CMO Rape and Sexual Assault Taskforce minutes: September 2021

Attendees and apologies

Attendees

• Greig Chalmers (Interim Deputy Director, CMO Directorate, SG), Chair
• Tansy Main (Unit Head, CMO Taskforce Unit, SG)
• Dr Edward Doyle (Senior Medical Adviser for Paediatrics, SG & Clinical Pathways Subgroup Chair)
• 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)
• Lesley Swanson (Lead for Child Protection, SG)
• Professor Amjad Khan (Associate Post Graduate Dean, NES)
• Michelle Harrity (CMO Taskforce Unit, SG)
• Ryan O’Donnell (CMO Taskforce Unit, SG)
• Mark Burgess (CMO Taskforce Unit, SG)
• Stefani Dinwoodie (CMO Taskforce Unit, SG)
• Sybil Canavan (Workforce & Training Subgroup Chair & Director of Workforce, HIS)
• Carol Rogers (Interim Operations Manager for Biology, SPA)
• Tricia Marwick (Board Chair, NHS Fife & Representative of all NHS Board Chairs)
• Colette Mackenzie (Associate Director, NSS & QI Subgroup Chair)
• Nighean Stevenson (Interim Lead Forensic Scientist for Sexual Offences, SPA)
• Emma Kennedy (Organisation GBV Lead, Public Health Scotland)
• Moira Price (Head of Victims & Witness Policy Division, COPFS)
• Anne Neilson (Director of Public Protection, NHS Lothian, Representing Nursing Directors)
• Helen Haworth (Interim Head of Forensic Biology, SPA)
• Louise Wilson (Director of Public Health, NHS Orkney, Representing Scottish Directors of Public Health)
• Katie Brown (Equally Safe Policy Manager, CoSLA)
• Lynsay Ross (VAWG & Barnahus Justice Policy, SG)
• Hannah Taylor (CMO Taskforce Unit, SG)
• Wendy Copeland (CMO Taskforce Unit, SG)
• Gill Imery (HMICS)
• Louise Raphael (HMICS)
• DCS Samantha Faulds (Head of Public Protection, Police Scotland)
• Fiona Wardell (Team Lead for Developing Standards & Indicators, HIS)
• Lynda Dobinson (CMO Taskforce Unit, SG)

Apologies

• Dr Gregor Smith (Chief Medical Officer for Scotland)
• Colin Sloey (National Co-ordinator, CMO Taskforce Unit, SG)
• Adam Bircham (CMO Taskforce Unit, SG)
• Karen Ritchie (Deputy Director of Evidence, Healthcare Improvement Scotland)
• Gary Jenkins (Chair of the Police Care Network, State Hospital GG&C)
• Chloe Poole (Deputy Unit Head, CMO Taskforce Unit, SG)
• Susie Buchanan (Director, NHS National Services Scotland)
• Jamie Lipton (Policy Division, COPFS)
• Fil Capaldi (Detective Superintendent, Police Scotland)
• Sandy Brindley (Chief Executive, Rape Crisis Scotland)
• Leanne Tee (Clinical Lead for Forensic Services, NHS Highland)
• Safia Qureshi (HIS Taskforce Lead)
• Sian Tucker (CMO Taskforce GP representative)
• Vicky Norris (CMO Taskforce Clinical Pathways Project Manager, NHS NSS)
• Iona Colvin (Chief Social Work Advisor, SG)
• Dr Duncan Alcock (Chair of the Information Governance Delivery Group)
• Carole Robinson (Legislation Subgroup Chair & CMO Taskforce Unit, SG)
• Vicky Carmichael (Interim Unit Head, CMO Taskforce Unit, SG)

Items and actions

• agenda
• minutes

Agenda

1. Welcome and introductions: Chair – Greig Chalmers (GC)
2. Minutes of previous meeting and actions log: GC
3. Matters arising: GC
4. Sub Group updates: GC plus subgroup Chairs
5. Agreed actions / next steps: GC/ Colin Sloey (CS)
6. AOB: GC
7. Date of next meeting: GC

Minutes

Welcome, introductions and apologies

Greig Chalmers (GC) welcomed members to the nineteenth meeting of the Taskforce.

GC explained to the group that Dr Gregor Smith, Chief Medical Officer, was unable to attend the meeting and introduced himself to the group.

GC explained to members that the Women’s Health Plan had recently been published by SG colleagues and referred to the link to the document in the papers.

GC added that the Programme for Government (PfG) commitment to the ‘Bairn’s Hoose’ was very encouraging and that an update on this had been added to the agenda.

GC welcomed members that were attending the meeting for the first time - Hannah Taylor and Lynsay Ross

GC welcomed back Gill Imery (GI) and Louise Raphael (LRa), HMICS, to the taskforce meeting.

GC congratulated Tom Nelson (TN) on his retirement and thanked him for his significant contribution to the work of the taskforce.

GC asked all members to briefly introduce themselves to the group.

GC noted the apologies listed above.

Minutes of the previous meeting and action log

GC noted Moira Price’s (MP) amendment to the minutes via email and informed members that this had now be updated.

GC asked members to approve the previous minutes (paper one) as an accurate account of the previous meeting. The previous minutes were approved with no objections.

GC asked members to highlight any possible omissions from the action log (paper two). No omissions were raised by members.

Matters arising

GC asked members to note the matters arising paper (paper three).

Barnahus Update

GC invited Lesley Swanson (LS) and Lynsay Ross (LR) to provide the Barnahus/ Bairn’s Hoose update.

LS explained that the term Bairn’s Hoose was used to describe the Scottish context to the European Barnahus standards.

LS noted the PfG commitment that all children and young people that have been subject to, or witnessed sexual abuse, physical abuse or violence would have access to a Bairn’s Hoose by 2025 and acknowledged that the Barnahus system would be a transformational change for children and young people and their families, across Scotland.

LS explained that Healthcare Improvement Scotland (HIS) were commissioned in 2019 to develop Barnahus standards. However, this work was paused at the beginning of the COVID-19 pandemic and only recommenced in December 2020. This resulted in a revision to the timetable and phases of the Barnahus work.

LS added that phase one built on the learning from existing policy and practice and how Barnahus could fit into a Scottish children’s system. This was contained in a Foundations Report. SG published a vision paper alongside the report to cover the vision and values of the Bairn’s Hoose.

LS stated that phase two would be scoping of the Barnahus standards and that work was underway to establish a governance group, for which membership was currently being reviewed. Involving the lived experience of children would be crucial to this group.

LS explained that the immediate next steps were to develop the draft standards, reconvene the standards development group and move to consultation in summer 2022 with the standards being published by the end of 2022.

LS added that in conjunction with the Barnahus work the Joint Investigative Interviews (JII) work would continue to ensure that interviews are conducted with the best interests of the child at heart to avoid re-traumatisation. This work would build on the momentum on the Scottish Child Interview model.

LS and LR invited members’ questions.

GC thanked LS and LR and expressed his hope that the work of the Taskforce would help in aligning this work with the lived experience of individuals.

Fiona Wardell (FW) echoed GC’s comments that listening to those with lived experience was essential and explained there was a lot of work ongoing to understand the most appropriate way to ensure children’s voices would be heard. The Standards Development Group would commence in November and networks would be set up to gather stakeholders’ views. FW encouraged members to take part in these networks if possible.

LS and LR shared links to relevant documents in the chat box.

Katie Brown (KB) explained that the VAWG partnerships across all agencies were keen to be involved in any upcoming consultations.

GI expressed HMICS interest in the progress of this work.

GC thanked LS, LR and FW for the update on this work.

Survivor Reference Group

RO explained that Sandy Brindley (SB) had passed on her late apologies but had explained there was no significant update from the Survivor Reference Group

 

Subgroup updates

Delivery and performance

GC noted that there was one open action for the Delivery and Performance Subgroup and that members had the following papers for noting:

• RAG Report (paper four)
• Stocktake Summary Paper (paper five)
• Stocktake Report (paper six)
• Taskforce Risk Register Summary Paper (paper seven)
• Taskforce Risk Register (paper eight)

GC acknowledged that the Taskforce’s work was now moving quickly towards commencement of the Act in April 2022 and recognised the amount of progress that had been made however, the focus must remain to ensure that we are as well prepared as possible for go-live.

GC asked Colin Sloey to provide an update on the work of the subgroup.

CS explained that the RAG status for the D&P subgroup was green but we were at a critical point in the delivery process and highlighted some key points from the RAG below.

It would be key for Subgroup Chairs to track that there was achievement within the required goals of their subgroup plan and to ensure there was clarity on existing co-dependencies across the subgroups and that these were effectively managed.

The Interim Performance Framework returns would be completed by Board Nominated Leads (BNLs) and returned to CS and Mark Burgess (MB) for monitoring.

Expected content of the Public Health Scotland annual report to be finalised. Need to ensure clarity on what data would be captured as well as the source from which it would be captured.

CS explained that he and Vicky Carmichael (VC) had been in attendance at a meeting with NHS Board Chairs and Chief Executives and received great support on the progress of the Taskforce work. An Update Summary report was then provided to NHS Board Chairs as well as self-referral readiness assessments which were being returned by health boards on a monthly basis to monitor their situation in the lead up to commencement of the FMS Act.

The Standard Operating Procedure for the new Environmental Monitoring regime must be finalised through the Scottish Police Authority prior to implementation.

GC agreed that managing the co-dependencies between subgroup was crucial and asked members for questions on the RAG Report (paper four). No questions were raised.

CS moved on to the Stocktake Report and Summary (papers five and six) and explained that these papers provided were for noting.

GC thanked CS and asked if GI had any thoughts on the progress made from the Taskforce.

GI expressed her appreciation to everyone involved in the Taskforce work and noted that considerable progress had been made.

GI explained there would be a more formal process to go through regarding the release of the Taskforce 10 Recommendations. However, GI stated the Taskforce should be proud of what it had achieved and that it was making a real difference to people at their most vulnerable.

CS thanked GI for her feedback and stated that this would certainly galvanise Taskforce members to finish the work that had been started.

GC also thanked all Taskforce members and stakeholders for their contribution to this work. TM thanked GI for the 2017 inspection report which had been a positive catalyst for change.

CS turned to the Risk Register and Summary (papers seven and eight) and explained that many risks had been de-escalated as a result of the success of the mitigating actions taken by subgroups.

CS highlighted the two mains risks:

• SR.4 - There is a risk that national telephony access is not in place by April 2022
• SR.6 - There is a risk that the national marketing campaign will not be delivered for launch

CS asked members if there were any questions.

Louise Wilson (LW) asked whether the COVID-19 pandemic should now be highlighted as a risk once more as winter approached.

LW also asked whether the progress made against the Five-Year Work Plan could be marked.

CS thanked LW for her questions and stated that currently the COVID-19 pandemic was not a significant risk to the work. However, CS assured LW that the Risk Register was regularly updated and if the situation changed then it would be escalated onto the register. CS thanked LW for her suggestion on the Five- Year Work Plan and agreed that this could be useful to track the progress that had been made.

GC thanked CS for the update.

Action: Taskforce team to review Five-Year Work Plan and consider how progress could be marked.

Legislation:

GC noted that there were no open actions under the Legislation Subgroup and that the RAG report (paper nine) was for noting.

GC invited Lucy Dexter (LD), in Carole Robinson’s (CRo) absence, to provide an update on the Legislation Subgroup.

LD explained that the RAG status for the subgroup was green and that the Taskforce team would shortly be informing the Cabinet Secretary for Health and Social Care of the result of the recent retention period consultation and providing a recommendation for the preferred retention period.

LD added that having a review of the length of the retention period was raised in the consultation and this was being considered. The Taskforce team had spoken to SARCS in England and Ireland as well as other stakeholders on this matter. All parties were in favour of the length of the retention period being subject to review.

LD added that there was a real risk of re-traumatising survivors by reminding people that their retention period was coming to an end so work was ongoing with Rape Crisis Scotland and the Survivor Reference Group to understand how best to ensure individual understanding of when this would be.

LD confirmed that the Taskforce team would update members on the response from the Cabinet Secretary.

GC thanked LD and invited GI’s comments.

GI acknowledged this work but noted the very real risk that people would forget the end date of the retention period. She stressed that while every effort should be made to avoid re-traumatising survivors there was still a need to remind people of the implications of the retention period coming to an end i.e. that submitting a police report would no longer be an option.

GC thanked GI and agreed that this was a delicately balanced issue and ensured members that the Cabinet Secretary for Health and Social Care would reflect on this issue.

LD thanked GI and explained that self-referral documentation was being developed that would be provided to survivors following examination. This documentation would provide information on the length of the retention period and their rights to have evidence stored and to request destruction.

GC thanked LD and recorded his thanks to SGLD colleagues for their work on the FMS Act and secondary legislation.

Workforce and training

GC explained there were two open actions for the Workforce and Training Subgroup. He also asked members to note the Workforce RAG report (paper 10).

Sybil Canavan (SC) explained that the key points were highlighted in the RAG report paper and that the RAG status was currently green.

SC explained that the QMU course was well underway with 14 attendees due to complete the course in January 2022 and there was plans for the course to run again in 2022.

SC explained that a remote evidence Working Group set up with the Scottish Courts and Tribunal Service, which Michelle Harrity (MH) was a part of, was currently undertaking a Test of Change (ToC) to explore the viability/ options for enabling professionals to provide evidence in court remotely.

SC added that the Nurse Sexual Offence Examiner (SOE) ToC was underway at Archway in NHS Greater Glasgow and Clyde. However, COVID-19 had had a considerable impact on the number of cases being seen as part of the ToC.

SC asked MB to provide an update on the CMO/ CNO letter.

MB explained that the letter was about to go to CNO and CMO for clearance.

SC asked members to note that the tasks and milestones had been updated in the report and invited any questions. No questions were raised.

Self-referral

GC noted there were no open actions for the Self-Referral Subgroup and that members had the RAG Report (paper 11) for noting and the National Protocol (paper 12) for approval.

GC invited Jillian Galloway to provide an update.

JG explained that status of the RAG remained at green and the two red risks contained in the report had been highlighted by CS earlier in the meeting. JG asked members to note the information contained in the report.

JG explained the Self-Referral Readiness Assessment had been an important factor in monitoring health boards’ progress towards being ready for commencement of the FMS Act.

JG turned to the National Protocol and thanked the members of the National Protocol and Retention Task and Finish group for their work in producing a final draft of the protocol.

JG opened up to any questions from members and asked for approval for the National Protocol.

GC thanked everyone involved in developing the National Protocol and acknowledged the importance of the document.

LD added that within the protocol there were a number of areas in square brackets which were subject to change. LD added that references would also possibly change based on the updated Clinical Pathways.

Emma Kennedy (EK) acknowledged the fantastic achievement in bringing this protocol together.

Tansy Main (TM) also expressed her thanks to everyone involved in developing the protocol.

JG passed on her thanks to LD, Wendy Copeland (WC), Stefani Dinwoodie (SD) and CRo in the development of this work.

LD noted that there would be significant progress made in the relation to the telephony system, national campaign and the website before the next Taskforce meeting. LD highlighted annex one of the Rag Report (paper 11) which detailed those milestones.

Members approved the National Protocol (paper 12).

Quality improvement

GC noted that there was one open action under the Quality Improvement Subgroup and that the RAG Report (paper 14) was for noting.

GC asked Colette Mackenzie (CM) to provide an update on the work of the Quality Improvement Subgroup.

CM confirmed that RAG status had moved from Red to Amber. There had been two IT Project Board meetings and a QI Subgroup meeting since the last Taskforce meeting. Work was ongoing with RioMed and clinical consultations on the Cellma system were underway.

CM added that the subgroup were working closely with the self-referral team to ensure the appropriate dependency management systems were in place between the Cellma System and the NHS24 systems.

CM invited questions from members. None were raised.

GC thanked CM and noted the progress that was being made by the QI Subgroup.

Clinical pathways

GC noted that there were no open actions from this subgroup and invited ED to provide an update on the RAG Report (paper 15).

ED explained that the report was brief as work was waiting on the completion of the Child Protection Guidance and the Self-Referral Protocol. The Children and Young People’s (CYP) Pathway was to be updated to reflect this. A final draft was to be approved by the Children and Young People’s Expert Group (CYPEG) in November, with the final Pathway coming to the Taskforce meeting in January 2022.

ED explained that UNCRC was already captured within the CYP Pathway.

ED added that there was agreement with NHS Directors of Regional Planning for scoping work to commence for a Children and Families Support Worker post that would be funded by the Taskforce. ED highlighted the relation of this piece of work to the ongoing Barnahus/ Bairn’s Hoose work.

GC thanked ED for this update.

Agreed actions / next steps

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

AOB

GC asked for any other business.

Dates of next meeting

GC explained the next meeting of the Taskforce in January 2022 would be the last meeting of the Taskforce ahead of commencement in April 2022.

GC thanked members for the continued work and support and closed the meeting.