The Child Sexual Assault Liz Costello - Lead Nurse Assessment Centre Liz Costello - Lead Nurse

Aims of the Service… The aim of the service is to provide a comprehensive child/young person medical assessment whenever sexual abuse or assault is disclosed or suspected. The service is for both acute cases (within the forensic window) and for non recent cases. The service is for children and young people from 0 to 16 years of age.

The assessment includes a full clinical history and examination and where appropriate forensic samples are taken. Identification of health needs, including mental, emotional and sexual health for young people are key in order to signpost for further support and aid the child/young person’s recovery, future health and well being.

The service is co-commissioned by the Office of the Police and Crime Commissioner (PCC) and NHS England. Quarterly data is collected to ensure the service is meeting the commissioner’s requirements.

Location The service is located on the Acorn Unit at York Hospital and covers the whole of North Yorkshire.

Our Rooms…

The Team Dr Liz Baker Dr Sarah Snowden Dr Ianthe Abbey Dr Lorna Highet Dr Gemma Barnes Liz Costello – Lead Nurse Jackie Sanders –Team Secretary Play Specialist Team

The Team

The service operates from Monday to Friday from 8.30 to 5pm Hours of Service The service operates from Monday to Friday from 8.30 to 5pm (excluding bank holidays).

If a medical is requested over a weekend or bank holiday Out of Hours of Service For acute cases only: If a medical is requested over a weekend or bank holiday Contact 0330 053 7040 This is the Mountain Healthcare number, they will then co-ordinate the appointment which will either be at Sheffield Children’s Hospital or the Hazelhurst Centre at Dewsbury.

Data Collection

What happens during the medical? A full medical history is taken. A top to toe examination. An examination of the anogenital area. If within forensic timescale, swabs are taken for DNA. Screening for Sexually Transmitted Infections (if within time frame). Referrals for further support e.g. ISVA.

What happens during the medical? We have a sitting room full of toys. We provide drinks and snacks. We have a shower room and can provide toiletries and new clothes if the child/young person’s clothing is seized. The appointment can take 2-3 hours.

Acute Forensic Examinations We will try to see the child /young person on the day of the request. The room is cleaned to Forensic Science regulator guidelines. We require a police officer to be present for the examination in order to discuss the forensic strategy and to check, sign for, and take the samples.

Forensic Time Frames Vaginal – penile penetration: 7 days Vaginal – digital penetration: 48 hours Anal – penile penetration: 72 hours Anal – digital penetration: 48hours Oral penetration: 48hours

Evidence / Signs of Injury At the end of the examination the paediatrician will discuss her findings with the Police Officer and Social Worker. We will provide a short written summary of the findings. A Child Protection report is completed within 10 days (if possible). If a statement is required for court, this must be requested by the police and 10 working days allowed for completion.

Remember… ‘A normal examination does not refute or confirm that penetration may have occurred as it is well recognised that children can heal very quickly in the anogenital area, leaving no residual sign of injury.’ Reference: ‘The Physical Signs of Child Sexual Abuse.’ (May 2015 Royal College of Paediatricians and Child Health.)

If a medical is declined or not indicated: Discuss ISVA referral – AND MAKE THE REFERRAL! Consider sexual health needs. Refer to Sexual Health Clinic.

Partnership working Police Children’s Social Care Mountain Health Care ISVA Sexual Health Services

Follow Up Support Referral to ISVA Sexual health services/ SCOT team for young people Supporting Victims of Crime Follow up appointment with Paediatrician CAMHS NSPCC

Feedback Feedback forms have been developed for parents, young people and professionals. We are still thinking of imaginative ways to receive feedback!

Feedback… The following are some comments we have received from children and young people who have attended our service: “I didn’t realise we’d be here all afternoon, but it’s been so nice, it’s like they’ve been at nursery all afternoon.” “Just wanted to say thank you all so much to the Acorn unit for the way you all made us feel so relaxed in such a horrible situation. My mind is totally at rest now after an awful few weeks of worry. We can now, as a family, look forward to Christmas.” “Make the appointment longer so I can play on the tablet longer.” “Lovely, friendly staff who made my 3 year old feel very comfortable during her Visit” “It wasn’t patronising or condescending. Thank you for making such a difficult situation much easier.” “I felt nervous and also I’m glad it’s over, I don’t need to worry about it anymore. I can not worry for the rest of my life…I am normal.”

Monday to Friday 9am to 5pm Our contact details: Liz Costello (Lead Nurse) 01904 721813 liz.costello@york.nhs.uk (non-secure) liz.costello2@nhs.net (secure) Safeguarding Children’s Office 01904 726647 childrens.safeguardingteam@york.nhs.uk (non-secure) sctyorkhospital@nhs.net (secure) Monday to Friday 9am to 5pm