564 An audit of the North East London Child Sexual Abuse Hub against RCPCH Clinical & Service Standards between 2019–2021. (17th August 2022)

• Record Type: Journal Article
• Authors: Riddell, Anna; Gupta, Sakshi; Lohesan, Myurri
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A288
• Page End: A288
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.466
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: The North East London Child Sexual Abuse (CSA) Hub was established in April 2019 following a 2015 review by Goddard et al. This review – commissioned by NHS England and the Mayor's Office for Police and Crime – identified an unacceptable variability in service provision for children experiencing sexual abuse. 1 Consequently, multiple CSA hubs were created across London to provide a 'one-stop shop' for medical assessment, advocacy, and early emotional support for children and their families. Since its creation, this hub has been audited annually. The second cycle aimed to: Analyse our patient demographics. Investigate whether the hub met the RCPCH quality standards. Compare the 2019-2020 cycle with current data to evaluate the impact of COVID-19. Methods: The service received 64 referrals in 2019-2020 and 51 in 2020-2021. Our exclusion criteria included non-CSA cases, cancellations, or cases that only required a referral to other services (see figure 1 ). Patient care records were used to collate: Demographic information from all CSA referrals (including cancellations). Compliance against the 11 RCPCH quality standards for the clinical evaluation of children who may have been sexually abused. 2 This data was collected for patients seen in clinic and was assessed using referral letters and clinic reports. Results: Most patients were aged between 1-9 years old. Over 80% of children across both years were female. 2020-2021 saw 13 fewer CSA referrals. Despite the pandemic, the hub continued to prioritise face-to-face assessments. The RCPCH quality standards were well met. However, some areas of improvement were identified: Ideally, non-urgent CSA cases should be seen within 2 weeks of referral. This occurred in 34% of cases in 2019-2020 and 45% in 2020-2021. Hiring another doctor would reduce waiting times but requires additional funding. Play therapists supported 76% of appointments in 2020-2021. This requires improvement as therapists act as chaperones during assessments. Fortunately, funding has recently been approved for a dedicated play therapy team. There should be better documentation of the reasons why STI screening and/or psychological follow-up was not offered to many children (e.g. parental refusal). Therefore, we have implemented dedicated sections for both in the clinic assessment proforma. Providing leaflets about psychological services may also help. Chain-of-evidence documentation was rarely completed. Performing appropriate documentation only for repeat STI samples might be more efficient. This remains compliant with BASHH guidelines, which state that positive samples must be repeated. 3 Conclusion: The North East London CSA hub continued to adhere to RCPCH quality standards. Our recommendations focused on reducing waiting times, facilitating greater support from the play therapy team, amending the clinic assessment proforma, and improving awareness of psychological services. Our aim for 2021-2022 is to collect patient experience data to better understand our patients' needs. References: Review of pathway following sexual assault for children and young people in London (2015), Goddard et al. Service specification for the clinical evaluation of children and young people who may have been sexually abused (2015), RCPCH. BASHH National Guideline on the Management of Sexually Transmitted Infections and Related Conditions in Children and Young People (2021), Ashby et al.