible for service delivery in this area. The Board, which is co-chaired by the SG Director-General for Health and Social Care (Paul Gray) and the Director-General for Education, Communities and Justice (Paul Johnston), has prioritised supporting delivery of the work of the Taskforce.

I recognise that there are healthcare professionals across the country who strive to deliver a person centred, trauma informed response to people who have experienced rape and sexual assault and I would like you to extend my sincere thanks to them for their hard work and commitment to this important area of work.

However, I have also been made aware through Rape Crisis Scotland, that some individuals who have reported a rape or sexual assault, have received a health care response which has not met with the core NHS values of privacy, dignity and respect.

In July 2017, Healthcare Improvement Scotland (HIS) consulted on new National Standards (Health Improvement Scotland Standards: Healthcare and Forensic Medical Services for People who Have Experienced Rape, Sexual Assault or Child Sexual Abuse: Children, Young People and Adults) to develop a consistency in approach to healthcare and forensic medical services for anyone who has experienced rape, sexual assault or child sexual abuse. The new standards will be published in December 2017 and are an important step toward ensuring that the same high level of trauma informed care is provided by Health Boards throughout Scotland. Standardising the quality of care offered will further ensure the timely collection of high quality evidence to support any criminal justice proceedings.

I will be writing to you again early in the new year to seek confirmation that that you are working collaboratively with partners to implement the HIS standards. Broadly, these are in 5 areas: leadership and governance; person centred care; facilities for forensic examinations; educational, training and clinical requirements; and consistent documentation.

Immediate action

You are asked to provide:

  • A short summary of the existing arrangements which are in place to ensure effective, integrated joint working between your Health Board, Police Scotland and other partner organisations, addressing the 5 areas highlighted above. Where possible, this should include qualitative feedback received from individuals who access these services, as well as from staff who work in this area.

  • Detail about the current skills mix of professionals you use to provide trauma informed, person centred care to individuals before, during and after a forensic examination.

  • Information about any immediate issues or concerns which may impact on your ability to deliver services that will meet the new HIS standards.

Your report should be emailed to tansy.main@gov.scot by Monday 4 December 2017.

If you have any questions about the content of this letter or the ask of you, please contact Tansy Main, the policy lead for the Taskforce.

Kind regards.

Yours sincerely,
Catherine Calderwood
Chief Medical Officer

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