Identification of Female Genital Mutilation (FGM) in Brent
Female Genital Mutilation (FGM) is illegal in the UK. This report outlines Brent Clinical Commissioning Group’s in identifying cases of FGM in Brent and seeks the support of the Committee for the work done locally to address this.
Doctor Sarah Basham (Vice Chair and Co-Clinical Director at Brent Strategic Commissioning Group (CCG)) introduced the report which outlined Brent CCG’s work on identifying cases of Female Genital Mutilation (FGM) in the Borough. Doctor Basham said that some of the data included in the report had been extracted from national reporting of FGM and stressed that FGM had been recognised as a problem in Brent. Doctor Arlene Boroda (Designated Doctor at Brent CCG) explained that work around FGM had been ongoing for a long period of time. She said that in addition to mandatory reporting, Brent CCG was trying to eradicate the practice by working with partners across the health economy, the Police, and the voluntary sector. Doctor Boroda noted that there had been a large number of reports of FGM in Brent and emphasised that women who had undergone the procedure experienced life-long complications. A key message that the Committee heard was that since 2015 it had been mandatory for hospitals, mental health trusts and General Practitioners to report cases of FGM and one of the main tasks of the CCG was to engage local communities and the voluntary sector and to support professionals to share information (‘Tell us once’). In relation to the latter, Doctor Boroda said that training had been provided to professionals for a number of years and refresher courses were available to ensure everyone understood their role in safeguarding women.
A Member of the committee enquired about the Department of Health’s prevention programme and the Committee heard that the Department’s data provided information about the prevalence of FGM as it extracted data from the locations where FGM had been reported, which allowed the identification of hotspots. Dr Basham said that Brent was an area where there were both high prevalence and high risk of FGM. Doctor Boroda confirmed that partners worked effectively in Brent to address the issue and gave an example of a roundtable discussion in which representatives of the CCG, the Designated Nurse, children’s social care representatives and the Police participated. In relation to a question about the collaboration with the Police and immigration officers to monitor when children were taken out of the country, she said that safeguarding was everyone’s responsibility so if a parent requested to take a child out of school, this raised concern as the child could have been at risk. Dr Basham added that there had been a case in her practice where a concern had been raised and passports had been retained.
The Committee focused its attention on raising awareness of FGM in schools and a Member asked a question that related to the expectations from teachers. Gail Tolley (the Council’s Strategic Director for Children and Young People) explained that the report presented to the Committee had been prepared by Brent CCG and it was the responsibility of the school Governing Boards and Ofsted to assess the safeguarding mechanisms adopted by schools and the awareness of key members of staff about FGM. As far as risks associated with the summer holiday were concerned, Ms Tolley said when children returned to school they would start disclosing what might have happened over the holiday so any concerns related to FGM were likely to come to attention of the Brent Family Front Door.
In relation to support for women who had undergone FGM, Doctor Boroda noted that a range of practitioners provided services to victims and a number of local hospitals had specialised clinics which had good reputation. When a referral was made, all concerns were taken into account and mental and physical assessments were carried out so clinicians could determine the individual’s health needs. Furthermore, a part of the risk assessment looked at victims’ daughters and granddaughters with an aim of reducing cases where the procedure was carried out on several generations.
The Committee examined whether the legal duty to report FGM had made a difference. Doctor Boroda said that she was not able to comment on the reasons why there had not been any applications for protection orders in Brent as this was a matter for the Police. The work of the CCG had been focused on safeguarding children and meeting the health needs of people who had undergone the procedure. Moreover, Doctor Basham noted that professionals had developed a culture of openness and dialogue about the issue which had increased information sharing on the topic, but there had been gaps in engagement with community and voluntary groups that had to be addressed – for instance, Brent CCG were to meet with Forward UK as part their engagement with the voluntary sector.
In terms of learning from other local authorities, Doctor Basham said that Brent had a high number of individuals at risk which was reflected in the number of cases of FGM. Doctor Basham stressed that it remained important to provide training to enhance the understanding of the issue and raise awareness about the importance of recording concerns promptly and accurately.
The Chair drew Members’ attention to the recommendations of the report outlined on page 53 to the Agenda pack and a Member asked for clarify on the operational leads for these. Doctor Boroda responded that Brent CCG would collate the information it received from providers and each provider would have a lead (most likely their executive lead for safeguarding) and it was the CCG’s responsibility to request updates and look into any issues that may come up.
(i) The contents of Identification of Female Genital Mutilation (FGM) in Brent, report, be noted;
(ii) the need for the commissioners of services to ensure an effective pathway for the transfer of relevant info from maternity services to health visiting services and GPs be endorsed;
(iii) Further engagement with the local community be carried out to raise awareness of the impact of FGM;
(iv) The committee support the continued provision of training by the Brent LSCB in order to support agencies with identifying and responding to FGM, including improvements with data collection;
(v) Service user feedback to service delivery and design continue to be monitored by relevant commissioners; and
(vi) Assurance be sought by the Brent LSCB from across the partnership that relevant agencies had offered the required level of training and awareness on FGM as per training guidance and key performance indicators.
Councillor Mili Patel left the meeting at 8:29 pm.