This article was updated on 1 April 2016.
From 31 October 2015, when a healthcare professional (or other specified registered professionals) in England and Wales discovers that an act of female genital mutilation (FGM) appears to have been carried out on a girl under the age of 18, they have a legal obligation to notify this to the police.
This follows a recent amendment to the Female Genital Mutilation Act, accompanied by procedural information and further full multi-agency statutory guidance, which was released in April 2016.
Under the new 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 which 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.
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 undertaken, or will be undertaken, and you should also ensure your organisation's designated safeguarding lead is kept updated as appropriate.
The Act requires the FGM notification to be made within one month of the discovery, though the procedural information advises that reports should be made as soon as possible after the discovery is made and that best practice will be for that to be by the close of the next working day.
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 the suspicion of FGM arises as part of an examination already under way.
Safeguarding those at risk of FGM
The mandatory obligation to inform the police does not apply if you receive information from another source which indicates a girl has undergone FGM, or if she may be at risk of FGM. You should though follow local safeguarding procedure as appropriate.
Application for an FGM protection order may need to be considered where you perceive that a child may be at risk of FGM.
If you become aware of information indicating there is a risk to life or likelihood of serious immediate harm to another person, an urgent report should be made 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 the disclosure of 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 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.
Additional requirements to report children at risk of abuse or neglect to the local authority come into force in Wales in April 2016.
If you are unsure whether you need to report a case of FGM to the police, or have questions about safeguarding a girl at risk of FGM, please speak to an MDU adviser.
You should make a comprehensive record of consultations and discussion 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
Failure to make a notification will be a breach of the statutory duty. There is no sanction provided for in the new provision, but the procedural information makes plain that professional regulators are expected to pay due regard to the seriousness of breach of 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 from October this year data from GP practices and mental health trusts will also be collected for an 'enhanced dataset'.
Practices will be expected to submit certain data about FGM to the Health and Social Care Information Centre (HSCIC) 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 HSCIC has published detailed Frequently Asked Questions about the enhanced dataset.
This guidance was correct at publication 30/10/2015. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.