Clinical pathways to support adults who experienced sexual assault: consultation

Appendix A: Roles and Responsibilities

Forensic Examiner

The phrase forensic examiner is used to refer to the professional carrying out the clinical forensic examination. It is noted that for good practice, a female forensic examiner should be available at all times. Standards for Healthcare and Forensic Medical Services for People who have experienced Rape, Sexual Assault or Child Sexual Abuse: Children, Young People and Adults (Healthcare Improvement Scotland 2017)

At present in Scotland, forensic examiners are medically trained. Work to develop the role of forensic nurse examiners in Scotland is being progressed under the remit of the CMO Taskforce workforce and training sub group.

Nurses

Where an appropriately trained nurse is available to be present during a forensic medical examination, their role is to provide trauma informed, person centered care and support to the individual and to help ensure that their immediate and on-going health and wellbeing needs are being met. Work to further develop the role of nurses in this context is being progressed under the remit of the CMO Taskforce workforce and training sub group.

Follow up care / co-ordination

Services have responsibility for coordinating the follow up care and support for an individual and to help them to navigate the healthcare system, including onward referrals to other services as required. At present this role is undertaken in a variety of ways; exploration of what constitutes best practice will be explored further under the remit of the CMO Taskforce workforce and training sub group.

Chaperones

In summary a chaperone should:

• Usually be a healthcare professional
• Be familiar with the examination or procedure being carried out
• Be sensitive and respect the individual’s dignity and confidentiality
• Be present throughout the entirety of the examination
• Be positioned so that they have a clear view of what the clinician is doing, as well as being able to hear clearly everything the clinician is saying to the patient
• Reassure the patient if they show signs of distress or discomfort
• Be prepared to raise concerns if they are concerned about the clinician’s behaviour and actions

The chaperone has an important role in forensic medical examination. As well as witnessing the conduct of the examination the chaperone offers support to the individual during examination and reduces risk of them feeling vulnerable. The chaperone may be used to corroborate evidence collection in Scotland, within the parameters detailed in Section 9 therefore the chaperon must be prepared to sign labels of productions seized during the examination, provide the police with a witness statement and attend at court to give evidence if cited to do so.

Standards for Healthcare and Forensic Medical Services for People who have experienced Rape, Sexual Assault or Child Sexual Abuse: Children, Young People and Adults (Healthcare Improvement Scotland 2017).

Standard 2.1.3 ‘A suitably trained, impartial chaperone is offered for all forensic examinations where there is a sole clinician present.’

The General Medical Council (GMC) guidance on Intimate Examinations and Chaperones (2013) states: When you carry out an intimate examination, you should offer the patient the option of having an impartial observer (a chaperone) present wherever possible. This applies whether or not you are the same gender as the person.

A corroborating witness requires to be able to confirm: the date and place of the examination; the name of the complainer; the taking of all swabs and samples; and the presence of any injuries. Hence, a forensically trained healthcare professional is the preferred option.

The chaperone role should not be undertaken by sexual offences liaison officers (SOLOs).

Sexual Offences Liaison Officer

The Sexual Offence Liaison Officer (SOLO) provides the critical link between the victim, Senior Investigating Officer (SIO) and the enquiry team in all rape investigations. The role of the SOLO will be wide and varied and this specially trained officer forms an integral part of the investigation team. Their duties include;

• obtaining a full statement from the victim
• arranging the forensic medical examination
• briefing the attending health professionals
• attending the forensic medical examination
• seizing clothing for evidential purposes
• seizing forensic samples for evidential purposes
• ensuring PSoS and RCS referral procedures are completed
• providing external agency referral information to victims
• providing enquiry updates to victim
• supporting the victim during any other police process (i.e. identification / VIPER parades)
• corroborate the forensic medical examination if a health care professional is not available

The SOLOs attendance at the forensic medical examination is primarily to support the criminal investigation; ensure the chain of evidence is recorded and protect the forensic integrity of productions seized. The SOLO should not have an active role in the forensic medical examination itself and corroboration should be provided by the 2nd health professional in attendance.

Rape Crisis Scotland National Advocacy Project

1. To improve the support available to survivors of rape and serious sexual crime

2. To improve the experience of the criminal justice process for survivors of rape and serious sexual crime; and

3. The development of a better understanding of survivors’ motivations to proceed or not to proceed with the criminal justice process and the difference advocacy support makes to this decision.