Forensic Medical Examination Standards

latex gloves worn to minimise contamination during a forensic medical examination

Two very pertinent documents regarding standards for forensic medical examination in cases of alleged sexual assault in England and Wales were published on 27 May 2020 by the Forensic Science Regulator (FSR).    These were developed  by our expert Julie Allard  and other experts from Principal Forensic Services (PFS), in conjunction with experts from Lime Culture CIC and the FSR’s Medical Forensics Specialist Group.The standards underwent public consultation prior to final publication in May 2020.

Examination Standards

FSR-C-116 Sexual Assault Examination: Requirements for the Assessment, Collection and Recording of Forensic Science Related Evidence
FSR-G-212 Guidance for the Assessment, Collection and Recording of Forensic Science Related Evidence in Sexual Assault Examinations

These define the codes of practice and conduct  for forensic medical examinations and detail guidance on how to achieve the required standards, providing a foundation for Sexual Assault Referral Centres (SARC) and other medical examination facilities to achieve accreditation to international standard ISO 15189. The Forensic Science Regulator has laid out the requirements for a staged implementation by all facilities between October 2020 and 2023.

The standard includes the requirements for organisation and management systems and also technical matters, encompassing:

  • personnel training and competence
  • examination room and environmental requirements
  • methods and procedures for the examination
  • evidence collection, handling, storage and transport
  • contamination minimisation, use of PPE, DNA elimination samples, decontamination and cleaning measures
  • record keeping and report

The accompanying guidance document provides detail and assistance on how to achieve the required standards. There is also a self-assessment template to guide facilities as to their readiness to meet the standards.

Benefits of the Examination Standards

The provision of dedicated high quality healthcare alongside forensic and medical examination for the collection of evidence has considerable benefits for both the health and well-being of complainants and the delivery of justice. Such services provide both the police and the complainant (patient) with the best possible opportunity to recover evidence for use within an investigation, and minimise the risk of a miscarriage of justice.

Defined standards ensure that there is confidence in the relevance of any medical findings documented during the examination and in any subsequent scientific results from the samples taken during the examination

Requirement

Sexual assault examination facilities are required to establish and maintain a quality management system that directs and controls the quality of services it provides, including appointment of a quality manager.  A quality manual is requisite which includes the provision of policies to control procedures, instructions and documentation and to provide a continual improvement process.

Forensic healthcare practitioners acting at all stages of the patient’s journey must demonstrate that they have undergone training and competency assessment and that they undertake continuing professional development to maintain their ongoing competency.

The accommodation used for the examination must meet the required standards in its layout, structure, air quality, equipment and furnishings. Cleanliness of the area is crucial  to maintain the quality of the examination and minimise the risk of contamination from DNA, body fluids and other particulate evidence.  Environmental monitoring for DNA provides evidence of effective cleaning. Single use consumables and the correct use of personal protective equipment (PPE) assist in minimising contamination.

On arrival at the facility, a crisis worker shall support the patient and explain the options available and how the examination will be conducted.  The forensic healthcare practitioner shall obtain consent from the patient and ensure their understanding before taking an initial account of the alleged assault. A record is made of other attendees such as family and supporters, in case a DNA elimination sample is required from them at a later date.

The examination process is defined in the standards, including the collection of relevant items of clothing and intimate swabs, with reference to the best practice guidelines provided by the Faculty of Forensic and Legal medicine (FFLM).

 

Please contact us if you have any queries relating to the medical examination in a sexual assault case you are dealing with. We cannot advise on medical matters but can assist with issues relating to the forensic aspects and its possible impact on the evaluation of the forensic findings.