An amendment to the Female Genital Mutilation Act 2003, which came into effect on 31 October 2015, imposes a legal duty on particular regulated professionals, which includes GPs, to notify the police if they 'discover' an act of FGM which appears to have been carried out on a girl aged under 18.
'Discover' has a specific meaning in this context: it is when either a girl aged under 18 tells you that FGM has been carried out on her, or you observe physical signs appearing to show FGM has been carried out (which do not arise from labour or birth, or necessary treatment for her physical or mental health).
More than 1,000 cases of female genital mutilation (FGM) were recorded in England between July and September 2015, according to the Health and Social Care Information Centre and many more women and girls are thought to be at risk. Of the newly-recorded cases, 70% were self-reported.
It is important to know what steps to take if you discover that an act of FGM appears to have been carried out.
1. Tell the police
If you discover a case of FGM in a girl under 18, either because the patient has told you or because you have observed physical signs indicative of FGM, procedural information from the DH sets out what you should do:
- Ordinarily - call the 101 non-emergency police phone number. The Act requires this should be within 28 days, though the procedural information indicates it is best practice to make the report by the end of the next working day. Using the 101 number should ensure that you are connected to your local police force.
- Provide your name and contact details, including both a work telephone number and email address, your role and your place of work.
- Provide the girl's name, date of birth and address.
- Record all decisions and actions and update your local CCG's designated safeguarding lead (and confirm to the police that you will undertake the safeguarding actions required in Working Together to Safeguard Children (2015).
- If you become aware of information indicating there is a risk to life or likelihood of serious immediate harm to another person, you should make an urgent report to the police, including by calling 999 if appropriate.
2. Cooperate with FGM protection order procedures
Depending on the circumstances of the case, an application for an FGM protection order be appropriate. In many instances, a local authority or the police may well be involved in such an application, though you should assist with the process if appropriate.
3. Discussion with the girl and/or her parents
The 2003 Act states that an FGM notification will not breach an obligation of confidence or any other restriction on the disclosure of information although it is considered best practice to contact the girl and/or her parents or guardians to explain the report, what it means, and why it is being made.
Wherever possible, this should be done before or at the time the report is made. However, if you believe that telling the child or the parents of the reporting might result in a risk of serious harm to the child or another person, or of the family fleeing the country, the reporting should not be discussed. If you are unsure or have concerns you should discuss them with your designated safeguarding lead.
4. Provide HSCIC with FGM data
From 1 October 2015, GPs in England have been required to collect information about all cases of FGM so that a national picture of FGM prevalence can be developed. Data has been collected by acute trusts since April 2014.
Practices should submit information about FGM to the Health and Social Care Information Centre (HSCIC) in certain circumstances to help determine the scale of the practice in the UK. The circumstances include whether a woman is having treatment related to FGM, whether a woman with FGM gives birth to a baby girl, or where FGM has been identified by the woman herself or by a care provider.
The HSCIC has published detailed 'frequently asked questions' about the enhanced dataset.
5. Get advice
If you fail to notify police of a case of FGM in a girl under 18 as described above, you will be in breach of a statutory duty. Although the 2003 Act does not specify a sanction for failing to make a notification, the procedural information makes clear that the matter may be reported to the GMC, and employers and regulators are expected to have regard to the seriousness of the breach of the duty.
If you are unsure whether you need to report a case of FGM to the police, or have questions about safeguarding, contact your medical defence organisation or your local designated safeguarding lead.
- Dr Michael Devlin is MDU head of professional standards and liaison.