Lindsay Voss Clinical doctorate student University of Southampton Head of Safeguarding Southampton City Clinical Commissioning Group April 2015

1. Multiagency Response to Childhood Sexual Abuse:
The role of a specialist centre
Lindsay Voss
Clinical doctorate student, University of Southampton
Head of Safeguarding,
Southampton City Clinical Commissioning Group
April 2015

2. Case study research
• Explored a single site children’s centre: based on adult SARC,
providing a suite of rooms and calm and private environment
for children where sexual abuse was suspected;
• ‘Tracked’ 60 children referred during an 18 month period:
reason for referral, type of examination, and health, social
care and criminal justice outcomes at 6 months;
• Interviewed 16 professionals (4 paediatricians ,4 nurses, 4
police officers, 4 social workers);
• Analysed patient satisfaction questionnaires.

3. Age profile of the children (n=60)
0
5
10
15
20
25
30
<5 5-11 12-15 >15
Number
Age groups

4. Genital Findings
(8 examinations were under forensic conditions, 10 examinations were refused or incomplete)
0 5 10 15 20 25 30 35 40 45 50
Genital findings
No genital findings
Number

5. Other identified health needs
(e.g. Enuresis, encopresis, head lice, abdominal pain, anxiety, sleep disturbance, outstanding immunisations, dental decay, skin
conditions, heart murmur, hearing problems, alcohol dependency)
0 5 10 15 20 25 30 35 40 45
No other findings
Other findings needing FU
Number

6. Criminal justice outcomes
0 5 10 15 20 25 30 35 40 45 50
Adult caution
Apologised (child perpetrator)
Final warning (child perpetrator)
No crime
Not involved
Guilty at court
No further action
Number

7. Social care outcomes
0 5 10 15 20 25
Section 47 inquiry in progress
Moved out of area
Social care were not involved
Foster care
Child in need planning
Child protection planning
Case assessed and closed
Number

8. Professionals’ experience
• Paediatricians’ unease due to: angry/ distressed families,
isolation from police and social care decision making,
unrealistic expectations of other professionals regarding
‘diagnosing’ abuse.
• Professional hierarchy: paediatricians were denied some of
the informal support networks due to their status, whereas
nurses were perceived as ‘human’.
• Concern that a ‘flurry’ of activity occurs but if abuse is not
‘confirmed’ then families are left ‘floundering’.

9. Key messages
• Children, when able, must participate in individualised
‘meaningful conversations’ about their care and management;
• The purpose and possible outcomes of medical examination
must be clearly described to children and families (i.e. not a
routine process);
• Is examination in the child’s best interests?
• Opportunity for prevention and early help – not a ‘one off’
event: has implications for training and education for
professionals in universal services

10. Key messages continued
• Professionals liked working in a specialist centre – child
focused, and helped them to communicate and co-operate
with other agencies;
• But, ‘tribalism’ was acknowledged – professionals place
priority on their ‘own’ organisational goals;
• ‘Restorative’ support is required for professionals (but is not
well established in medical profession)
• Opportunities for nursing roles to enhance child sexual abuse
services must be explored .

11. Thank you!
Any questions or comments?