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Blog Jon Rouse


FGM - preventing the unthinkable

Posted by: , Posted on: - Categories: Guidance and support, safeguarding

There are some actions which, once taken, can never be undone. Female genital mutilation is one such action – it changes everything. We owe it to survivors of this terrible practice to provide the best physical and psychological support we can, but we also need to strengthen the way we detect and report those potentially at risk, so that more girls and young women can be taken out of harm’s way.

When I spoke on this issue at the National Children and Adult Services (NCAS) Conference last October, I heard from many dedicated professionals who want to increase awareness of FGM in their local areas, and who are committed to doing all they can to eliminate this illegal practice imposed upon girls and young women.

The mandatory reporting duty has been in force since 31 October this year. All registered health, social care and education professionals are now required to report FGM in under-18s to the police. To fulfil the duty, a professional can call the police non-emergency telephone number, 101, whenever a girl under 18 tells them she has undergone FGM or if they see signs that may show she has already experienced this awful – and unlawful – procedure.

This film on NHS Choices complements the FGM guidance package to provide at-a-glance advice on what action to take.
This film on NHS Choices complements the FGM guidance package to provide at-a-glance advice on what action to take.

It can never be an easy discussion to have with young women, especially in cases where FGM is suspected rather than presented. It is important professionals feel supported to take the necessary action to deliver the duty. To help, the Department of Health has published a range of guidance and support materials for staff and patients explaining how to implement the duty, what it means and what healthcare professionals should do if they think a child has experienced or is at risk of FGM. A training package introducing the duty to staff has also been produced, as has a leaflet explaining the duty to patients and the families affected. Posters, action flowcharts and a film on NHS Choices complement the package to provide an at-a-glance advice on what action to take.

Any failure to meet the mandatory reporting duty will be dealt with through your regulator’s existing disciplinary processes. But this is a last resort. Firstly we want to empower health professionals to feel confident when taking action to implement the duty. We will support NHS and social care colleagues at every stage in the process, to do what is needed to care for girls and young women and protect future generations from FGM.

I am sure NHS colleagues will continue to fulfil their wider safeguarding obligations under local arrangements as before. The mandatory reporting duty does not replace existing safeguarding obligations – rather it enhances the prevention response. Health professionals should already be acting whenever they identify a child who has been abused. In cases where FGM seems imminent or a girl appears to have been recently cut, urgent action must always be taken, including calling the police if appropriate.

We know we still need to do more to strengthen FGM safeguarding and prevention across the NHS. To this end, the Department of Health will soon launch the FGM Risk Indication System (FGM RIS), a new national system to allow healthcare professionals to mark on a girl’s healthcare record that she may be at risk of FGM. This information can then be used by others treating the girl over the course of her childhood up to age 18, to prompt them to consider whether they see anything which concerns them, to have conversations with the girls and families in their care, and to consider what safeguarding actions may be needed to prevent FGM. Guidance for NHS and care colleagues will follow in due course.

Equally, the mandatory reporting duty does not replace the requirement for NHS staff to record FGM data in a patient’s healthcare record whenever it is identified in girls and women, and to submit this centrally for publication by the Health and Social Care Information Centre. This remains a necessary requirement which must also continue as before.

The latest FGM official statistics from the HSCIC show us that between July and September there were 1,385 newly recorded cases of FGM reported in England. For the very first time, country of birth has also been published, which although only recorded for 37 percent of cases, shows us that women with FGM were reported to be born in the Middle East and Asia as well as Africa. Women and girls with FGM were also reported to have been born in the UK, and 17 girls with FGM were reported as being under the age of 18 at the point of their first attendance.

This is why it is so important to continue to record and collect this data – so we have a clear picture of the problem, to ensure that we are fulfilling our duty to safeguard every girl we see, to protect future generations of from harm and to eradicate this illegal practice.

These measures are being delivered as part of the Department of Health’s ongoing national FGM Prevention Programme which, in partnership with NHS England, aims to improve the NHS response to FGM, to better care, protect and actively support prevention. I have confidence these measures, when combined, will put the NHS on the front foot in taking action to prevent FGM and finally eradicate this abusive practice.

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