Healthcare professionals - supporting adults who present having experienced rape or sexual assault: clinical pathway

3. Self-referral

This section:

• Provides an introduction to self-referral services as defined within the Forensic Medical Services (Victims of Sexual Offences) (Scotland) Act 2021^[37] (FMS Act)
• Provides an overview of who can access self-referral FME, what considerations must be made before offering self-referral, and where to find further information

Key points

• The FMS Act places a statutory duty on Health Boards to provide self-referral FMS subject to professional judgement
• Self-referral services are available for people aged 16 and over, unless in their professional judgement there are vulnerabilities, including child protection, sexual exploitation or trafficking
• The Self-Referral National Protocol provides full guidance on self-referral services

The FMS Act requires consent information to be given to a person who has experienced rape or sexual assault prior to examination. More guidance on this can be found in the Self-Referral National Protocol

The Forensic Medical Services (Victims of Sexual Offences) (Scotland) Act 2021) (“FMS Act”), places a statutory duty on health boards to provide Forensic Medical Services (FMS) for victims of sexual offences and establishes a legal framework for consistent access to self-referral so a victim can access healthcare and request a FME without first having to make a report to the police. This service is called ‘self-referral’ and will be available to those aged 16 and over, subject to professional judgement.

Subject to that professional judgement, a self-referral service allows young people aged 16 and 17 years, who have experienced rape or sexual assault the opportunity to access appropriate support and healthcare services as well as a FME to collect any potential evidence, at a time when they do not feel ready to report to the police.

3.1 Self-referral and certain vulnerabilities

The Self-Referral National Protocol outlines and provides guidance on the requirements of Health Boards under the provisions of the FMS Act and The Forensic Medical Services (Retention Period) (Scotland) Regulations 2021 (“Retention Period Regulations”)^[38] in relation to self-referral services.

The Protocol provides examples of potential indicators of vulnerability that should be considered for further discussion with partners, based on professional judgement. Every person is unique and particular consideration should be given to their presentation and the verbal and non-verbal cues they provide.

The following list, whilst in no way exhaustive, provides examples of potential indicators of vulnerability that should be considered for further discussion with partners, and based on professional judgement, could indicate the need for referral to child or adult protection procedures, including an IRD.

The young person self-referring:

• Lacks capacity to consent to the medical
• Is defined as a child for the purposes of the Children’s Hearings System
• Is a Looked After Child or is care experienced
• Self-referred previously
• Was under the influence of drugs or alcohol at the time of the offence
• Intimates that they may have been drugged
• Has other injuries such as bruising, which may indicate a violent assault
• Provides an address in a different area or locality, which may indicate they have been trafficked
• Displays any indicators of CSE or Child Criminal Exploitation^[39]
• Displays any indicators of Honour Based Violence or FGM^[40]

In addition, if a young person provides information about a perpetrator and these indicators are present, then Police Scotland should be contacted immediately:

• If the perpetrator is an adult with potential continued access to the young person or other children
• If the perpetrator is a sibling of the young person
• If the perpetrator holds a position of trust such as Teacher, Police Officer, Medical Professional, Social Worker, Youth Worker, Foster Parent, runs/is involved in a club or organisation that other children attend