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?

dwardle@nhs.net www.bashh.org.uk www.victimsofcrimeinscotland.org.uk/infowww.victimsofcrimeinscotland.org.uk/info www.fflm.ac.uk www.scotland.gov.ukwww.scotland.gov.uk