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

4 Self-referral for 16 and 17 year olds

The Forensic Medical Services (Victims of Sexual Offences) (Scotland) Act 2021) (“FMS Act”), will create a statutory duty for health boards to provide Forensic Medical Services (FMS) for victims of sexual offences and will establish a legal framework for consistent access to self-referral so a victim can access healthcare and request a Forensic Medical Examination (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.

The national self-referral protocol outlines and provides guidance on the requirements of health boards under the provisions of the FMS Act and The Forensic Medical Services (Self-referral Evidence Retention Period) (Scotland) Regulations 2022 (“Retention Period Regulations”)^[35] 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 circumstance is unique. However particular consideration should be given to the person’s 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 examination
• Is defined as a child for the purposes of the Children’s Hearings System
• Is a Looked After Child or has experience of care
• Self-referred previously
• Was under the influence of drugs or alcohol at the time of the offence
• Intimate 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
• Has any indicators of Child Sexual Exploitation or Child Criminal Exploitation^[36]
• Has any indicators of Honour Based Violence or FGM

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

• If the perpetrator is an adult family member 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/involved in a club or organisation that other children attend