Royal Victoria Infirmary

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 2 quality statements under the effective key question. Staff fully assessed patients’ needs and delivered care and treatment in line with recognised standards. They understood the importance of seeking informed consent.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

On arrival at the SARC patients were greeted by a nurse and paediatric consultant and received a comprehensive assessment of their needs. Any injuries sustained during a sexual assault were documented, including a body map and this informed the forensic examination that staff carried out. In addition, assessments of patients’ physical and mental health, post sexual assault health and other factors such as family life were carried out.

Where necessary the SARC staff made referrals to relevant services for follow on support, such as local Independent Sexual Violence Advisor (ISVA) services. The SARC was located in a large hospital and patients could also be referred to other departments, such as sexual health and infectious disease services for any follow on care needed.

Following a full assessment, patients were provided with any required emergency medical and sexual health treatments in accordance with published national guidance. Forensic samples were taken using specialist equipment based on the patient’s account of what had happened to them. There was a small supply of children’s toys and fidget toys, and staff tried to make the experience as child friendly as possible. Patient records that we reviewed were detailed and described the care and treatment offered and provided to patients, as well as any follow up actions.

Cases were reviewed during weekly peer review meetings attended by the team of consultant paediatricians. This involved a review of the notes and any colposcope images that had been taken and checking that appropriate care and treatment had been provided to the patient. A colposcope is a specialist piece of equipment which is used to capture magnified images of the cervix, vulva and vagina as part of the examination. Staff spoken with told us that they felt all patients were provided with the emotional support they needed alongside any treatment that was necessary.

The provider ensured that updates to guidance were made available to staff, such as when changes to NICE or Faculty of Forensic and Legal Medicines (FFLM) guidance were made.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

Staff understood the importance of gaining consent from patients and their responsible adult prior to carrying out any examinations. Consent was kept under review throughout their time at the SARC. Staff strived to ensure patients, and their parent/guardian understood the options available to them and helped them to make informed decisions.

In the patient records we viewed there was a ‘Patient assessment form’ where consent was recorded in relation to sharing information with ISVAs and other relevant support services.

Additionally, the ‘Paediatric Forensic Assessment form’ contained a section for staff to complete assessments of patients’ competence and capacity to consent for their forensic exam, and parent/guardian consent was recorded. Staff understood the importance of gaining consent from younger children, even where their age meant they could not formally give consent.

Where patients required medication and referrals to other services, such as for follow up on potential infectious diseases, consent for this was also recorded.

Training provided to staff included modules covering the Mental Capacity Act and the Gillick competence and Fraser guidelines.