Petals for Professionals
Introduction to FGM
If you are a young person living in the UK and want to find out more about Female Genital Mutilation (FGM) and how it might affect you or others you may know. Please follow the link 'Petals for Young People' below
Petals for Professionals is a new online resource which explains the legal responsibilities of professionals and provides information on where to get further help and advice.
In July 2015, Coventry University launched an interactive web app on FGM for young people called 'Petals'.
The purpose of the web app was to educate young people between the ages of 11 – 17 about FGM, the health and legal consequences of the procedure, the myths associated with its continuation and in particular where to go to get further advice and help. The University worked with a group of young people from the Sidney Stringer Academy in Coventry to ensure that the web app had the most appropriate tone, language and format which would appeal to young people themselves. In addition the web app had in-built privacy features to allow young people to view the web app without fear that others could trace their usage of it.
A few months later the University was commissioned by Coventry City Council to develop a web app aimed at increasing the knowledge of FGM amongst professionals such as teachers, healthcare workers, social workers and the police. Petals for Professionals is designed to give professionals the most up-to-date information in a useable format including not only the latest legislation but also a range of videos which help to bring the content to life. In particular it stresses the important role that professionals play in preventing FGM, protecting those at risk and supporting survivors of FGM. It explains the legal responsibilities of professionals and provides information on where to go to get advice, help and more information on this abuse of girls' and women's human rights.
Coventry City Council is the first local authority in the country to take a proactive approach to tackling FGM and protecting girls and young women.
Listen to "Councillor Alison Gingell", talking about the Council’s approach to FGM. Sadly Councillor Gingell passed away in 2016 and this web app is a tribute to her and her activism in tackling FGM in the City of Coventry.
We hope that this web app helps all professionals to take a more informed and pro-active approach to tackling FGM. Ultimately by working with each other and with affected communities we will eradicate FGM in this country within a generation, hopefully sooner.
According to the World Health Organisation (WHO), female genital mutilation (FGM) refers to all types of procedures that involve the "partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons" (WHO, 2000).
The practice is sometimes called female genital cutting (FGC), traditional cutting or female circumcision. The preferred term adopted by the WHO is female genital mutilation. This is because ‘mutilation’ reinforces the gravity of the harm of the practice and also reflects that it is a human rights violation.
In the UK FGM is common among some migrant communities from Africa, Asia and the Middle East. It is a cultural practice and carried out on both girls and women. The practice has no health benefits and has been found to cause many health problems, both physical and psychological.
FGM comprises a range of different procedures. Different ethnic groups perform different kinds of FGM. The WHO has classified FGM into 4 major types.
Please note the shaded red areas in the illustrations represent parts of the vagina which are removed as part of the FGM process.
This is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris). This is sometimes called a clitoridectomy.
This is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva ). This is sometimes called 'excision'.
This is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris. This is known as 'infibulation'
Images adapted from WHO (2008) classification of female genital mutilation
This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping, cauterizing and burning the genital area. This is also known as 'labia stretching/pulling'
The exact number of women and girls who have undergone FGM is unknown. However, the United Nations Children's Fund (UNICEF) estimates that more than 200 million have been subjected to the practice in 30 countries (UNICEF, 2016). These 30 countries are to be found in Africa, Asia and the Middle East. However, FGM is also practiced elsewhere, including South America, North America and Europe. It is therefore a global issue.
More than 50% of girls and women who have been subjected to FGM live in just three countries: Egypt and Ethiopia (Africa) and Indonesia (Asia).
There are ten countries where 75% of girls and women (aged 15 – 49) have had FGM performed on them, with Somalia having the highest prevalence of FGM.
|Egypt (Africa/Middle East)||87|
Understanding the countries and specific cultural groups that practise FGM is a key step to prevention, as migrants from countries where the practice still occurs, often take the practice with them to their host country.
While information about the practicing countries may help in identifying girls that are at risk of the practice, not every person that comes from these countries practises FGM. There is a high degree of ethnic diversity in practising countries and FGM may only be common among certain ethnic groups.
Due to the migration of people from FGM practising countries FGM has become a problem in the UK and other western countries.
The House of Commons Home Affairs Committee (2014) estimated that around 170,000 women and girls living in the UK have been affected by FGM, and a further 65,000 young girls are at risk each year. The true extent of the practice is unclear due to the ‘hidden’ nature of it.
FGM is most common in large cities and towns which have large migrant populations from practising countries. Cities such as London, Cardiff, Manchester, Sheffield, Northampton, Birmingham, Reading and Coventry have significant numbers of FGM survivors and girls at risk of FGM.
However 'Taking Local Action on FGM: An Essential Guide for Local Authorities’, (City University London and Equality Now 2015), states that ‘no Local authority area in England and Wales is likely to be free from FGM.'
All acute health trusts, mental health trusts and GPs in England are now legally required to collect and submit data on FGM to the Department of Health. The FGM Enhanced Information Standard requires all clinicians to record in medical notes when a patient with FGM is identified and what type of FGM it is. Data has to be submitted on a quarterly basis. The Health and Social Information Centre, working with the Department of Health, manages and publishes the data.
Guidance on the recording of FGM and the FGM Enhanced Dataset standard is available at: www.hscic.gov.uk/fgm
The December 2015 report indicates that of the cases reported in England:
It also established that the highest volume of cases reported in England were reported for girls and women born in:
The aim of the FGM Enhanced Dataset is to collect and collate more precise figures on FGM in order to best manage the needs of those who have undergone FGM and safeguard those at risk.
FGM Enhanced Datasets can be accessed at Health and Social Information Centre website:
In Wales data on FGM is collated by the FGM Lead of each Health Board.
FGM is traditionally performed by a woman with no medical training. It is usually carried out with crude instruments such as knives, scissors, scalpels, pieces of glass or razor blades, without anaesthetic and antiseptic treatments.
There is an increasing number of cases where FGM is being performed under medical conditions such as in a clinic or elsewhere by a medically trained professional. This is called ‘medicalisation’. However, regardless of how or where FGM is carried out, it is still illegal in the UK.
The majority of women and girls living with FGM in the UK were cut in their home country before they arrived in the UK. However, there are cases where girls are being subjected to FGM here in the UK or are being sent to their parents' countries of origin to have FGM performed on them, both of which are illegal under UK legislation. Girls of school age are usually subjected to FGM in the school summer holiday, so that there is sufficient time for them to recover before they return to school. Often this takes place when a girl is moving from junior to senior school (age 11). The school summer holidays are a high risk period and often termed 'the cutting season'.
Research shows that FGM poses many short and long term health risks both physical and psychological. The health consequences may occur at the time of the procedure as well as during adulthood. FGM can also have an indirect effect on the psychological wellbeing of the woman/girl's sexual partner and close family members.
All of the four types of FGM are harmful; however Type III (infibulation) causes the most serious health risks due to its severe invasiveness.
These include problems from actually being cut and problems which happen afterwards. Some of these problems are:
FGM can also cause psychological or mental health problems for girls, which may stay with them for life.
These can include:
These problems can sometimes lead to difficulties at school and college and future relationships with sexual partners. They can also cause girls to feel betrayed by their families.
FGM is illegal in the UK unless performed by a medical practitioner for 'medical reasons'.
Based on these laws, it is an offence to:
These Acts established the maximum penalty for this criminal offence as 14 years in prison, a fine or both.
As amended by the Serious Crime Act 2015 , the Female Genital Mutilation Act 2003 now also includes:
In addition FGM is covered under wider child protection and domestic violence legislation
The duty to mandatory report FGM applies to Professionals in England and Wales as follows:
The Serious Crime Act (2015) has instituted FGM Protection Orders (FGMPOs) for girls and women.
NOTE whilst the FGMPOs use the term 'girl' throughout the documentation girls and women of all ages can be protected through an FGMPO.
The purpose of FGMPOs is to:
A FGMPO can be applied for by the girl/woman who is to be protected or a third party such as professionals, local authority, family members. A Court can also make an FGMPO without application being made to it in certain family and criminal proceedings. For example a Court might put an FGMPO on a younger sister of a victim of an FGM offence which is being heard in the court.
The court 'can make an order which prohibits, requires, restricts or includes any other such terms as it considers appropriate to stop or change the behaviour or conduct of those who would seek to subject a girl to FGM or have already arranged for, or committed FGM.', (Multi-Agency Statutory Guidance on FGM, HM Government, 2016, page 21)
Examples of the types of FGMPO that might be made include:
The breach of an FGMPO is a criminal offence with a maximum of 5 years imprisonment; or as a civil breach (contempt of court) punishable by up to two years in prison.
FGMPOs can be applied for online using the following website:
If a girl/woman is applying on her own behalf she must complete form FGM001.
If you are applying for an FGMPO for somebody else you will need to complete form FGM006.
Whilst the FGMPO is the responsibility of the police to enforce, all relevant professionals need to work closely together with the girl or woman who is to be protected to ensure the relevant support services are in place and the level of protection is adequate.
As part of performing their safeguarding role, professionals need to be alert to identify situations where a girl may be at risk of FGM or has undergone the practice already. This is needed both for prevention and provision of support to victims.
The Multi-agency Statutory Guidance on FGM (HM Government, 2016) lists a number of principles that professionals need to adhere to in relation to identifying and responding to those at risk, or who have undergone FGM, and their parents and guardians:
A range of indicators exist that would suggest that FGM has taken place or is about to take place. These indicators may not mean much when they occur individually, but may be significant if one or more occur at the same time.
A girl may be generally at risk of FGM if:
In addition to general risk factors there may also be potential risk factors including:
Professionals should complete the in depth risk assessment found on their local Safeguarding Children's Board Website or the BAFGM website. The completed assessment should then be sent to the MASH (multi agency safeguarding hub) Team for discussion and possible response. The MASH may make a referral to the Information Advice and Support Service (IASS) for strategy discussions with the police and coordinated Children's Services.
These indicators suggest that FGM may be about to happen:
If risk of harm is imminent, emergency measures need to be implemented immediately to protect the girl. This will require reporting suspicions to the Police using 999. They will consult with the UK Border Agency and Children's Services. A protection plan will be agreed and actioned.
These indicators suggest that FGM may have already been performed on a girl/woman.
Professionals subject to Mandatory Reporting requirements must report suspected cases of FGM in girls under18 years old to the police.
The Department of Health has recently issued a detailed risk assessment tool and guidance regarding FGM and safeguarding to be used to assess the risk of FGM on girls and women. This can be found in the following document:
Department of Health, 2015, Female Genital Mutilation Risk and Safeguarding: Guidance for professionals.
This is designed for health professionals and includes a risk assessment of pregnant women, non-pregnant women over the age of 18 years and girls under the age of 18.
The legislation requires regulated health and social care professionals and teachers in England and Wales to make a report to the police where, in the course of their professional duties, they either:
Under the Serious Crime Act (2015) regulated professionals have a legal duty to contribute to protecting girls from FGM. These responsibilities are spelt out in both the specific FGM legislation and wider child safeguarding guidelines.
The Serious Crime Act 2015 requires professionals employed in regulated professions in the UK to make an immediate report to the police if they encounter a 'known case' of FGM in the course of their work. These professionals include teachers, health care professionals and social workers. This came into force on 31st October 2015.
The Serious Crime Act (2015) states that this mandatory report:
NOTE: the report must be made DIRECTLY to the police rather than to social care.
This mandatory reporting applies to FGM cases where:
The reporting obligation does not give professionals the mandate to perform any physical examination on the girl to ascertain if FGM has occurred if that is not already part of their job. For example, while healthcare professionals may undertake physical examination of girls through which FGM may be discovered, social workers and teachers may not. These professionals are only required to ‘pass on’ their ‘suspicion’ to the police for further investigation.
Professionals who fail to comply with mandatory reporting and safeguarding procedures may face disciplinary action from their professional regulator. This may include recommendations for retraining, suspension, supervision and dismissal from the profession or the withdrawal of a licence to practice.
The Multi-agency Statutory Guidance on FGM (HM Government, 2016) states very clearly:
'FGM is child abuse, and employers and the professional regulators are expected to pay due regard to the seriousness of breaches of the duty.' (page 25)
Under the Serious Crime Act (2015) teachers, health care professionals and social workers, are legally required to follow specific guidelines for reporting known cases of FGM in girls under the age of 18 to the police.
In the event that a professional needs to report that they suspect that a girl under 18 years has undergone FGM they must do the following:
After the report, the police are expected to initiate a multi-agency response which will consider measures that will be needed to protect the girl and provide her with the support she needs.
The FGM Mandatory Reporting Process Map is shown below:
[www] Source: Mandatory Reporting of Female Genital Mutilation – procedural information | www.gov.uk/government/uploads/system/uploads/attachment_data/file/469448/FGM-Mandatory-Reporting-procedural-info-FINAL.pdf
Information on mandatory reporting and how to make a report can be found here:
Additional information for healthcare professionals in England can be found here:
FGM is a complex practice motivated by a range of different factors. While the motives for the practice may vary from one ethnicity to another, they are mostly underpinned by cultural and religious myths. FGM is a social norm that is followed and enforced by communities with little or no questioning.
[www] View Factors promoting and hindering the practice of female genital mutilation/cutting (FGM/C) | www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwiyn6yi-vfMAhWIF8AKHWybBUAQFggkMAA&url=http%3A%2F%2Fwww.kunnskapssenteret.no%2Fpublikasjoner%2F_attachment%2F166681%3F_ts%3D14853c1a917%26download%3Dfalse&usg=AFQjCNF78vodTFx7fcUh_7LwwBDxpf3aMg
In a systematic review of 25 studies of the factors promoting and hindering FGM in Western countries, Berg et al (2010) concluded that there is 'an intricate web of cultural, social, religious and medical pretexts for FGM/C'.
One of the reasons most commonly used to support FGM is that it helps to control girls'/women's sexuality and enables them to maintain their virginity prior to marriage. For example, it is believed that the excision of the clitoris reduces a girl's libido and thus prevents her from being involved in sex before marriage and in extra martial sexual relations. The covering of the virginal opening through infibulation (Type III) is designed to cause pain during sex, which will discourage girls enjoying sex before marriage. At the time of marriage the bride is commonly opened up (cut open) to allow sexual intercourse by the groom.
Marriageability is an important factor in perpetuating the practice of FGM. Girls who have undergone FGM and are able to maintain their virginity are well respected in their communities. Parents believe that having their daughters cut (and thus preserving their virginity) gives them better prospects of finding a husband from a 'good' family.
Parents are also motivated by the community respect derived from subjecting their daughters to FGM. They are seen as responsible parents, with virtuous daughters who are adhering to the traditions of their home country.
FGM can also be underpinned by religious motives. It has been found to be common among Muslims, Christians and orthodox Jews. However, FGM has no religious basis and no religious script has been found to support it. Some families believe that FGM makes girls purer and that it is required by religion. For example, some Muslims believe that FGM is an approved practice of the Prophet Mohammed, so they call it 'sunna' and perform it to gain religious reward.
In some cultures FGM is seen as an ideal for femininity and modesty. For example in some cultures the clitoris is considered as a masculine organ that needs to be cut to make a woman feminine. In contrast, women who have not undergone FGM are regarded as unfeminine.
In many communities girls are not accorded the privileges of womanhood if they have not undergone FGM. FGM is considered as a rite of passage through which girls learn to become good wives and mothers. Women who have not undergone FGM are stigmatised and excluded from social events such as naming ceremonies, weddings and funerals and are prohibited from eating with the rest of the community.
FGM is also associated with cleansing. Some believe the clitoris produces an offensive discharge and produces bad smells. The Arabic word for FGM is 'tahur', which literally means purity and cleanliness. It is believed that if a woman has not undergone infibulation, air will enter through her vagina and cause an infection.
Most people in the UK who practise FGM think that it is a cultural tradition which must be followed at all costs. It is seen as an identity marker, which defines their religious and cultural identity. Some people fear that not practising FGM will lead to them being accused of abandoning their culture.
"Now that you know, say NO to FGM" - Professionals
FGM is a social norm and enforced through social mechanisms. Both girls and parents are faced with social pressures to conform. Such pressures emanate from both the migrant/diaspora community as well as relatives in the parents' country of origin.
The pressures that enforce FGM take the form of subtle rewards and punishments.
At the household level FGM is enforced by the girl's parents and extended family including grandparents, uncles and aunts. Mothers and grandmothers are particularly influential in facilitating the process for a girl to undergo FGM. However husbands and fathers have the final say in whether FGM should be performed by providing the resources needed for the FGM procedure and accompanying ceremony and gifts.
Although extended family members often live in the country of origin, they can still be influential in persuading families who live in the UK to subject their girls to FGM. The influence is transmitted through regular communication via telephone and social media as well as visits between family members.
Men often deny their role in FGM, and call it 'a woman's affair'; yet they are very influential in promoting the practice. The father finances the practice and as head of the household wields the final approval for his daughter to be subjected to FGM. Men also enforce FGM through only marrying women who have undergone FGM.
At the community level, FGM is enforced by support from some religious leaders, traditional advisors and revered older people. Peer influence can also be a strong enforcement factor, especially where the girls' peers have undergone FGM or friends of the girl's parents have subjected their daughter(s) to the practice.
Families are motivated to subject their daughters to FGM by the prospects of marrying a man from a 'good' family, as well as respect and privileges from the community. In many migrant communities girls/women who fail to undergo FGM are stigmatised and seen as prostitutes. Being ostracised by one's extended family and community can be a big incentive to conform, as this quotation demonstrates:
"Even when parents recognise that FGM/C can cause serious harm, the practice persists because they fear moral judgements and social sanctions should they decide to break with society's expectations. Parents often believe that continuing FGM/C is a lesser harm than dealing with these negative repercussions."
"The Silent Scream", a short film made by Integrate Bristol tells the story of Yasmin who is trying to persuade her mother not to put her younger sister through FGM.
More and more survivors of FGM are standing up and speaking out against FGM. Speaking out takes courage. In the video clips below, women share their experience of FGM and how it has affected their lives.
"Ifrah Ahmed" Ifrah was born in Somalia but now lives in Ireland. In this video clip she talks about FGM.
"Hoda Ali" This is a video of Hoda talking about her FGM experience at a conference in Coventry in November 2014.
Many boys and men in the UK do not really understand what FGM is and how it affects girls and women. Once they are made aware, many are shocked and start to speak out against FGM and are joining campaigns to end it.
"Fadel Takrouri" Fadel Takrouri, Chair, British Arab Federation talking about FGM.
"Now that you know, say NO to FGM" Is a short film made by a group of young men. The aim of the film is to tell young men about FGM and what men can do to stop it happening.
"Charlie" A student from Sierra Leone talks about FGM.
The delivery of appropriate prevention and support activities requires that professionals engage with FGM victims and affected communities effectively. Much of this will depend on the manner in which the professional communicates and interacts with the affected person, their family and wider community. Good communication skills are essential in conducting conversations with girls/women who have had FGM, are at risk of FGM or people who are affected by FGM.
The Department of Health (FGM: Multi-agency practice guidelines) recommends that when speaking to a girl or woman at risk of FGM or who has undergone FGM the following protocols should be followed:
The Home Office (H M Government 2016) state that there are three key standards in conducting a conversation concerning FGM in a sensitive and appropriate way:
Professionals may find FGM an awkward subject to discuss because they fear coming across as culturally insensitive. However, professionals are encouraged to be proactive in initiating conversations about FGM with individuals who are affected by, or are at risk of the practice. It is through such conversations that potential cases can be identified and prevented.
There are a number of considerations that professionals must consider when initiating a conversation with a girl or woman affected by FGM.
Create an opportunity for her to talk. Use welcoming and friendly body language. Ensure she is happy talking to you and if she needs an interpreter. Give her time to talk - she will be nervous and this may be the first time she has ever spoken about FGM.
Maintain a professional approach and explain your role, authority and responsibility. Explain why it is important to ask the questions you are asking.
Do not assume anything based on the girl's/woman's appearance, cultural and religious background. Keep an open mind, listen carefully and record all the information you need to make a good assessment of the case. Remember if she has undergone FGM she is not a criminal, but a victim.
You must point out that FGM is illegal in the UK and explore the health effects of the practice, but do not blame the girl/ woman.
Avoid technical or medical terminology or jargon. Use straight forward questions. For example, in probing whether they have undergone FGM, you may ask them direct questions such as:
You may also use leading questions such as:
Assure her that confidentiality will be maintained. Explain the limits of confidentiality, including the fact that information disclosure may become necessary in order to provide her support services and referrals to Well Women Clinics.
In some cases she may be concerned that using an interpreter will compromise her privacy and confidentiality. It is therefore recommended that an interpreter does not come from the same community. It is recommended that professional interpreters are used. Use telephone interpreters if possible. Interpretation should be verbatim and the girl's/woman's name should be anonymised.
Discuss with her the legal implications of FGM as well as the health consequences. If she is pregnant or has daughters then the legal situation must be clearly spelt out to her, with appropriate reading material for her to take away and read/share with her family.
Assess to see what support she may need and signpost her accordingly.
Avoid using judgemental terms such as female genital mutilation as this can create a sense of prejudice and stigmatisation. Instead use neutral terms such as female circumcision, female cutting. If possible use the local terminology such as 'sunna' that is used to describe FGM in her community. This will help build trust and respect with her.
The table below provides examples of some terms used for describing FGM among FGM affected communities in the UK.
|Country||Term used for FGM||Language|
|CHAD – The Ngama||Bagne|
|Guinea-Bissau||Fanadu di Mindjer||Kriolu|
Kutairi was ichana
Didabe fun omobirin/ ila kiko fun omobirin
Source: Multi-agency Statutory Guidance on FGM (HM Government, 2016, page 71)
It is worth noting that FGM does not only affect women and girls who have undergone the practice but also their siblings, parents, grandparents and sexual partners. Hence, in some cases the professional will have to involve such individuals in conversations about FGM particularly if they believe a girl is at risk of FGM.
Professionals must always remember that:
FGM can have a serious detrimental impact on girls' educational development. It can lead to poor performance and withdrawal due to the physical and psychological consequences of the practice. As FGM is likely to be performed on young girls who are still in school, teachers have a special responsibility and opportunity to prevent it.
Under the Serious Crime Act (2015) teachers have a responsibility to report FGM cases on children under the age of 18 that they find during the course of their work. They are also bound by wider child safeguarding laws and professional standards to protect girls from FGM. The DoE document on ‘Keeping Children Safe in Education' (2015) provides guidance for teachers, schools and colleges for safeguarding children.
The following measures can be adopted by schools, colleges and their teaching staff to minimise the risk of FGM.
Girls are most at risk of FGM during the long summer holidays, when they may be sent abroad for the procedure or will have it done here in the UK. Hence, teachers should be particularly vigilant in the days leading up to the summer holiday so that they can identify girls who may be at risk.
In the event that a girl is found or suspected to be at significant risk of FGM, as a teacher you should do the following:
When a girl from an FGM practising community stops attending school it may be an indication that FGM is imminent or has occurred. Teachers can take the following steps to safeguard the girl.
Teachers should do the following if they find that a girl has undergone FGM.
Remember that she might not want to be referred. However it is important to explain to her the need for such support.
FGM is child abuse and gender-based violence; therefore social workers are more likely than any other professional to encounter FGM on a regular basis. All local authorities in the UK have multi-agency policies and procedures for handling child safeguarding issues. Social workers should use this as a general guide for dealing with FGM cases involving children.
In addition, the Home Office documents on ‘Working Together to Safeguard Children (2013) and Safeguarding Children: Working Together Under the Children's Act 2004' are useful guides that social workers in England and Wales should refer to concerning FGM.
As social workers you are likely to receive referrals on FGM cases from other professionals such as teachers, the police and healthcare professionals. You are likely to also come across new cases during your normal work duties. These will be cases where a girl or a woman is at risk or has already undergone FGM.
Whatever the case may be it is important to respond appropriately in order to safeguard the welfare of the girl/woman.
Healthcare professionals have an important responsibility in supporting FGM victims. Due to the nature of their work, they are able to identify FGM cases, especially through routine check-ups of girls and women, and during delivery. A vaccination request for a girl to visit an FGM practising country should raise suspicion that FGM might be about to occur.
Healthcare workers have four general responsibilities when they encounter FGM in the course of their work:
FGM cases involving adults are considered as domestic violence. Therefore, healthcare professionals are not required to report this to the police and/or social services due to patient confidentiality. However, if you find the need to report the case make sure you obtain the explicit consent of the victim before you do so.
" Dr Abdullah Shehu ", Consultant Neurologist at University Hospital Coventry and Warwickshire talks about FGM
Healthcare professionals should complete the FGM Risk Indication System (FGM RIS). This is a national IT system for health that allows clinicians across England to note on a girl's record within the NHS Summary Care Record application that they are potentially at risk of FGM. This allows the potential risk of FGM to be shared confidentially with health professionals across all care settings until a girl is 18 years old.
If a girl is identified as being at risk of FGM, the FGM risk indicator should be added to the system following completion of an FGM risk assessment (see Department of Health, 2015, FGM risk and safeguarding guidance for professionals.)
The FGM RIS should be used in conjunction with local safeguarding frameworks and processes.
Only authorised health professionals with the relevant security permissions on their NHS Smartcard are able to access the FGM RIS. The main groups of health professionals most likely to use the system are GPs, practice nurses, midwives, school nurses, safeguarding specialists and health visitors. It can also be viewed by clinicians working in NHS travel centres, acute trusts, mental health trusts, minor injury units and A & E.
Healthcare professionals can also contribute to the prevention of FGM by doing the following:
FGM is a criminal offence and therefore police officers have a special responsibility to prevent, investigate and prosecute cases involving FGM. In dealing with FGM police officers are recommended to follow national and local police guidance for safeguarding and child abuse investigations.
FGM is a cultural practice and therefore needs to be approached with great sensitivity in order to engage effectively with the victim, their family and practising community.
Most cases of FGM that the police deal with will be the result of a Mandatory Report from other professionals or the general public for an action to be taken. This will mostly involve a girl/woman who is at risk or has recently undergone FGM.
"Detective Inspector Nathan Percival" of Greater Manchester Police speaks on International Day of Zero Tolerance for Female Genital Mutilation.
Police officers should refer to the College of Policing's Authorised professional practice on FGM which includes guidance on prevention, protection and evidence collecting in cases of FGM.
The strategy should among other things consider the following:
This should consider the following:
If you think the girl is at imminent risk of FGM then you must speak to your local police child protection officer or ring 999. If you do not think the girl is at imminent risk you must report your suspicions to your safeguarding lead.
You should access your local LSCB website.
No, as this could put her in imminent danger of FGM or of removal from the UK for the purpose of FGM. Get advice from your safeguarding lead for guidance. If you think the girl is at imminent risk of FGM then you must contact your local police child protection officer or ring 999.
[www] HM Government (2014) Multi-Agency Practice Guidelines: Female Genital Mutilation | webarchive.nationalarchives.gov.uk/+/http://www.isb.nhs.uk/documents/isb-1610/amd-01-2014/1610012014mapguid.pdf
[www] Mandatory Reporting of Female Genital Mutilation: Procedural Information | www.gov.uk/government/uploads/system/uploads/attachment_data/file/469448/FGM-Mandatory-Reporting-procedural-info-FINAL.pdf
[www] Department of Health (2015) Female Genital mutilation: Risk and safeguarding – guidance for professionals. | www.gov.uk/government/uploads/system/uploads/attachment_data/file/525390/FGM_safeguarding_report_A.pdf
[www] Home Office (2015) Mandatory Reporting of Female Genital Mutilation:Procedural Information | www.gov.uk/government/publications/mandatory-reporting-of-female-genital-mutilation-procedural-information
Integrate Bristol is a charity that works towards equality and integration. They have produced educational resources around FGM to use in schools.
[www] Working Together Under the Children’s Act 2004 (2004) - Wales | www.wales.nhs.uk/sitesplus/documents/863/Safeguarding%20Children%20Working%20Together%20under%20the%20Children%20Act%202004%20%282006%29.pdf
Also known as 'Health Passport' which sets out the law on FGM and sources of help and support. Available in 11 languages.
[www] College of Policing (2015) Authorised professional practice: female genital mutilation. | www.app.college.police.uk/app-content/major-investigation-and-public-protection/female-genital-mutilation/
Case studies, links to organisations and resources to support local work to tackle FGM
[www] Welsh Government, Live fear free: training on domestic abuse, sexual violence and violence against women. | livefearfree.gov.wales/guidance-for-professionals/national-training-framework/?lang=en
[www] Macfarlane, A & E. Dorkenoo (2015) Prevalence of female genital mutilation in England and Wales: National and local estimates. London, City University London and Equality Now | openaccess.city.ac.uk/12382/
The National FGM Centre is a partnership between Barnardo's and the Local Government Association. It aims to end new cases of FGM for women and girls living in England within the next 15 years, (LGA)
Birmingham Against Female Genital Mutilation seeks to lead and co-ordinate multi-agency activity to prevent the practice of FGM; to protect girls from FGM and to address the physical, psychological and emotional health and support needs of women and girls who have undergone FGM. There are lots of resources on their website.