CMO Rape and Sexual Assault Taskforce minutes: May 2022

Attendees and apologies

Attendees

• Chair – Professor Sir Gregor Smith (Chief Medical Officer for Scotland)
• Greig Chalmers (Head of CMO Policy Division, CMO Directorate, SG)
• Tansy Main (Unit Head, CMO Taskforce Unit, SG)
• Vicky Carmichael (Acting Unit Head, CMO Taskforce Unit)
• Dr Edward Doyle (Senior Medical Adviser for Paediatrics, SG and Associate Medical Director for Women’s and Children’s Services, NHS Lothian)
• Colin Sloey (National Co-ordinator, CMO Taskforce Unit, SG)
• Lucy Dexter (Deputy Unit Head, CMO Taskforce Unit, SG)
• Jillian Galloway (Chair of the Self-Referral Subgroup and NHS Tayside, Head of Justice Healthcare and Urgent Primary Care)
• Professor Amjad Khan (Associate Post Graduate Dean, NES)
• Carole Robinson (FMS Act Implementation Lead, CMO Taskforce Unit, SG)
• Michelle Harrity (CMO Taskforce Unit, SG)
• Ryan O’Donnell (CMO Taskforce Unit, SG)
• Jane Russell (CMO Taskforce Unit, SG)
• Mark Burgess (CMO Taskforce Unit, SG)
• Lynda Dobinson (CMO Taskforce Unit, SG)
• Louise Wilson (Director of Public Health, NHS Orkney)
• Carol Rogers (Interim Operations Manager for Biology, SPA)
• Tricia Marwick (Board Chair, NHS Fife)
• Colette Mackenzie (QI Subgroup Chair)
• Wendy Copeland (CMO Taskforce Unit, SG)
• Emma Kennedy (Organisational Lead for GBV, Public Health Scotland)
• Moira Price (Victims and Witness Policy Division, COPFS)
• Dr Fiona Wardell (Team Leader for Standards and Indicators, HIS)
• Hannah Taylor (CMO Taskforce Unit, SG)
• Stef Dinwoodie (CMO Taskforce Unit, SG)
• Anne Armstrong (Mental Health Nursing Advisor, SG)
• Carol Potter (Chief Executive, NHS Fife)
• Gareth Hill (HIS, Deputising for Safia Qureshi)
• Adam Bircham (CMO Taskforce Unit, SG)
• Hannah Cornish (Programme Manager, NSN)
• Helen Haworth (Interim Head of Forensic Biology, SPA)
• Jeff Gibbons (Unit Head VAWG Justice, SG)
• Sheila Considine (Safer Marketing, SG)
• Sybil Canavan (Director of Workforce Healthcare Improvement Scotland)
• DCS Samantha Faulds (Public Protection, Police Scotland)
• Sandy Brindley (Chief Executive, Rape Crisis Scotland)
• Carol Potter (Chief Executive of NHS Fife and Chair of the NSN)

Apologies

• Chloe Poole (Deputy Unit Head, CMO Taskforce Unit, SG)
• Jamie Lipton (Policy Division, COPFS)
• Sandy Brindley (Chief Executive, Rape Crisis Scotland)
• Dr Duncan Alcock (Chair of the Information Governance Delivery Group)
• Safia Qureshi (HIS Taskforce Lead)
• Iona Colvin (Chief Social Work Advisor, SG)
• Anne Neilson (Director of Public Protection, NHS Lothian)
• Lesley Swanson (Bairns’ Hoose Unit Head, SG)
• Fil Capaldi (Detective Superintendent, Police Scotland)
• Gary Jenkins (Chair of the Police Care Network, State Hospital GG and C)
• Leanne Tee (Clinical Lead for Forensic Services, NHS Highland)
• Dr Nighean Stevenson (Interim Lead Forensic Scientist for Sexual Offences, SPA)
• Rod Finan (Professional Social Work Advisor, SG)
• Sian Tucker (Senior GP Advisor, SG)
• Katie Brown (Equally Safe Policy Coordinator, CoSLA)
• Gill Imery (HMICS)

Items and actions

Agenda

• welcome, introductions and apologies: Chair – Professor Sir Gregor Smith (GS)
• minutes of previous meeting and actions log: GS
• matters arising: GS
• subgroup updates: GS plus subgroup Chairs
• agreed actions/next steps: GS/Colin Sloey (CS) 
• any other business: GS
• date of next meeting: GS

Welcome, introductions and apologies

GS welcomed members to the 21st, and final, meeting of the taskforce.

GS asked members to introduce themselves and noted the apologies listed above.

GS congratulated members on the commencement of the Forensic Medical Services (FMS) Act and reflected on the amount of work that had been delivered as part of the taskforce’s five year work plan. GS also acknowledged that 9 of the 10 recommendations from HMICS had now been closed. GS explained that the only outstanding recommendation was the development of the Nurse Sexual Offence Examiner (SOE), which was being progressed through a Test of Change, alongside the Advanced Forensic Practice Post-Graduate Certificate (PG Cert) at Queen Margaret University (QMU).

GS congratulated the first cohort of 12 nurses that had now received their PG Certand thanked Jess Davidson for her hard work and tenacity in developing, delivering, and leading the course at QMU.

GS explained that as it was the final meeting of the taskforce, End of Project (EOP) reports would replace the usual RAG reports.

GS highlighted that there were several links to relevant pieces of recently published work contained in the agenda.

Minutes of the previous meeting and actions log 

GS asked members to approve the minutes (paper 1) as an accurate account of the previous meeting. These were approved with no corrections. 

GS asked members to highlight any omissions from the action log (paper 2). None were raised. 

Matters arising 

Marketing campaign

GS invited Sheila Considine (SCo) and Amy Witherspoon (AW) to provide an update on the self-referral marketing campaign. 

SCo provided an overview of the marketing campaign, while AW shared a PowerPoint presentation.

SCo explained that the main aim of the campaign was to raise awareness of the national NHS Scotland Sexual Assault Response Coordination Service (SARCS) and self-referral so that people over 16 who have recently experienced rape or sexual assault can access healthcare and a Forensic Medical Examination (FME), without first having to report to the police. 

SCo explained that work was ongoing to understand how marketing and awareness raising could continue throughout the year.

GS thanked SCo and emphasised that raising awareness would remain an ongoing piece of work.

Tansy Main (TM) thanked the marketing team for all their work.

Matters arising

GS asked members to note the matters arising paper (paper 3).

GS drew members’ attention to the SG consultation on improving victims’ experiences of the justice system, published on 12 May 2022 and invited their views on potential legislative reforms to the justice system which were aimed at improving the experiences and strengthening the rights of victims of crime, including specific measures relating to victims of sexual crime.

GS explained that the consultation paper was available to read on the Citizen Space platform and a link was provided in paper 3. GS encouraged members to respond and share the link to the consultation within their organisations and networks.

Barnahus update

GS congratulated Val De Souza on her appointment as chair of the Bairn’s Hoose steering group and added that he looked forward to working with her.

GS invited Eddie Doyle (ED) to provide an update on the Bairn’s Hoose work.

ED explained that work on the standards was well underway through the Standards Development Group with input from young people via third sector organisations. The standards would be released for an 8-week consultation during August 2022. ED said he would welcome input when this went live.

ED added that the forensic medical aspects of the Bairn’s Hoose standards had already been completed through the work of the taskforce.

Fiona Wardell (FW) stated that the final standards would be published in December 2022. 

FW requested that any questions or comments from members be directed to the Bairn’s Hoose Standards email address, which was shared in the chat box.

Survivor Reference Group (SRG)

GS invited Sandy Brindley (SB) to deliver the SRG update.

SB explained that she and TM had met with a survivor that had been integral to this work from the outset. SB thanked TM for the ethical way in which she involved survivors in this work.

The survivor had spoken with SB and audio from this discussion was shared with the group.

SB noted the positive difference this work had made to the survivor and that it acted as a tangible reminder of the importance of this work.

GS thanked SB and agreed that this work made a real difference to individuals. GS emphasised the need for this life changing work to be continued. 

Subgroup updates

Delivery and performance

GS noted that there was one outstanding action for this subgroup.

GS added that members had the following papers for noting:

• EOP report (paper 4)
• stocktake report (paper 5)
• National Strategic Network (NSN) S-BAR (paper 6)
• SARCS Programme Board ToR (paper 7)
• environmental monitoring regime (paper 8)

GS asked Colin Sloey (CS) to provide an update on papers 4 and 5, Hannah Taylor (HT) to speak to papers 6 and 7 and Mark Burgess (MB) to provide detail on paper 8.

CS asked members to note the deliverables that had been achieved and detailed the content of the End of Project (EOP) report (paper 4).

CS explained that he had reviewed all boards’ Interim Performance Framework returns for the year and shared several highlights with the group, including that nationally 69% of Sexual Offence Examiners (SOE) were now female and 93% of Forensic Trained Nurses (FTNs) were female. 

CS explained that while there was a lot that had been achieved there was still much to be done and this work would continue through the NSN. CS thanked all that had been involved in this work.

CS asked members to note the Five Year High Level Work Plan.

CS explained that the Stocktake Report (paper 5) was based on the 10 recommendations in the 2017 HMICS report. One recommendation relating to the development of the role of forensic nurse examiners was outstanding. CS confirmed that Sybil Canavan (SC) would cover that later in the agenda.

CS added that the previously highlighted risks had now been mitigated and there was no longer a need to report against these. 

CS asked members for comments or questions. None were forthcoming.

CS invited HT to speak to papers 6 and 7.

HT explained that the NSN S-BAR (paper 6) set out the transition from the current set up to the NSN and the Scottish Government led Sexual Assault Response Coordination Service (SARCS) Programme Board. HT confirmed that the CMO Taskforce Unit would now become the SARCS Policy Unit.

HT explained that feedback from the NSN mandate day was detailed in annex A. Work to develop a new network logo and recruit to the network was ongoing.

HT shared the Terms of Reference for the SARCS Programme Board (paper 7). HT detailed how the SARCS Programme Board would be structured and outlined what the remit and objectives of the group would be. HT explained that the paper was for noting but welcomed comments from members.

TM added that the mandate session had been very positive and thanked everyone who’d taken part in that. While members could be proud of what had been achieved so far HT noted that there was still a lot of work to be done.

Carol Potter (CPo) seconded TM’s comments.

FW thanked TM for her comments and continued commitment.

GS invited MB to provide an update on the Environmental Monitoring Regime (paper 8).

MB provided some background on the regime for those that had not been involved in the work from the start.

MB explained that environmental monitoring was now happening within health boards and asked that any questions on this should be directed to himself or Carol Rogers (CR).

CR explained that she and MB had visited several SARCS facilities and the change in attitude within SARCS to environmental monitoring had been incredibly positive. 

CR explained that the first set of samples had been a bit of a mixed bag but there had been significant improvements across the board since that point.

Legislation

GS noted that there were no outstanding actions under the Legislation Subgroup and that the EOP report (paper 9) was for noting. 

GS invited Carole Robinson (CRo) to provide an update on the Legislation Subgroup.

CRo explained that all work under the Legislation Subgroup had now been completed. CRo highlighted the scale of achievement not only in terms of volume but noted that much of the work had been done while staff were working from home. 

CRo thanked Greig Walker, the previous team lead, for his contribution to this work. CRo said that the work of the group had been a product of listening to, and learning from, those with lived experience citing when MSPs heard from members of the Survivor Reference Group in the Stage 2 committee.

CRo thanked all members involved in the work.

GS and TM recorded their thanks to CRo.

Workforce and training

GS explained there was one outstanding action for the Workforce and Training Subgroup. He also asked members to note the Workforce EOP report (paper 10).

Action: Taskforce Unit to link with RCGP’s to discuss how resources could be utilised to address resourcing issues.

GS invited SC to provide an update on the work of the subgroup.

SC explained that the Guidance for Wider Healthcare Professionals (HCPs), which had been recently published to provide guidance to a wide range of healthcare professionals (GPs, dentists, pharmacists, Emergency Dept. staff etc) in the event of a disclosure of rape or sexual assault meant that the open action could now be closed. However, work to further advise/support HCPs would be ongoing.

SC pointed out that there were a few outstanding risks in relation to the work of the subgroup particularly around the Nurse Sexual Offence Examiner (SOE) Test of Change (ToC). The ToC was currently paused but and work was ongoing with the SARCS Policy Unit, COPFS, SPA and Police Scotland to develop plans to progress the ToC. 

SC highlighted several achievements from the previous 5 years including the NES Essentials Training Course; the NES National Annual Conference; development of the nurse SOE ToC; development of a PG Cert in Advanced Forensic Practice at QMU – of which the first cohort had recently graduated (funding for priority places had been provided); development of a skills lab within QMU to maintain the skills of the newly qualified nurses; development of guidance for wider healthcare professionals on how to deal with a disclosure of rape or sexual assault; commencement of the Community Pharmacy ToC; development of a Testimonial Video to raise awareness of the SOE role within the NHS; and PHS commissioned reporting of detailed workforce data.

Michelle Harrity (MH) thanked SC for her continued commitment to this work.

GS thanked SC and MH and once again thanked Jessica Davidson for her work on the course at QMU.

Self-referral 

GS noted there were no outstanding actions for the Self-Referral Subgroup and that members had the EOP report (paper 11) for noting. GS added that there was a link to the Self-Referral Toolkit in the agenda.

GS invited Jillian Galloway (JG) to provide an overview on the report.

JG said that the audio of the survivor played at the start of the meeting gave her a real sense of pride that this work had made such a difference. 

JG asked members to note the outputs from the subgroup, which were detailed in the EOP report.

JG explained that there the monitoring work would be continued through one of the facet groups within the NSN.

Lucy Dexter (LD) thanked JG and the other subgroup members for their contribution to this work and successfully going live on 1 April in spite of the challenges.

GS thanked JG for this update.

Quality improvement

GS noted that there were no outstanding actions under the Quality Improvement (QI) subgroup and that the EOP report (paper 12) was for noting.

GS asked Colette Mackenzie (CM) to provide an update on the work of the QI Subgroup.

CM explained that she had only become chair in the last year and thanked the previous chair Martin Morrison for his work. CM highlighted several points from the EOP report. 

CM explained that a fully engaged Cellma user group, meeting on a weekly basis, that had been instrumental in progressing things.

CM explained work would be ongoing with Public Health Scotland (PHS) around annual reporting.

GS and TM thanked subgroup members for their contribution to this work.

Clinical pathways

GS noted that there were no outstanding actions from the Clinical Pathways Subgroup and invited Eddie Doyle (ED) to provide an update on the EOP report (paper 13). 

ED thanked all members for their contributions to the clinical pathways work and to the Children and Young People’s Expert Group (CYPEG). 

ED noted that there was work still to be done around therapeutic support for victims and families in the aftermath of an incident of child sexual abuse and on the age restrictions for self-referral.

GS thanked ED for his contribution to the work and invited questions.

TM acknowledged that this had been an incredibly complex piece of work because of the interdependencies of the national forms, data sets and standards/QIs and thanked members for their contribution to this work.

Agreed actions/next steps 

GS asked CS to review any agreed actions from the meeting as noted above.

CS confirmed there were no outstanding actions and emphasised that although the taskforce had officially come to an end, the drive for continued improvement to these services would continue through the NHS led NSN, the SARCS Programme Board and SARCS Policy Unit within Scottish Government.

Any other business 

GS asked members for any other business. There was no other business.

GS asked members for any reflections on the last five years.

JD reflected on the previous 5 years, the challenges and the very real commitment to improving services. JD thanked GS for his comments and for spearheading this work.

JG seconded JD’s comments. JG said it had been a privilege to help people at such a traumatic time in their life and thanked Wendy Copeland (WC) and LD personally.

TM thanked all taskforce members for their shared commitment to improving these services particularly during the challenges of the pandemic.

SB thanked TM for her input and leadership of the taskforce unit.

TM thanked Gill Imery (GI) and HMICS as their review in 2017 highlighted an urgent need for reform and improvement.

GS thanked CMO Taskforce members and the CMO Taskforce Unit and acknowledged the contribution of the former Chief Medical Officer, Dr Catherine Calderwood.

GS asked members to contact the CMO Taskforce Unit (SARCS Policy Unit) if there were any more questions following the meeting.

GS officially brought the final CMO Taskforce meeting and the CMO Taskforce to a close.