CMO Rape and Sexual Assault Taskforce minutes: August 2020

Attendees and apologies

Attendees

• Colin Sloey (National Co-ordinator - CMO Taskforce, SG)
• Tansy Main (CMO Taskforce Unit Head, SG)
• Dr Edward Doyle (Senior Medical Adviser for Paediatrics, SG and Associate Medical Director for Women’s and Children’s Services, NHS Lothian)
• Greig Walker (FMS Bill Team Leader, SG)
• Jennie O’Reilly (CMO Taskforce, SG)
• Rod Finan (Professional Social Work Adviser, SG)
• Sandy Brindley (Chief Executive, Rape Crisis Scotland)
• Sybil Canavan (Director of Workforce Healthcare Improvement Scotland)
• Anne Marie Hicks (Head of Victims and Witnesses Policy, COPFS)
• Carol Rogers (SPA National Lead Forensic Scientist - Sexual Offences)
• Karen Ritchie (Deputy Director of Evidence, Healthcare Improvement Scotland)
• Martin Morrison (Chair of Quality Improvement Sub Group and Associate Director NHS National Services Scotland)
• Lucy Dexter (Deputy Unit Head, CMO Taskforce Unit, SG)
• Gary Jenkins (Chair of the Police care network, State Hospital GG&C)
• Katie Cosgrove (Gender Based Violence Programme Lead, NHS Health Scotland)
• Lesley Swanson (Child Protection, SG)
• DCS Samantha McCluskey (Police Scotland)
• Niove Jordanides (Project manager, NSS)
• Ieva Morrison (Deputy Unit Head, CMO Taskforce unit, SG)
• Tricia Marwick (Chair of NHS Fife)
• Adam Bircham (CMO Taskforce, SG)
• Mark Burgess (CMO Taskforce, SG)
• Anne Neilson (Director of Public Protection, NHS Lothian)
• Dr Duncan Alcock (Chair of the IGD group)
• Professor Amjad Khan (Associate Post graduate Dean, NES)
• Wendy Copeland (NHS Dumfries and Galloway)
• Greig Chalmers (Deputy Director, CMO Directorate, SG)
• James Cox (Child Protection, SG)
• Louise Wilson (Director of Public Health, NHS Orkney)
• Lynda Dobinson (FMS Bill Team Manager, SG)

Apologies

• Chair – Dr Gregor Smith (Interim Chief Medical Officer for Scotland)
• Jillian Galloway (Chair of the self-referral Sub Group and NHS Tayside, Head of Justice Healthcare and Urgent Primary Care)
• Iona Colvin (Chief Social Work Advisor, SG)
• Lindsay Thomson (Medical Director of the State Hospitals Board for Scotland)
• James Crichton (Chair of Network Board, NSD and Chief Executive of the State Hospitals Board for Scotland)
• Katie Brown (Equally Safe Policy Coordinator, Cosla)
• Fil Capaldi (Detective Superintendent, Police Scotland)
• Michelle Harrity (CMO Taskforce, SG)

Items and actions

Agenda

1. Welcome and introductions: Chair –Colin Sloey
2. Minutes of previous meeting and Actions Log: CS
3. Matters arising: CS
4. Sub Group updates: CS plus Sub Group chairs
5. Agreed actions / next steps: CS/AB
6. AOB: CS

Date of next meeting: CS

1. Welcome, Introductions & Apologies

• Colin Sloey (CS) welcomed members to the meeting and explained that he was chairing as Dr Gregor Smith (GS), Interim Chief Medical Officer, was required to address COVID-19 business. GS extended his apologies to members.
• CS stated that GS had asked him to pass on his thanks for all the work that the group had achieved so far. He noted that even though GS had only been in post for a short time he had been truly impressed by the quality of the work the Taskforce.
• CS went on to say that GS had also asked him to note his thanks to Dr Catherine Calderwood who stepped down as CMO in April 2020.
• CS then welcomed Taskforce members who were attending the meeting for the first time:

• DCS Sam McCluskey from Police Scotland. DCS McCluskey replaced Lesley Boal who retired earlier in the year.
• Dr Leanne Tee, NHS Highland. Dr Tee replaced Boyd Peter.
• Professor Amjad Khan from NES. Dr Khan replaced Prof Alan Dennison who had moved to a new role within NES.

• CS also welcomed Wendy Copeland from NHS Dumfries and Galloway who was in attendance to provide an update on the telephony options appraisal. Also in attendance was Niove Jordanides, Project Manager for the Children and Young People Expert Group. Niove was observing the meeting.
• CS then welcomed the new members from Scottish Government. These were Greig Chalmers, Deputy Director for the CMO Policy Division; Lucy Dexter, Deputy Head of the CMO Taskforce Unit, who joined from NSS to cover Vicky Carmichael’s maternity leave. Lucy leads on clinical pathways, quality improvement, children and young people and information governance. Ieva Morrison, Self-referral and Workforce and Training Subgroup Lead and Lynda Dobinson who joined the Bill team on 1 April.
• CS updated members that Vicky Carmichael had given birth to a healthy baby boy, Aaron in June. CS noted the well wishes on behalf of members.
• CS highlighted that an updated governance diagram for the Taskforce had been circulated with the agenda.
• CS noted the above apologies.

2. Minutes of the previous meeting and Actions Log

• CS reminded the group that as the previous meeting was conducted as an update paper, there was no minute to approve.
• However, CS noted that members agreed to take no comments on the February minutes as approval.
• CS indicated that the outstanding actions from the action log would be covered during the relevant sections of the meeting.

3. Matters Arising

• CS commented that as the meeting was being held virtually it had been decided that, in order to keep the meeting timely and focused, matters arising would be provided as an update paper instead of the usual verbal update.
• CS asked members to note the matters arising paper.

Survivor Reference Group

• CS highlighted the Rape Crisis Scotland (RCS) ‘Imagine How it Feels Campaign’ that had been sent to Taskforce members with the agenda. He went on to say that this very powerful and moving campaign centred on the experiences of Mr and Mrs Smith, whose daughter was raped in 2017 and the impact that this had on all of them. Many of the group are familiar with their daughter’s story.

• CS noted that Mr and Mrs Smith’s daughter had been involved in the design of the RCS campaign. He reiterated that the voice of those with lived experience had always been the touch stone of the Taskforce and urged all to take the time to look at the campaign.
• CS then invited Sandy Brindley (SB) of RCS to provide an update on the Survivor Reference Group.
• SB explained to the group that she hoped the campaign would offer support for other parents who were supporting loved ones.
• SB also highlighted a survey, carried out to help inform the telephony options appraisal, that had sought views from survivors of what was important for them when accessing services.

5. Subgroup updates

Delivery and Performance

• CS invited Lucy Dexter (LD) to provide an update on the open action under the subgroup
•  ​​Colin Sloey and Lucy Dexter to update on the work of a co-dependencies map.
• LD explained that it had been agreed through the Taskforce Unit’s strategic planning and Subgroup Chairs’ meetings that the dependencies were well managed. Therefore there would be no need for a dependency map
• LD stated that they would continue to be managed as they had been through the various forums. Members had no further questions on that approach and the action was closed.
• CS asked members to note Paper 3 Delivery and Performance RAG report, Paper 4 Stocktake Summary, Paper 5 Stocktake Report, Paper 6 Risk Register Summary, Paper 7 Risk Register and Paper 9 Environmental Monitoring Update.
• CS noted that the current risk rating was green. He went on to say that the performance monitoring system was providing up to date Board and regional information against the HIS Standards.
• CS then commented that the risk register had been updated and highlighted the notable changes in the risks related to COVID-19, the IT system and the CYP Pathway. Members approved version seven of the risk register.
• CS then invited Mark Burgess (MB) and Carol Rogers (CR) to update members on the Environmental Monitoring Short Life Working Group.  
• MB stated that the group had met for the first time on 30 January 2020. However, due to COVID-19, the work had stalled and they had been unable to undertake any site visits.
• MB went on to say that the visits would now be arranged with all 14 Health Boards either virtually or physically. He noted that there had been a second meeting at the start of August with the next meeting scheduled for 31st August 2020.
• MB commented that the next steps would be to consider the range of samples to be collected, training, frequency of sampling, how the samples would be submitted to SPA and who the results would be fed back to. He invited members to note the paper and asked for any questions.
• Eddie Doyle (ED) asked how the virtual inspections would be carried out.
• CR explained that a list would be compiled of commonly used equipment and then the site would be inspected virtually via a video conference.
• CS then invited LD to talk to Paper 8 Taskforce Performance and Governance Framework. LD advised a draft framework had been proposed under which the Boards would submit quarterly data reports, based on the HIS standards, that would be submitted to the Taskforce.
• LD went on to say that in addition to the reports submitted to the Taskforce, there was also the process where Boards would submit data through Public Health Scotland. She stated that this had not been initiated yet due to the impact of COVID-19 on the package of resources being implemented.
• LD then advised members that all 14 Health Boards had provided self-assessments and CS had pulled together an overall report. CS had also provided individual feedback to nominated leads. LD went on to say that Tansy Main (TM) and CS would use the self-assessments when talking to nominated leads and Chief Executives about strengths and challenges.
• Karen Ritchie (KR) flagged that the Sharing Intelligence Group did not directly link to the Health Board annual review process.
• CS and LD were to engage with KR and Kevin Freeman Ferguson to reflect on the content of the paper.

Children and young people expert group and Clinical Pathway

• CS asked LD to cover the open actions for the subgroup: 

• The Clinical Pathway Subgroup were to produce a summary leaflet for survivors.
• Vicky Carmichael and Eddie Doyle to finalise the launch of the Adult Clinical Pathway in March and confirm the roadshow dates. 

• LD updated members on the development of the leaflet for survivors that Jennie O’Reilly (JO) had been working on. LD commented that it was being finalised and would be discussed with RCS and then sent to the Clinical Pathways Subgroup for approval.
• LD updated members that the planned roadshows to launch the package of resources had been postponed due to COVID-19. A short life working group had been formed to work on the roadshows and the plan was for them to go ahead virtually by the end of 2020. LD went on to say that the Children and Young Person’s (CYP) Pathway would also be included in the package of resources.
• CS then highlighted to the group Paper 10 for noting, the CYPEG RAG report. CS then invited ED to provide an update of the work of the subgroup.
• ED commented on the complexity around the children and young people’s landscape with changes in relation to the CYP Pathway, the revised child protection guidance and the Barnahus facility proposed in Scotland from the Children 1st grant.
• ED noted that the subgroup had updated the draft CYP Clinical Pathway in light of the public consultation and he commented that members had a draft for comment.  ED went on to say that both the CYP Clinical Pathway and the Adult Clinical Pathway and national form would be presented at the October 2020 Taskforce meeting for final approval prior to implementation.
• ED then updated the group on discussions around the age of 16 for self-referral and work ongoing with child protection colleagues to try to come to an agreement on this. It had been agreed that the CYO Pathway would be up until the 16th birthday of a child. ED noted that changes had been made based on the consultation feedback regarding Barnahus and the UN Convention on the Rights of the Child (UNCRC), as well as to provide guidance on FME for young people with vulnerabilities or additional support needs.
• ED then asked the group for comments on the CYP Pathway by 28 August 2020.
• Martin Morrison (MM) commented that he had spoken with the child protection Managed Clinical Networks and that any changes to the CYP proforma which would be reflected in the clinical IT system would need to be communicated to the new supplier no later than 25 September 2020.
• LD commented that she would pick up with MM after the meeting.

New Action

• Members to provide comments on the CYP Pathway by 28 August 2020
• Lucy Dexter to link in with Martin Morrison for any changes to the IT system from the CYP Pathway

Legislation

•    CS noted that there were no open actions under the subgroup and that the RAG report was for noting.
• CS then invited Greig Walker (GW) to provide an update on the Bill.
• GW explained that due to COVID-19, the Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill was proceeding to a new timetable.
• GW noted that at the Oral evidence sessions at Stage 1 the Interim CMO, along with the Cabinet Secretary for Health and Sport, appeared before the Scottish Parliament Health and Sport Committee on 23 June 2020. He commented that there were videos, transcripts and written evidence of these committee sessions online.
• GW then went on to say that the committee would make an assessment of the evidence and publish a report in the coming weeks which the Scottish Government and the Taskforce would have to respond to. He noted that this was likely to be early September 2020 with amendments to the Bill proposed in October/November 2020 during stage 2. Stage 3 would happen in December 2020. If passed the Bill would receive Royal Assent and become an Act of Parliament in January 2021.
• GW commented that the Bill would not commence any earlier than July 2021.
• GW also noted that the Bill team were looking at further engagement with survivors with lived experience and also more ethnic minorities and gypsy traveller communities.
• GW invited questions and comments but none were raised by members.

New Action

• Members are to ensure they are familiar with the key provisions of the Bill.

Self-Referral

• CS confirmed there were no outstanding actions for the Self-referral Subgroup and that the RAG report was for noting.

• CS highlighted that members were asked for comment on the Retention Period paper, the skeleton National Protocol and the Telephony Options Appraisal paper.
• Jillian Galloway was unable to attend the meeting, therefore, MB provided an overview of the papers for members.
• MB explained to members that based on the evidence gathered to date, the retention period likely to be recommended to the October Taskforce would be 26 months. MB went on to say that there would be engagement with survivors around this and the final recommendation would be brought to the October 2020 Taskforce meeting. He asked members to provide comment on the retention period before the final recommendation was made by the subgroup.
• MB asked the group for any questions. ED asked if survivors would be contacted before specimens were destroyed. MB explained that there had been some feedback that belongings had been destroyed without people’s knowledge which had caused distress. Moving forward survivors would be made aware of when any items were to be destroyed at the time of the forensic medical examination.
• Duncan Alcock (DA) asked whether the retained specimens would be classed as health or justice specimens. Tricia Marwick (TrM) asked if the legislation would specify where the specimens should be kept and what should be kept.
• GW commented that what was kept and where it was kept was not proposed to be decided by the legislation but would be clarified in the National Protocol.
• TM explained that the samples would be retained for a criminal justice purpose.
• MB then explained the status of the National Protocol and that an early first draft would come to the Taskforce meeting in October. He went on to ask members to suggest any volunteers to assist with the Protocol’s development.
• CS noted that the questions raised would be discussed with Chief Executives and Chairs at their next meetings.
• CS then invited Wendy Copeland (WC) to speak to the Telephony Options Appraisal paper. WC explained the process that would be followed during the Options Appraisal and the methodology.
• SB noted her thanks to WC for her work on the project.

New Action

• Members are to provide comments on the retention period of 2 years and 2 months to Mark Burgess by Friday 28th August.
• Members are asked to suggest volunteers to assist with the development of the National Protocol.
• Colin Sloey and Lucy Dexter are to raise Self-referral questions with NHS Chief Executives and Chairs and reiterate the boards’ responsibilities.

Quality Improvement

• CS noted there were no outstanding actions for the Subgroup.
• CS highlighted to the group the RAG report for noting and the Full Business Case (FBC) for the National IT System for comment. CS reminded members that the FBC was a commercially sensitive document and not for sharing out with the meeting.
• CS then invited MM to talk through the FBC.
• MM explained that the FBC was the culmination of a year’s work that had whittled down to 3 potential suppliers. He highlighted that there was one clear winner that would be announced shortly. He asked members to approve the business case so the contract could be awarded. Members approved the business case.
• TM thanked MM and his team for their hard work on the project and for getting it back on track and noted that the April 1st 2021 implementation of the system would be a big milestone for the subgroup and the Taskforce.

Workforce and Training

• CS  noted the three outstanding actions for this subgroup and asked Sybil Canavan (SC) to provide an update:
•  
• Michelle Harrity to develop a robust proposal for the Remote Evidence Test of Change.
• Katie Cosgrove to provide an update on the Community Pharmacy Test of Change for August Taskforce.
• Michelle Harrity to develop a proposal to obtain DNA samples from staff involved in forensic medical examinations to be held on an SPA elimination database in the event of accidental cross-contamination.
• CS highlighted to group that they had the RAG report for noting.
• SC commented that the remote evidence test of change had been impacted by Covid-19 but contact had been made with the SG Technology Enabled Care & Digital Healthcare Innovation Team and NHS E-Health leads identified. The current use of digital technology in court was being closely monitored.
• SC confirmed that it had been agreed that revising the proposal in light of the ongoing Covid-19 crisis would be a logical next step.
• Work on a domestic abuse initiative within Community Pharmacies in Scotland is currently being undertaken by the Violence against Women and Girls (VAWG) Team in SG and discussions are ongoing with them about how any data from that initiative could be used to inform and possibly act as a springboard for the Community Pharmacy Test of Change. 
• SC asked the group to note that work was ongoing on the DNA elimination database and that a S-BAR was being developed by MB so the action would move to Delivery and Performance and would be tabled at the next Taskforce meeting for approval.
• SC confirmed that a workforce data collection exercise would be undertaken in September by Public Health Scotland, with initial figures available at the end of October/ beginning of November.

6. Agreed actions / next steps

• CS reviewed the agreed actions from the meeting as above.

7. AOB

• CS asked for any other business but none was raised.

8. Dates of next meeting

• CS thanked everyone for their attendance and contribution and confirmed the next meetings were scheduled on the following dates:
  • 27 October 2020
  • 25 February 2021
• CS reminded members of the need to send an able deputy if they were unable to attend.