Healthcare professionals - supporting children and young people who may have experienced child sexual abuse: clinical pathway

Appendix D – Roles and responsibilities

All professionals working with children and young people who have experienced sexual abuse should have completed the relevant trauma-informed training modules^[69]. All staff should be trauma informed however further details on the level of trauma training for each role are noted below.

Police: The police are the lead agency with responsibility for criminal investigations relating to children who have suffered or are likely to suffer significant harm (physical, sexual or neglect).

Senior Investigating Officer (SIO): An officer of Detective Inspector rank who has overall responsibility for the investigation of a serious crime. This will usually be the Detective Inspector of the Child Protection Team. In terms of trauma training, the SIO should be trained to a trauma-skilled level.

Inter-agency Referral Discussion (IRD) Sergeant: Usually of Detective Sergeant (DS) rank who undertakes the day-to-day police representation during IRDs:

• Will be responsible for assessing and deciding what information it is necessary, proportionate and justified to share with other agencies
• Conduct risk assessments in respect of all relevant children in child protection cases
• Makes decisions in conjunction with other IRD participants with regards to tasks and actions required in child protection cases
• Will provide a point of contact to professionals who require an understanding of what is happening in a criminal investigation

In terms of trauma training, IRD Sergeants should be trained to a trauma-skilled level.

Investigating Officer: Usually a Detective Constable (DC) who will undertake joint investigations with social work (and other relevant agencies) conducting enquiries including (but not limited to):

• Joint Investigative Interviews (JII) of children*
• Attending joint paediatric forensic examinations and provide briefing to the paediatrician and forensic physician prior to the examination and obtain a debrief and initial opinion at the end of the examination
• Use of Emergency Child Protection powers (where required) to ensure safety of a child
• Will take statements from witnesses (civilian and professional)
• Seize relevant productions and documents pertinent to the case
• Arrest suspected persons
• Report circumstances to COPFS and/or SCRA
• Attend multi-agency meetings relevant to the case

*Some areas of Scotland have dedicated officers whose only involvement in the child protection investigation is to undertake the JII of the child. At conclusion of the interview, they will pass the details over to the Investigating Officer and take no further part in the enquiry.

In terms of trauma training, Investigating Officers should be trained to a trauma-skilled level and trauma-enhanced level if also involved in the JII.

Children’s Reporter: Children’s Reporters are employed by the Scottish Children’s Reporter Association. The reporter’s primary function is to decide whether to refer a child (generally up to age 16 but up to age 18 in some circumstances) to a children’s hearing. Any person may refer a child to the reporter if they consider a compulsory supervision order might be necessary for the child; local authorities and the police have a duty to do so. The reporter will investigate a referral as appropriate to determine whether there is sufficient evidence of any of the statutory grounds for referring a child to a children’s hearing and, if so, whether there is a need for a compulsory supervision order. Investigation may include seeking information and reports from a range of persons such as social workers, teachers, health visitors and doctors. The Reporter will refer a child to a children’s hearing only if satisfied as to the evidence of a statutory ground and the need for a compulsory supervision order. If the Reporter refers a child to a hearing, the Reporter prepares the ‘statement of grounds’ setting out the statutory ground and the supporting facts that the reporter believes apply.

If arranging a children’s hearing for any purpose, the reporter gives notification and papers to those entitled to receive them. Within a children’s hearing the reporter keeps the record of proceedings and supports fair process, but decision-making lies with the panel members. If the child and relevant persons do not accept or understand the statement of grounds, the children’s hearing may refer the statement of grounds to the sheriff for proof. The reporter conducts any proof proceedings, and also conducts any appeal to the sheriff against a decision of a children’s hearing.

Social Worker: The social worker has joint lead responsibility along with an officer from Police Scotland for conducting a child protection inquiry agreed on and planned at the IRD. This will include interviewing a child who has been the victim of child abuse and/or neglect. This will happen under JII arrangements.

They have responsibility for child protection inquiries relating to children who have suffered or are likely to suffer significant harm, assessments of children’s immediate safety and their wellbeing in the longer term. As the joint Lead Professional with a Police Scotland officer, they ensure coordination of the assessment, the identification of desired outcomes and actions to be taken by whom and by when within a single assessment and planning process. They are the key point of contact for family/carers/advocates/guardians and other professionals who as partners to the Child’s Plan provide support and services to ensure the safety and wellbeing of the child.

The social worker will also assess the immediate safety and longer-term wellbeing needs of the child and assume the Lead Professional role for the coordination and delivery of the agreed desired outcomes in the Child’s Protection Plan.

The longer-term coordination of the Child’s Plan/Child’s Protection Plan may be undertaken by a different social worker than the one who took part in the child protection inquiry. Local practice will vary in relation to this according to local child protection procedures.

As lead professional, social workers should be trained to a trauma enhanced level.

Paediatrician: With appropriate training and expertise in child protection, a paediatrician will:

• Contribute to IRD discussions, advise on the need for an examination along with the type of examination and timing. If an examination is not required they will record the reasons for that decision
• Gather relevant background information on the child and family along with a comprehensive medical history of the child
• Carry out the examination, if required, in line with relevant standards and guidance
• Provide or arrange for any immediate health needs to be met
• Make a detailed contemporaneous record of the examination and findings (if any)
• Arrange appropriate follow up and ongoing care
• Communicate with the General Practitioner and other health services as required
• Produce a report (jointly with forensic physician if a joint paediatric forensic examination has been performed) within an appropriate period
• Liaise with police and social work as required as part of ongoing child protection procedures e.g. in relation to a Child Protection Order
• Give expert evidence to a hearing or trial if required

In terms of trauma training, paediatricians should be trained to a trauma-skilled level.

Forensic Physician: A doctor responsible for the forensic aspects of a joint paediatric forensic examination, contributing to joint report with the paediatrician and, if required, giving evidence in legal proceedings. Doctors fulfilling this role for adults or for children or young people who may have experienced sexual abuse, should have completed the NES Essentials in Sexual Offences Forensic Examination and Clinical Management (Adults & Adolescents) - Best Practice for Scotland training course, and should be trained to a trauma-skilled level.