 GP in North and West London  Lead GP for Safeguarding Children in West London CCG (K+C and Queen’s Park + Paddington in Westminster)  ONE day per week  NHS England FGM Steering Group  Department of Health FGM Strategy Planning Dr Neera Dholakia

 Violence against women and girls  Represented all the Lead GPs in London at the NHS England FGM steering group  Home Office select committee report critical of GPs How I got involved in FGM

TRAINING SUPPORT How can GPs deliver on this directive?

 Face to face training  More effective then online learning for retention  GP forums  Dissemination of information  Collaboration with CCG, LA, Community  FUNDING for provision of training TRAINING

 Availability of support services for patients  Clinics for deinfibulation  Clinics for managing the short and long-term consequences, particularly psychological and sexual  Advocacy and community support networks  Availability of support for GP staff  Clinical advice  Practical advice e.g. where to refer  Working with communities to strike balance between advocacy, trust and safeguarding Support

Mandatory Level 3 Safeguarding Children Training for GPs Multi Agency, Domestic Violence and Female Genital Mutilation ConfidentSafeguarding

 Prevalence  Legislation  Classification  Identification  Complexities and community perspectives  Consequences  Coding  Referral  Information sharing, consent, confidentiality FGM

Girls at risk of FGM  Any female child is born to a woman who has undergone FGM  Any female child whose older sibling (sister or in extended family) has undergone FGM must be considered to be at immediate risk  The family is not integrated into UK society Girls who have undergone FGM  Risk to female siblings Women who have undergone FGM  Risk to daughters Opportunities in general practice to identify FGM  New patient registrations: include country of origin, if from a practicing community, ask about FGM  Smear tests: identify women that have undergone FGM  Travel clinics: vaccinations and malaria prophylaxis  Routine childhood immunisations  Pregnancy booking  Red book – document if maternal FGM  Opportunistic history taking from women and girls, asking about school holidays FGM:Identification

BARRIERS Women and Children disclosing Clinicians asking

 Specific for GPs  Female Genital Mutilation speaker and community perspective  Simulated Consultations  Case studies  Discussion and questions - interactive Face-to-face vs E-learning

‘ West London CCG FGM training: An example of best practice’ NHS England CCG case study pinboard Evaluation assessed knowledge, awareness and skills Participants improved from 56% confident to 83% confident in all areas

Why isn’t everyone receiving this training? FUNDING

Thank you and any questions