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 and Executive Director at NHS England.

Jane specialised in emergency care and has held a wide variety of roles across the NHS including Director of Commissioning, Director of Nursing and Deputy Chief Executive.

In February 2004, she became the national lead for emergency care agreeing and implementing the 98% operational standard. She has also worked as the nursing advisor for emergency care. In January 2005, she was appointed as the National Implementation Director for ‘Choice’ and ‘Choose and Book’.

Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance as well as QIPP, commissioning and for a time Deputy Chief Executive Officer. In October 2011, she was appointed to the role of Chief Nurse for the North of England SHA Cluster.

She was appointed as Chief Nursing Officer for England in March 2012 and started full time in June 2012. Jane is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December 2012, followed by publishing the ‘Leading Change, Adding Value’ framework in May 2016.

Jane has executive oversight of maternity, patient experience, learning disability and, in January 2016, became executive lead for Patient and Public Participation.

She was awarded Doctorates by Edge Hill University and by Bucks New University, and she is a visiting professor at Kingston University and St George’s University, London.

She is also Director and trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses.

Follow Jane on Twitter: @JaneMCummings.

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One comment

  1. ACCAF says:

    keep up the good work there is indeed a need to revise the medical curriculum in matters FGM/C treatment and care as most of the health workers do not know how to handle and care for those affected.