National standards for forensic examination

New nationwide standards are being introduced to ensure consistent delivery of forensic medical examinations for victims of sexual violence.

Healthcare Improvement Scotland has been commissioned to produce the standards, which will ensure best practice is applied when examining victims following a rape or sexual assault – including the conditions and way examinations are handled.

The new standards will build on the good work of the National Coordinating Network for Forensic Medical Services and put beyond doubt what is expected in the delivery of care for victims. It will also ensure NHS boards are clear in their role, helping ensure greater consistency throughout the country.

The announcement comes as a survey is issued this week to find out what more can be done to encourage more female doctors to get involved in this field of work. The Scottish Government and NHS Education for Scotland are working in partnership to gather information on the perceptions and concerns of female doctors.

Justice Secretary Michael Matheson said:

“It is important that victims of sexual violence feel confident coming forward, knowing they are going to be supported every step of the way, including forensic examination.

“While the way evidence is gathered and recorded is a top priority for the legal process, it must be balanced with the needs of victims, who may be vulnerable and traumatised. Therefore I am pleased Healthcare Improvement Scotland are developing new national standards – an important step in ensuring a consistent and sympathetic service.

“Understandably, many sexual assault victims want to be examined by a female doctor. We are working hard to understand the barriers for woman getting involved in this area of medicine, as we seek to achieve a greater gender balance.”

Dr Louise Scott, who carries out forensic examinations on Stornoway, said:

“When an individual has been brave enough to come forward after sexual assault, healthcare professionals have a vital role as part of that multi-agency response in meeting both the therapeutic needs of the victim and the high standard of evidential requirements.

“Many doctors and healthcare professionals may not realise they already have many of the professional skills required to provide a competent and caring response for victims of sexual assault and that, with the additional training and support available, they could be contributing to a high quality, co-ordinated, sensitive and victim-centred forensic medical response within their community.

“We need more female healthcare professionals prepared to take on this rewarding work, especially those from a GP, sexual health or gynaecology background, and help improve the experience and outcomes for victims.”

Sara Twaddle, Director of Evidence for Healthcare Improvement Scotland, said:

“It is vital that victims of rape or sexual assault receive the best care and support possible, that they have confidence in the service and that forensic examinations are carried out to the same high standard across the country.

“The setting of clear standards is vital in helping drive improvements in the care people receive – not only to help services know the key areas where a high standard of care needs delivered, but also where to to improve and focus their attention. We look forward to being involved in this important work and building on the positive work of the National Coordinating Network for Forensic Medical Service.”

Sandy Brindley, National Coordinator of Rape Crisis Scotland said:

“The response someone receives following rape can vary greatly, depending where they live and when the offence took place. Developing new standards should ensure that, no matter where someone lives in Scotland, they can access an appropriate and sensitive response.

“Forensic examinations conducted in an appropriate location, by a female doctor, with coordinated sexual health follow up and emotional and practical support, could make a huge difference to rape survivors experiences.”

Professor Stewart Irvine, Medical Director of NHS Education for Scotland, added:

“We believe that these standards, in conjunction with our work identifying potential barriers to female doctors and supporting a greater gender balance in doctors carrying out examinations, will help provide better outcomes for survivors of sexual assault.”

Background

The process for developing the new standards will involve relevant stakeholders and look at the up-to-date evidence available, consider other national health and social care standards, as well as an open consultation period.  The standards are expected to be rolled out before the end of 2017.

The National Health and Social Care Workforce Plan, due to be published this year, will support NHS boards to develop sustainable, appropriate, trained and competent workforce to deliver trauma informed and responsive services in this area.

Minimum standards for the forensic examinations to victims of a sexual offence were set out in 2013 by a working group with members from NHS boards, the Scottish Government, the Crown Office and Procurator Fiscal Service, Victim Support Scotland, SPA Forensic Services, Police Scotland and Rape Crisis Scotland. These standards have been implemented to some degree but are not obligatory and boards do not have to formally report on how they are applied.

The National Coordinating Network for Healthcare and Forensic Medical Services is a partnership of organisations involved in delivery of police custody healthcare and forensic medical services.