The aim of this report is to provide a strategic overview of the forensic medical services provided to adult and child victims of sexual crime, and to give a high-level assessment of these services in terms of their current delivery against national policies and standards. It highlights strategic issues for consideration by key stakeholders, and is intended to inform future scrutiny of this area.
The evidence in this review confirms the need for national standards, and highlights wider issues affecting the quality of service delivered to victims of sexual crime. The review shows that significant disparity in the services currently provided, and supports the need for further investment in healthcare professionals, premises, and equipment. The priority for forensic medical examinations should be to address the immediate health needs and future recovery of patients, with the contribution to potential criminal justice proceedings being a important but not the sole consideration.
We have taken the opportunity to look at how services are provided to victims of sexual crime in other jurisdictions and identified several approaches that may inform future provision in Scotland. These all focus on the health and wellbeing of victims within a supportive healthcare setting.
HMICS has engaged with a wide range of agencies and stakeholders to gather evidence for this review, and we are grateful for all of the advice and information provided. Although our statutory duties primarily relate to Police Scotland and the Scottish Police Authority, we have included some wider recommendations to other key stakeholders, including the Scottish Government. The motivation for this review and the recommendations is to drive improvement in the services provided to victims of sexual crime in Scotland.
The Scottish Government should review the legal basis for the current agreement between Police Scotland, the Scottish Police Authority and NHS Scotland to deliver healthcare and forensic medical services. This review should inform the nature and need for any refreshed national Memorandum of Understanding between the parties.
Police Scotland should work with the partners responsible for delivering the Archway service in Glasgow and the West of Scotland and strengthen its current governance arrangements to ensure the service is adequately resourced and meets the needs of the communities it serves.
The Scottish Government should engage with relevant agencies and stakeholders and bring forward proposals for establishing dedicated healthcare facilities across Scotland to meet both the healthcare needs of victims of sexual crime and the necessary forensic requirements. This should be informed by research and current best practice.
The Scottish Government should consider formally issuing the newly proposed national standards for the delivery of forensic medical examination for victims of sexual violence to all NHS Boards. These standards should be supported by a framework of publicly reported quality indicators and monitored through an effective audit and inspection regime.
Police Scotland should work with NHS Boards to urgently identify appropriate healthcare facilities for the forensic medical examination of victims of sexual crime. The use of police premises for the examination of victims should be phased out in favour of healthcare facilities as soon as is practicable.
The Scottish Government should work with relevant stakeholders and professional bodies including NHS Scotland, Police Scotland and the Crown Office and Procurator Fiscal Service to develop the role of forensic nurses in Scotland.
The Scottish Government should work with relevant stakeholders and professional bodies, including NHS Scotland, Police Scotland and the Crown Office and Procurator Fiscal Service to develop self-referral services for the victims of sexual crime. This should clarify the legal position for obtaining and retaining forensic samples in the absence of a report to the police and support formal guidance for NHS Boards and Police Scotland.
The Scottish Government should work with NHS Scotland to ensure that the existing healthcare ICT system (ADASTRA) is being used consistently for collating information on the volume and nature of forensic medical examinations across Scotland. This will inform future policy and decision making, including resourcing.
Police Scotland should work with the Scottish Police Authority and NHS Scotland to introduce standard operating procedures for the forensic cleaning of police premises which continue to be used for medical examinations. These should comply with current guidance.
Police Scotland should work with NHS Scotland to ensure suspected perpetrators of sexual abuse who are under 16 years old are not forensically examined within police custody facilities. The Criminal Justice (Scotland) Act 2016 defines a child as being a person under the age of 18 and consideration should be given to how this affects the treatment of child suspects in the context of forensic medical examinations.