Our fight to end Female Genital Mutilation must go on

The Chief Nursing Officer for England  talks about the efforts of the NHS to tackle FGM.

Each year we mark the International Day of Zero Tolerance to Female Genital Mutilation (FGM) – but why is this still needed?

More than 125 million girls and women alive today have undergone female genital mutilation in various countries around the world, mainly in Africa, parts of the Middle East and Asia.

Everyday health professionals deal with complications and consequences for women and girls who have undergone FGM, which is the removal of all or part of a female’s genitals for no medical purpose. This often results in recurrent bladder infections, cysts, painful periods, childbirth complications and mental health conditions.

A report from City University in 2015 showed that across every local authority area in England or Wales, there are families affected by FGM. Nearly 6,000 women who had FGM were treated in NHS services during 2015-16.

As I hope you’re aware, health and social care professionals and teachers in the NHS and partner organisations have a legal duty to report under 18s with FGM to the police under the mandatory reporting duty.  We are working with partners in the police to get feedback as a result of every report made, so that there is ongoing learning.

Across England, I hear about how hard teams are working to make sure that locally, pathways and policies are updated.

Starting your work to tackle FGM takes a significant effort, but no-one needs to re-invent safeguarding procedures. FGM is child abuse, and sharing information with the police about abused children is essential.

I want to take this opportunity to tell you about one area’s journey. The Newcastle safeguarding children’s board commissioned a public health paper. Rather than focus on national statistics which can feel obscure, they looked into the detail and found how these figures related to their local population. From this, they considered local pathways. The pathway recognises different situations, and how actions need to take account of the needs of your patient. The pathway covers how and when to share information with the police, and to refer to social services.

Our ongoing work with patient groups and survivors also tells us consistently, women want you to ask questions, our patients want us to listen to them, and not to be afraid to ask questions.

Back to the work in Newcastle, another important step was to understand where services were to refer to. This includes the provision of formal healthcare, but also community and support groups.

The groups worked with the Newcastle Safeguarding Children Board (NSCB) throughout. We all know to listen to patients when developing services, but if the patient group is a minority group with potentially isolating factors, you need to be mindful that any consultative effort reaches a representative group.

The last part of the work in Newcastle I will mention was to look at the training needs of their staff. The working culture must be changed so it is understood that if as a professional you seen something which might indicate FGM, you act.

Looking over this description of the work in the North East, I hope many of you think this sounds like how we approach any of the emerging health challenges in our area. I know the NHS has the skill and sensitivity to take forward this work, and make a real impact in meeting the needs of the women who have had FGM, and safeguarding to protect our young girls from harm.

No area of England has finished the work needed on FGM, but I know that many of you are leading the way. Of course, I’ve mentioned working with partners. This too can be challenging. But my advice is to use the evidence – girls in England are at risk of this harmful abuse.

My team at NHS England is leading the FGM prevention programme. In coming months, we will publish guidance on commissioning services to meet the needs of women and girls with FGM. We will implement a new safeguarding system. We are looking at a national training strategy, and focusing on how to maintain the highest standards to ensure that all staff know what to do if they come across FGM.

This week, there are lots of events across the country and I am delighted to see real progress in all regions. Online you can now find updated safeguarding guidance, targeted to be easy to use, and advice on providing paediatric examination services. Join in online and tweet about your work to #EndFGM.

Jane Cummings

Professor Jane Cummings is the Chief Nursing Officer for England.

In this role, she is the professional lead for nurses and midwives in England and she will oversee quality improvements in patient safety and patient experience.

Follow Jane on Twitter: @JaneMCummings.

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