Dr Deb Wardle Lead Clinician Archway

1. Dr Deb WardleLead Clinician Archway Managing sexual assault An update on Scotland’s first referral centre

2. Where did we come from? • i

3. How Archway Evolved • Where we came from • Where we are • Where we are heading

4. Background • 3 year government funded pilot • Partnership between NHS, Strathclyde Police and Glasgow City Council • External evaluation by London Metropolitan University • Opened in April 2007 • 24/7 since October 2007

5. Ethos & Philosophy • To provide forensic, medical, support and counselling services to survivors of sexual assault with courtesy, privacy, dignity and respect.

6. Aims • Increase rate of disclosure • Encourage disclosure to police • Facilitate continued support with criminal justice system-links with VIA • Increasing convictions never an aim –unsafe- may be a s/e of a more co-ordinated supportive approach to management and investigative process.

7. Entry Criteria • Police and other agency referrals EXTENDED IN 2009 to all Strathclyde police area • Self referrals from anywhere • Adolescents over age of 13 years • Compulsory police engagement for adolescents • EXTENDED FOLLOW PERIOD whenever support needed.

8. What’s changed? Logo!

9. Police Referrals What’s changed? Sexual Offences Liaison Officer (SOLO) trained officer Archway involved in SOLO training

10. Forensic Support Provided a summary of incident, reasons for ‘unusual’ productions/samples taken Officers aware to deliver the envelope to lab along with productions 2 way traffic with training seminars Annual staff training day extends beyond clinical staff

11. Toxicology Update and issues of consent • Altered legislation Autumn 2010- possiblity of more emphasis –’incapable of giving consent’ • Toxicology role > witnesses to complainer’s inability to consent? • Faculty of forensic and Legal Medicine guidance on samples

12. Toxicology changes Multi-agency review of local procedure comparing FFLM guidance One hair sample at 28 days – less intrusive Possible seizure of urine in all but not necessarily testing unless allegation of drug/alcohol playing a significant role. Developing ‘App’ for staff as aide memoire to taking hair samples.

13. Self referrals • Time to consider options • Forensic examination an option with storage of samples of Archway and transfer to police if complainer decides to take allegation to the police • In the interim ‘opt out’ policy of 3rd party reporting –Archway staff providing intelligence about incidents anonymously to police.

14. Anonymous testing • Self referrals – consent to samples being tested and run against DNA databases for match with any ‘unidentified DNA’. • Feedback facilitated via Archway – support transition to engaging with criminal justice system.

15. Anonymous testing Trial run with retrospective samples dated from time of altered consent form Small number eligible /still able to contact but 50% yielded significant intelligence for police One complainer swayed towards police engagement but reasons which initially deterred this route remained.

16. Support Do not under estimate this role! NOT encouraging police engagement SUPPORTING complainer to make right choice for them and not restrict options available to them if their mindset alters. EMPOWERING them again

17. Archway Adolescent Protocol • multi-agency development • Police • NHS • SW • Child Protection Paediatrician • PF….

18. Age Range • 13, 14, 15 years • 16,17 18 if looked after or looked after and accommodated

19. Pre Archway Under 13 established service at Yorkhill • Over 13 as for adults • Lanarkshire health board continue to see adolescents with Lanarkshire postcodes despite boundary extension to incorporate Strathclyde police

20. Changes in adolescents Glasgow child protection committee aware for multiagency working and management of adolescents. Pilot police responsible for initial sw liaison- Archway safety net standard letter that adolescent attended and thei details and those of police investigating team to facilitate any –joint sw/police investigation

21. Current Gold Standard • 2 doctor examination • Child protection paediatrician and forensic medical examiner • This happens in paediatric cases • Archway not funded for access to 2 docs

22. Adolescents Increasing numbers 15% total Still no male adolescents

23. Follow up • Adolescent’s low but hopefully enough information sharing to have services aware of circumstances

24. Adolescent Referral Documentation • Social Work • - standard letter • Child Protection Paediatrician • Child protection Unit (health) Yorkhill • Archway Adolescent assessment for continuing care (pg 2-10 of proforma) • GP • Archway Summary of Attendance (within proforma) • The Place • Archway Summary of Attendance • Archway Adolescent assessment for continuing care (pg 2-10 of proforma) • scanned onto ‘NASH’ clinical record by admin

25. Adolescent cases by health board of residence

26. Archway Cases Cases Since Opening of which 2011 Adult Female 893 63 Adult Male 59 4 TOTAL 952 67 Adolescent Female 130 15 Adolescent Male TOTAL 130 15 GRAND TOTAL1082 82

27. Health Board of Residence Adults April 2010 til March 2011 • Greater Glasgow & Clyde 257 • Lanarkshire 58 • Argyll&Bute 2 • Highland 8 • Forth Valley 2 • Ayreshire & Arran 41 • Lothian 2 • Other (unknown/Yorkshire) 2

28. Where are we now?

29. Partnership working • WISH well being in sexual health award for innovative partnership working • Glasgow child protection committee award for partnership working • Increasing joint training • All SOLO officers receive training which Archway has input • Archway staff attend COPFS training events – better perspective on what PF is looking for best way of presenting information to facilitate the process and reduce any duplication of documentation.

30. Implications of financial restraints • 10% redn (£36000) police input from April 2011 • Health board funding GG& Clyde • Requirement for service led agreement to see referral to Archway who reside in neighbouring health boards • FFLM standards – potential for mandatory qualification recommendations in future • BASHH guidance on management. • Impact on training budget / recruitment

31. Complainer • Remains central to whole process • Post evaluation looking to gain feedback via focus groups • Self referrals –no geographical boundary • Re-vamped complainer handbook

32. Legislation changes National sex crime advisory group

33. Where we have been? • Court appearances • Concerns about the impact on ‘the day job’ • Citations frequent but court appearances less so. • Estimated 10% • Trafficking /murders /stolen items used in other crimes leading to assailant ID

34. Where are we heading? • Complainer feedback now evaluation complete • Focus groups, • Anonymous testing of samples from those self referrals not initially opting to engage with police • Legislative changes in place-procedure changes may /may not occur in response

35. Where next?

36. Database development • Post pilot review of database to facilitate effective ‘case tracking’ from start of process to end of trial • Every case different every time line different • Multi-agency input • Archway,police,copfs

37. Future Approved standards at last! Space. new site? Time. ? 2nd forensic bubble More staff? Less funding??!!!

38. Proven charges of rape /attempted rape 2008-09 35% 2009-10 46%

39. Fusion

40. Questions? • dwardle@nhs.net • www.bashh.org.uk • www.victimsofcrimeinscotland.org.uk/info • www.fflm.ac.uk • www.scotland.gov.uk