Dr Deb Wardle Lead Clinician Archway Managing sexual assault An update on Scotland’s first...
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Transcript of Dr Deb Wardle Lead Clinician Archway Managing sexual assault An update on Scotland’s first...
Dr Deb WardleDr Deb WardleLead Clinician ArchwayLead Clinician Archway
Managing sexual assaultManaging sexual assault
An update on Scotland’s first referral An update on Scotland’s first referral centrecentre
Where did we come from?Where did we come from? ii
How Archway EvolvedHow Archway Evolved Where we came fromWhere we came from Where we areWhere we are Where we are headingWhere we are heading
BackgroundBackground 3 year government funded pilot3 year government funded pilot Partnership between NHS, Strathclyde Partnership between NHS, Strathclyde
Police and Glasgow City CouncilPolice and Glasgow City Council External evaluation by London External evaluation by London
Metropolitan UniversityMetropolitan University Opened in April 2007Opened in April 2007 24/7 since October 200724/7 since October 2007
Ethos & PhilosophyEthos & Philosophy
To provide forensic, medical, support and To provide forensic, medical, support and counselling services to survivors of sexual counselling services to survivors of sexual assault with courtesy, privacy, dignity and assault with courtesy, privacy, dignity and respect.respect.
Aims Aims Increase rate of disclosureIncrease rate of disclosure Encourage disclosure to policeEncourage disclosure to police Facilitate continued support with criminal Facilitate continued support with criminal
justice system-links with VIAjustice system-links with VIA Increasing convictions never an aim –Increasing convictions never an aim –
unsafe- may be a s/e of a more co-unsafe- may be a s/e of a more co-ordinated supportive approach to ordinated supportive approach to management and investigative process.management and investigative process.
Entry CriteriaEntry Criteria
Police and other agency referrals Police and other agency referrals EXTENDED IN 2009 to all Strathclyde police EXTENDED IN 2009 to all Strathclyde police areaarea
Self referrals from anywhere Self referrals from anywhere Adolescents over age of 13 years Adolescents over age of 13 years Compulsory police engagement for Compulsory police engagement for
adolescentsadolescents EXTENDED FOLLOW PERIOD whenever EXTENDED FOLLOW PERIOD whenever
support needed.support needed.
What’s changed?What’s changed?
Logo!Logo!
Police ReferralsPolice Referrals
What’s changed?What’s changed? Sexual Offences Liaison Officer (SOLO) Sexual Offences Liaison Officer (SOLO)
trained officertrained officer Archway involved in SOLO training Archway involved in SOLO training
Forensic SupportForensic Support
Provided a summary of incident, reasons Provided a summary of incident, reasons for ‘unusual’ productions/samples takenfor ‘unusual’ productions/samples taken
Officers aware to deliver the envelope to Officers aware to deliver the envelope to lab along with productionslab along with productions
2 way traffic with training seminars2 way traffic with training seminars Annual staff training day extends beyond Annual staff training day extends beyond
clinical staff clinical staff
Toxicology Update and issues of Toxicology Update and issues of consentconsent
Altered legislation Autumn 2010- possiblity Altered legislation Autumn 2010- possiblity of more emphasis –’incapable of giving of more emphasis –’incapable of giving consent’consent’
Toxicology role > witnesses to Toxicology role > witnesses to complainer’s inability to consent?complainer’s inability to consent?
Faculty of forensic and Legal Medicine Faculty of forensic and Legal Medicine guidance on samplesguidance on samples
Toxicology changesToxicology changes
Multi-agency review of local procedure Multi-agency review of local procedure comparing FFLM guidancecomparing FFLM guidance
One hair sample at 28 days – less intrusiveOne hair sample at 28 days – less intrusive Possible seizure of urine in all but not Possible seizure of urine in all but not
necessarily testing unless allegation of necessarily testing unless allegation of drug/alcohol playing a significant role.drug/alcohol playing a significant role.
Developing ‘App’ for staff as aide memoire Developing ‘App’ for staff as aide memoire to taking hair samples.to taking hair samples.
Self referralsSelf referrals Time to consider optionsTime to consider options Forensic examination an option with Forensic examination an option with
storage of samples of Archway and storage of samples of Archway and transfer to police if complainer decides to transfer to police if complainer decides to take allegation to the policetake allegation to the police
In the interim ‘opt out’ policy of 3In the interim ‘opt out’ policy of 3rdrd party party reporting –Archway staff providing reporting –Archway staff providing intelligence about incidents anonymously intelligence about incidents anonymously to police.to police.
Anonymous testing Anonymous testing
Self referrals – consent to samples being Self referrals – consent to samples being tested and run against DNA databases for tested and run against DNA databases for match with any ‘unidentified DNA’.match with any ‘unidentified DNA’.
Feedback facilitated via Archway – Feedback facilitated via Archway – support transition to engaging with criminal support transition to engaging with criminal justice system.justice system.
Anonymous Anonymous testingtesting
Trial run with retrospective samples dated Trial run with retrospective samples dated from time of altered consent formfrom time of altered consent form
Small number eligible /still able to contact Small number eligible /still able to contact but 50% yielded significant intelligence for but 50% yielded significant intelligence for policepolice
One complainer swayed towards police One complainer swayed towards police engagement but reasons which initially engagement but reasons which initially deterred this route remained.deterred this route remained.
SupportSupport
Do not under estimate this role!Do not under estimate this role! NOT encouraging police engagementNOT encouraging police engagement SUPPORTING complainer to make right SUPPORTING complainer to make right
choice for them and not restrict options choice for them and not restrict options available to them if their mindset alters.available to them if their mindset alters.
EMPOWERING them againEMPOWERING them again
Archway Adolescent ProtocolArchway Adolescent Protocol multi-agency developmentmulti-agency development Police Police NHSNHS SWSW Child Protection PaediatricianChild Protection Paediatrician PF….PF….
Age RangeAge Range
13, 14, 15 years13, 14, 15 years 16,17 18 if looked after or looked after and 16,17 18 if looked after or looked after and
accommodatedaccommodated
Pre ArchwayPre ArchwayUnder 13 established service at YorkhillUnder 13 established service at Yorkhill Over 13 as for adultsOver 13 as for adults
Lanarkshire health board continue to see Lanarkshire health board continue to see adolescents with Lanarkshire postcodes despite adolescents with Lanarkshire postcodes despite boundary extension to incorporate Strathclyde boundary extension to incorporate Strathclyde policepolice
Changes in Changes in adolescentsadolescents
Glasgow child protection committee aware Glasgow child protection committee aware for multiagency working and management for multiagency working and management of adolescents.of adolescents.
PilotPilot police responsible for initial sw liaison- police responsible for initial sw liaison-
Archway safety net standard letter that Archway safety net standard letter that adolescent attended and thei details and adolescent attended and thei details and those of police investigating team to those of police investigating team to facilitate any –joint sw/police investigationfacilitate any –joint sw/police investigation
Current Gold StandardCurrent Gold Standard
2 doctor examination2 doctor examination Child protection paediatrician and forensic Child protection paediatrician and forensic
medical examinermedical examiner This happens in paediatric casesThis happens in paediatric cases Archway not funded for access to 2 docsArchway not funded for access to 2 docs
AdolescentsAdolescents
Increasing numbers 15% totalIncreasing numbers 15% total Still no male adolescentsStill no male adolescents
Follow upFollow up Adolescent’s low but hopefully enough Adolescent’s low but hopefully enough
information sharing to have services information sharing to have services aware of circumstancesaware of circumstances
Adolescent Referral DocumentationAdolescent Referral Documentation Social WorkSocial Work
- standard letter- standard letter
Child Protection Paediatrician Child Protection Paediatrician Child protection Unit (health) YorkhillChild protection Unit (health) Yorkhill
Archway Adolescent assessment for continuing care (pg 2-10 of proforma)Archway Adolescent assessment for continuing care (pg 2-10 of proforma)
GP GP Archway Summary of Attendance (within proforma)Archway Summary of Attendance (within proforma)
The PlaceThe Place Archway Summary of Attendance Archway Summary of Attendance Archway Adolescent assessment for continuing care (pg 2-10 of proforma)Archway Adolescent assessment for continuing care (pg 2-10 of proforma) scanned onto ‘NASH’ clinical record by adminscanned onto ‘NASH’ clinical record by admin
Adolescent cases by Adolescent cases by health board of residencehealth board of residence
Health Board Health Board Area Area
Pre-boundary Pre-boundary expansionexpansion
Post Post boundary boundary expansion expansion
of which of which 20112011
GG&Clyde GG&Clyde 3333 6969 99
Ayrshire & Arran Ayrshire & Arran 99 22
Highland Highland 44 11
Lanarkshire Lanarkshire 11 1010 22
Lothian Lothian 11 00
Forth ValleyForth Valley 11 11
GRAND TOTAL GRAND TOTAL 3434 9494 1515
Archway CasesArchway Cases
CasesCases Since OpeningSince Opening of which 2011of which 2011Adult FemaleAdult Female 893893 6363Adult MaleAdult Male 5959 44TOTALTOTAL 952952 6767
Adolescent FemaleAdolescent Female 130130 1515Adolescent MaleAdolescent MaleTOTALTOTAL 130130 1515
GRAND TOTALGRAND TOTAL 10821082 8282
Health Board of Residence Adults Health Board of Residence Adults April 2010 til March 2011April 2010 til March 2011
Greater Glasgow & Clyde Greater Glasgow & Clyde 257257 Lanarkshire Lanarkshire 5858 Argyll&ButeArgyll&Bute 22 HighlandHighland 88 Forth ValleyForth Valley 22 Ayreshire & ArranAyreshire & Arran 4141 LothianLothian 22 Other (unknown/Yorkshire)Other (unknown/Yorkshire) 22
Where are we now?Where are we now?
Partnership workingPartnership working WISH well being in sexual health award for innovative WISH well being in sexual health award for innovative
partnership working partnership working Glasgow child protection committee award for Glasgow child protection committee award for
partnership workingpartnership working Increasing joint trainingIncreasing joint training All SOLO officers receive training which Archway has All SOLO officers receive training which Archway has
inputinput Archway staff attend COPFS training events – better Archway staff attend COPFS training events – better
perspective on what PF is looking for best way of perspective on what PF is looking for best way of presenting information to facilitate the process and presenting information to facilitate the process and reduce any duplication of documentation.reduce any duplication of documentation.
Implications of financial restraintsImplications of financial restraints
10% redn (£36000) police input from April 10% redn (£36000) police input from April 20112011
Health board funding GG& ClydeHealth board funding GG& Clyde Requirement for service led agreement to see Requirement for service led agreement to see
referral to Archway who reside in referral to Archway who reside in neighbouring health boardsneighbouring health boards
FFLM standards – potential for mandatory FFLM standards – potential for mandatory qualification recommendations in futurequalification recommendations in future
BASHH guidance on management.BASHH guidance on management. Impact on training budget / recruitmentImpact on training budget / recruitment
ComplainerComplainer
Remains central to whole processRemains central to whole process Post evaluation looking to gain feedback Post evaluation looking to gain feedback
via focus groupsvia focus groups Self referrals –no geographical boundarySelf referrals –no geographical boundary Re-vamped complainer handbookRe-vamped complainer handbook
Legislation changesLegislation changes
National sex crime advisory groupNational sex crime advisory group
Where we have been?Where we have been?
Court appearancesCourt appearances Concerns about the impact on ‘the day job’Concerns about the impact on ‘the day job’ Citations frequent but court appearances Citations frequent but court appearances
less so.less so. Estimated 10%Estimated 10% TTrafficking /murders /stolen items used in rafficking /murders /stolen items used in
other crimes leading to assailant IDother crimes leading to assailant ID
Where are we heading?Where are we heading? Complainer feedback now evaluation Complainer feedback now evaluation
completecomplete Focus groups, Focus groups, Anonymous testing of samples from those Anonymous testing of samples from those
self referrals not initially opting to engage self referrals not initially opting to engage with policewith police
Legislative changes in place-procedure Legislative changes in place-procedure changes may /may not occur in responsechanges may /may not occur in response
Where next?Where next?
Database developmentDatabase development
Post pilot review of database to facilitate Post pilot review of database to facilitate effective ‘case tracking’ from start of effective ‘case tracking’ from start of process to end of trialprocess to end of trial
Every case different every time line Every case different every time line differentdifferent
Multi-agency input Multi-agency input Archway,police,copfsArchway,police,copfs
FutureFuture
Approved standards at last! Approved standards at last! Space. new site?Space. new site? Time. ? 2Time. ? 2ndnd forensic bubble forensic bubble More staff?More staff? Less funding??!!!Less funding??!!!
Proven charges of Proven charges of rape /attempted raperape /attempted rape
2008-09 2008-09 35%35% 2009-10 2009-10 46%46%
FusionFusion
Questions?Questions?
[email protected] www.bashh.org.uk www.victimsofcrimeinscotland.org.uk/infowww.victimsofcrimeinscotland.org.uk/info www.fflm.ac.uk www.scotland.gov.ukwww.scotland.gov.uk