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How to make a referral

Victims of recent sexual abuse will usually be seen by the on-call team at our Horizons centre (Hub), Ida Road, in Walsall. Where appropriate, the PSAS team aim to be available within 90 minutes of referral.

The on-call team is available 24 hours a day, seven days a week.

Alongside its urgent response service, the PSAS also operates week-day clinics which offer planned appointments at five venues across the region. These provide medical examination and holistic care for CYP where there is concern about possible sexual abuse, but the concern is not deemed to be within the forensic window (non-recent). The clinic offers a choice of venues, dates, and examiner.

Why refer non-recent abuse, and concerns where the child has not disclosed?

If there is any concern about possible sexual abuse, a medical examination should be considered; the PSAS doctors are happy to give telephone advice and be involved in strategy discussion.

The medical examination is undertaken in a child-friendly way and is generally very well tolerated. Most CYP say they felt reassured by it.

The reasons for medical examination are to:

• ensure the health needs of the CYP is met - this includes screening for sexually transmitted infections.

• provide emotional support - the CYP referred to the service is offered a package of counselling and emotional support.

• to provide reassurance - the importa  nce to the CYP of knowing they are physically ‘normal’ should not be underestimated. Even where there are physical findings, the CYP can be reassured that it has taken a specialist examination to detect them. It is a chance to discuss any fears the CYP has in relation to their experiences.

• to provide evidence - it is important to understand that the examination can never rule out sexual abuse, as a high percentage of CYP who have been abused will have normal examinations. However, in some cases, there are examination findings to substantiate the concern; this can significantly contribute to safeguarding decision-making.

Please note this service has a paediatrician on call 24 hours a day. If you are unsure about whether or not to refer a CYP to the West Midlands Paediatric Assault Service for a medical, please Tel: 0800 953 4133 for a case discussion with the on-call paediatrician.

Crisis counselling may be offered to clients who are seen by a paediatrician as part of the service.

The service covers the Staffordshire, West Midlands, West Mercia and Warwickshire police force areas.  Victims of recent sexual abuse will usually be seen by the on call team at our Horizon Centre, Ida Road - Walsall.  For historic cases children and young people will be seen at one of other centres:

How to refer

Professionals/services should follow Local Safeguarding Children’s Board (LSCB) processes, referring safeguarding concerns where the CYP is thought to be at risk of significant harm to the Multi Agency Safeguarding Hub (MASH).

If the CYP needs urgent medical attention for physical injury (e.g. life-threatening/severe ongoing bleeding) they should be referred urgently to local paediatricians for stabilisation in parallel to this. Otherwise suspected/disclosed sexual assault should not be referred to local Paediatricians.

If a clinician/practitioner wishes to talk through a case (for example if they are unsure if a child’s actions represents sexualised behaviour or if physical symptoms are of concern) the PSAS Paediatricians are happy to give advice by telephone and are available 24/7 through the single point of contact phone line. Access to the service is via: 0800 953 4113 for referrals from professionals or agencies.

Email

General enquiries pSASWestMids@uk.g4s.com.cjsm.net

Sharing confidential information (including referrals) - pSASWestMids@uk.g4s.com.cjsm.net


Clinic Referral Form

Leaflet - For professionals

Click here for information about expressing concerns and making comments or complaints about PSAS.

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One of these centres will be available to see acute cases every day of the year. Most weekdays, a second centre will run planned clinics.

Safeguarding and Child Protection

The welfare of the child or young person is paramount. It is essential that wider safeguarding issues are considered, including for those young people 16-17 years of age (for example, to consider the possibility of child sexual exploitation).

Strategy discussion between statutory agencies should occur in every case. Health professionals should refer to the police or children’s social care, following local safeguarding pathways.

The police have specially trained officers who will treat the client with respect and dignity and advise them on the process involved.

What to do if your patient doesn’t want to report to the police or social care

After you have carefully considered safeguarding issues, and discussed it with our team, we accept direct referrals from
health professionals.

Rape and sexual assault can have a serious long-term impact on the health and wellbeing of the client and their family. The most important thing is that they feel that they are believed and they get appropriate support as soon as possible.

In the first instanc,e issues such as emergency contraception and sexual health screening need to be addressed. We do accept self-referrals, and are able to store forensic samples while the young person decides if he/she wishes to make a police report.

Consent and assent

We strive to make the examination as child-friendly as possible. We will only examine a child or young person who agrees to be examined (assents), regardless of age. We will keep them informed, and, as much as possible, give them control over what is done.

Sometimes this may mean only conducting part-examinations, or agreeing that they take their own swabs. We also need formal written consent, which can be achieved in a number of ways, such as:

The young person can sign their own consent if they are Gillick Competent. (This should not be assumed, particularly if under the age of 12, or if known to have learning difficulties; please discuss with the doctor)

A person with parental responsibility is aware of referral and agrees to attend

A Court Order with directive to examine is in place.

Aftercare

All our clients will be offered a bespoke aftercare package, tailored to their individual needs. Advice and screening for sexually transmitted infections, emergency contraception and pregnancy testing will be offered.

We will also make any referral to other specialties such as urology, gynaecology, general paediatrics
or mental health teams that are needed.

Counselling

Any child or young person aged 5 - 17 years old who undertakes a medical examination and/or has been sexually
abused or exploited will be offered specialist counselling. If the counsellor thinks it would be beneficial to talk to the supportive adult about their child’s counselling (for example in the case of the younger child or a child with specific additional needs), the counsellor would do this.

The child or young person would always be kept informed about what information was being shared with whom and why and this would be discussed in age appropriate language that respects the autonomy of the child or young person.

For children aged 0 - 5 years old, the counselling support will be available to the child’s parent and or carer. Being able to talk about their feelings and thoughts can benefit them and help them to provide the best support for their child. The counselling will be provided by specialist, registered, counsellors and psychotherapists who are experienced in supporting children and young people and helping them cope and recover from the impacts of sexual abuse and/or sexual exploitation.

All clients will be offered counselling sessions which have been set up in a number of locations which have been set up to provide a safe and supportive environment.