1. EMCYPSAS Clinical Lead March 2018
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East Midlands Children and Young People Sexual Assault Service EMCYPSAS
Fiona Straw
EMCYPSAS Clinical Lead
March 2018

2. Operational Model NUH will be the lead provider
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Operational Model
NUH will be the lead provider
Integrated Hubs with a managed clinical network
Each Hub will be a designated suite within hospital Trusts
One management team:
Clinical Lead
Service Manager
Data Manager
Central data reporting management system to report Key Performance Indicators and other data requirements
Shared governance processes, protocols and referral pathways

3. Clinical Model This text will NOT appear on your slide show.
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Clinical Model
Single point of access answered by a Crisis Support Worker (CSW)
- 24 hours per day, 7 days per week, 365 days per year
9am - 7pm working days
9am - 5pm weekend and Bank Holidays
- Acute sexual assault/abuse (within 21 days)
- Non-recent assault/abuse (more than 21 days)
Up to the age of 18
Adults with significant needs (e.g. learning disability) up to age 24 years
Young people have a choice as to whether they access the CYP or adult services
* Inform EMCYPSAS about all CYP to ensure that they get the same access to services

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East Midlands Children and Young People Sexual Assault Service
Regional Hubs

5. Collection of forensic evidence Documentation of injuries
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Why refer
Collection of forensic evidence
Documentation of injuries
Prevention of unwanted pregnancy
Prevention of infections
CYP sometimes give medical staff more information
Reassure CYP and their carers
Onward referrals

6. Sexually Transmitted Infections Self-harm Domestic abuse
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Operational Model
Risk assessment
Pregnancy
Sexually Transmitted Infections
Self-harm
Domestic abuse
Child Sexual Exploitation
Female Genital Mutilation

7. Onward referrals into local services - Integrated sexual health
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Operational Model
Onward referrals into local services
- Integrated sexual health
- Therapeutic support
- CAMHS
- Paediatric
- ChISVA service

8. https://www.youtube.com/watch?v=cZD5uFi6SnM Clinical Model
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Clinical Model

9. Single point of access This text will NOT appear on your slide show.
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Single point of access
CSW will answer the phone within 60 secs
‘Hello you are through to the EMCYPSAS and speaking to… how can I help you’
When and where the assault took place
Details of the CYP
Details of the referrer
Have they been referred to CSC
Who can give consent, has parental responsibility
Do they need an interpreter
Do they need urgent medical attention
Are they intoxicated
Advise Early Evidence Kit collection if appropriate
Advise that CYP may need a spare set of clothes

10. Guide to establishing urgency of sexual offence examination in CYP
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Guide to establishing urgency of sexual offence examination in CYP

11. Child, young person, family focussed
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Clinical Model
Child, young person, family focussed
CYP chose who they want to support them
Giving control back
Fully informed
Balance between needs of the child and gathering evidence to safeguard/prosecute
Video colposcope

12. Consent Parent with parental responsibility
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Consent
Parent with parental responsibility
YP if has capacity and is competent
Written
Countersigned
Unable to do examination without, unless life threatening
History taking
Documentation
Examination
Collection of samples
Use of colposcope
Written report

13. Clinical Model Police, CYP and their carer greeted by CSW
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Clinical Model
Police, CYP and their carer greeted by CSW
Holistic assessment by single doctor supported by CSW
- Physical examination
Documentation of injuries including use of a colposcope
Collection of forensic samples
Urinary pregnancy testing
- PEPSE provision
Emergency contraception
Screening and treatment for Sexually Transmitted Infections

14. Clinical Model This text will NOT appear on your slide show.
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Clinical Model

15. Forensic sample collection
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Forensic sample collection
Skin samples
48 hours (up to 7 days if haven’t washed)
Oral penetration
48 hours
Anal penetration
Digital 48 hours
Penile 72 hours
Vaginal penetration
Penile 7 days

16. Forensic sample collection
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Forensic sample collection
Blood sample
Drug/alcohol 3 days
Urine sample
Drug/alcohol 5 days
Hair
From 4-6 weeks
Up to 6 months
Avoid cutting hair and chemically treatments

17. Hand written summary of allegation and opinion Clear follow up plan
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Clinical Model
Hand written summary of allegation and opinion
Clear follow up plan
Contact number for CYP and their carer
Formal typed report for all cases
Statement as requested
Daily review of cases
Regular peer review and supervision of staff
Ongoing training and updates

18. Network of CYP Sexual Assault Services Peer review of similar services
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Service development
Network of CYP Sexual Assault Services
Peer review of similar services
Development of the service website
Stakeholder and service user participation to inform service development
Education and awareness raising

19. Improved recording of sexual offences by the police
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Activity
All UK nations saw an increase in the number of recorded sexual offences against children in 2015/16.
Improved recording of sexual offences by the police
Increased willingness of victims to come forward
The rate of recorded sexual offences across the UK has doubled since 2005/06
2015/16 seeing the highest number of offences in the past decade.

20. Activity Assumptions Exact prevalence is unknown
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Activity Assumptions
Exact prevalence is unknown
In 2014/15, in UK, 45,631 reports to the police
NSPCC survey 2011
18-24 year olds 11% considered that they had been sexually abused as child
34% year olds who had experienced contact CSA by an adult did NOT disclose
83% yr olds who experienced contact CSA by a peer did NOT disclose
90% by someone they know

21. Activity Assumptions NHSE data suggests 600 cases per annum
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Activity Assumptions
NHSE data suggests 600 cases per annum
~400 Nottingham hub
~200 Northampton hub
2/3 cases non-recent
1/3 cases acute
Research suggests 5-10% of the population at risk
Population of the region ~ 1 million
50-100,0000 CYP

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Contact Details
All referrals acute and non-recent telephone
General enquiries e.g. statement requests
Nottingham
Northampton
Website

23. Questions This text will NOT appear on your slide show.
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Questions