1. Female Genital Mutilation
Safeguarding children in City and Hackney
Level 3 update

2. Panel
Sarian Kamara Community Facilitator Reggie Marriage Named Nurse for Safeguarding Children Homerton Hospital Cathal Ryan Service Manager Hackney Children’s Social Care Jane Kennedy Consultant Midwife Homerton Hospital Leethan Bartholomew Community Partnership Advisor for City and Hackney Ruth Hallgarten Named GP for Safeguarding Children

3. Learning objectives Raise awareness of FGM in our local population
To safeguard and protect all girls and women who may be at risk of FGM to avoid the often severe consequences for their physical or mental health
Inform Primary Care of our recording and reporting responsibilities
Provide a consistent and joined up approach to tackling the risk of FGM for our patients

4. Before FGM has happened
FGM is child abuse FGM is a serious criminal offence in the UK. Female Genital Mutilation Act 2003 Therefore we must report anyone undertaking or facilitating FGM to the police Be aware of the communities in which FGM is practiced Be aware of any families within these communities who are making preparations for the child to take the child on holiday, arranging vaccinations or planning absence from school Be aware of the child talking about a special procedure/ ceremony that is going to take place

5. FGM Multi-Agency Practice Guidelines 2011
To support front line professionals in recognising and preventing FGM guidelines

6. Tackling FGM in the UK: Intercollegiate recommendation for identifying, recording and reporting 2013
FGM is child abuse and must be integrated into all UK safeguarding procedures The NHS should document and collect information on FGM The NHS should develop protocols for sharing information about girls at risk of FGM with other health and social care agencies, education and the police Develop the competence, knowledge and awareness of frontline health professionals to ensure prevention and protection of girls at risk of FGM Identify girls at risk and refer them as part of child safeguarding obligations and provide sustained information and support to families to protect girls at risk

7. Primary Care
Pregnant women are now routinely asked by their midwife about her own FGM at booking in order to identify girls who may be at future risk
GP receives electronic booking letter giving details of FGM if relevant
GP codes Female genital mutilation K58 on patient’s notes (EMIS code)
GP discusses this woman at the link meeting with health visitor and midwife
GP does a household search on patient, if she has any daughters or girls under 18 living in the same household who are registered at the practice these children may also be at risk of FGM.
Be aware of private fostering arrangements
Seek further advise from Children’s Social Care telephone

8. Midwifery
Pregnant women are now routinely asked about FGM at booking Hospital Children’s Safeguarding Teams bring the cases for discussion to the maternity psychosocial meeting Appropriate physical and psychological care offered to the woman Once delivered, midwifery will share this information with Children’s Social Care, the GP and the Health Visitor

9. Health Visitors
Health Visitors will identify maternal FGM from the new birth notification and apply a red flag alert on RIO for both mother and baby daughter ( also any older sisters) Health Visitor will check that a referral to Children’s Social Care has been made and will follow up the outcome of this referral Will discuss at GP link meeting When the child is 5, the Health Visitor will transfer this information to the School Nursing Service School Nursing will review termly with their school safeguarding teams about girls at risk of FGM

10. Primary Care
When a daughter has been born to a mother known to have undergone FGM
Emis computer codes: 13IF-1 vulnerable child then narrative
12b Family history of female genital mutilation
Opportunistically discuss at post natal checks, baby checks, immunisations etc.
Provide information on the legal consequences of FGM to families requesting holiday vaccinations and document in their medical records
It is illegal to take a British national or permanent resident abroad for FGM or to help someone to do this

11. Children’s Social Care
What happens after referral? Children’s Social Care undertakes an assessment of need and risk on all female children under the age of 18 years when a woman has been identified as having been subject to FGM GP input may be requested

12. Children’s Social Care outcomes of referrals
Assessment shows that girl is not at risk of FGM and case is closed Assessment shows that girl is at risk of FGM and joint child protection enquiries and legal steps are taken as needed, GP input may be requested

13. What to do if you identify that a woman has FGM or you have concerns that a girl may be at risk of FGM
Call Children’s Social Care to check there has not been a previous referral If an assessment has already been completed, unless there is new information there is no need for a referral

14. Useful contacts NSPCC FGM helpline 0800 028 3550 fgmhelp@nspcc.org.uk
Home Office
Metropolitan Police Child Abuse Investigation
Command / Project Azure
Foundation for Women’s Health Research and Development (FORWARD)
Childline
Manor Gardens Health Advocacy Project