Healthcare professionals in England and Wales must notify the police if they discover that an act of female genital mutilation (FGM) appears to have been carried out on a girl under 18.

The legal requirement to notify the police came into force in October 2015 in England and Wales. This followed an amendment to the Female Genital Mutilation Act 2003, accompanied by procedural information and further full multi-agency statutory guidance, which was released in April 2016 (FGM itself has been illegal in the UK since 1985).

Under the requirement, healthcare professionals can 'discover' FGM in one of two ways:

where a girl tells you that an act of FGM has been carried out on her
where you observe the physical signs on the girl appearing to show an act of FGM has been carried out and you have no reason to believe the act was part of surgery that was necessary for the girl's physical or mental health, or was surgery on a girl in labour or who had just given birth, for purposes connected with the labour or birth.

In Scotland, agencies are expected to respond to FGM using existing child and adult protection structures, procedures and policies, including multi-agency arrangements. There is a national action plan to prevent and eradicate FGM and there has been consultation on the introduction of mandatory reporting, which has not yet been implemented.

What to tell the police

This includes the girl's identity, age and address, and why the report is being made. It is recommended that the report is made by calling the 101 non-emergency police phone number, though reporting can be made orally or in writing.

You should tell the police what safeguarding action has been or will be undertaken, and ensure your organisation's designated safeguarding lead is kept updated as appropriate.

Although the Female Genital Mutilation Act requires the FGM notification to be made within one month of the discovery, the procedural information advises that reports should be made as soon as possible after the discovery is made - ideally by the end of the next working day.

FGM diagnosis

The procedural information states that you do not need to be certain that FGM has been carried out. You have a duty to tell the police if you discover by one of the two mechanisms above that FGM appears to have been carried out.

The procedural information is clear that an examination should not be carried out to confirm the diagnosis, unless FGM is suspected as part of an examination already underway.

Safeguarding those at risk of FGM

The obligation to inform the police does not apply if you receive information from another source that indicates a girl has either undergone or may be at risk of FGM. You should nevertheless follow local safeguarding procedures, as appropriate.

You might need to consider applying for an FGM protection order where you believe a child may be at risk of FGM.

If you become aware of information that gives you reason to believe 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.

Patient confidentiality and information to patients/parents

The Act states that an FGM notification will not breach an obligation of confidence or any other restriction on disclosing information.

When making a report to the police, the procedural information makes clear that in line with safeguarding best practice, you should contact the girl and/or her parents or guardians to explain the report, what it means, and why it's being made. Wherever possible, this should be done before or when 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, you should not discuss the reporting.

If you're unsure or have concerns, you should discuss them with your designated safeguarding lead. Additional requirements to report children at risk of abuse or neglect to the local authority came into force in Wales in April 2016.

If you're unsure whether you need to report a case of FGM to the police, or have questions about safeguarding a girl at risk of FGM, contact our advisers.

Records

You should make a comprehensive record of consultations and discussions in line with safeguarding practice, including details of the identification of FGM, safeguarding action, discussion with the patient/parents, and the reporting to the police.

Keep your organisation's designated safeguarding lead up to date as appropriate.

Failure to comply

Failing to make a notification will be a breach of your statutory duty. There is no sanction mentioned, but the procedural information makes plain that professional regulators are expected to consider the seriousness of breaching the duty.

The FGM Enhanced Dataset

From 1 October 2015, GPs in England have been required to collect information about FGM so that a national picture of FGM prevalence can be developed. Data has been collected by acute trusts since April 2014, but data from GP practices and mental health trusts is also collected for an enhanced dataset.

Practices are expected to submit certain data about FGM to NHS Digital to help determine the scale of the practice in the UK. This includes 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 Department of Health and Social Care has published a list of resources for healthcare professionals on mandatory reporting or FGM.

Reporting FGM: your obligations

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