NHS Standard Contract for Community Services
SERVICE SPECIFICATION
Service / SEXUAL ASSAULT REFERRAL CENTRE (SARC)Commissioning Organisation / PORTSMOUTH CITY TEACHING PRIMARY CARE TRUST
Commissioner Lead / Innes Richens
Director of Strategy and System Management
Trust Head Quarters
St James’ Hospital
Southsea
PO4 8LD
(023 92684832
*
Provider Lead / Mary Bridgman
SARC Manager
The Treetops Centre
Northern Road
Cosham
Portsmouth
PO6 3EP
( 023 9263 0343
*
Period / 1st April 2009- 31st March 2010
1. Purpose
1.1 Aims
The SARC will:
· Ensure the best possible care of the client to minimise the risk of further harm, physical and mental health issues and to promote recovery
· Facilitate forensic examination so that evidence can be collected for use in the investigation of crime should the client choose
· Promote partnership working at all levels; throughout Hampshire and the Isle of Wight and nationally to assist with providing best practice and best value
· Provide a centre of excellence which places client care and quality of service at the heart of its work
1.2 Evidence Base
The Treetops Sexual Assult Referral Centre (SARC) is one of only 22 SARCs nationally and the only SARC for Hampshire and the Isle of Wight. The Home Office states in “Saving Lives, Reducing Harm, Protecting the Public”, an Action Plan to tackle violence 2008-2011, that they wish to more than double the current number of SARCS across the country.
The Treetops SARC is regularly visited by other agencies from around the country looking to develop good practice whilst developing their new SARCs.
The service operates within the Standards for Better Health framework and the requirements of the criminal justice system.
1.3 General Overview
The SARC exists to provide a comprehensive service to people who have experienced rape or serious sexual assault, primarily for residents of Hampshire and the Isle of Wight but is available to anyone aged 13 and over, male or female, who has been a victim of rape and/or serious sexual assault in Hampshire and the Isle of Wight.
1.4 Objectives
· Create a supportive environment for clients
· Avoid delays in attendance by a forensic medical examiner (FME)
· Aim to provide a team of all female doctors
· Address inconsistencies in evidence gathering
· Address the issue of medical follow up and support
· Address the issue of variable co-ordination between agencies that can be to the detriment of the client and/or the progression of criminal proceedings
1.5 Expected Outcomes
The Service complies with the National Minimum Standards for SARCs and is delivered to the following quality standards:
· An FME will be available 24 hours a day, 365 days per year
· For all clients requiring a forensic medical examination an FME will be available at the Treetops Centre within 1 hour of being called
· Statements requested by police from FMEs and project workers will be completed within 10 working days
· Clients who have requested follow-up contact will be contacted by a project worker or the Young Person’s Worker within 72 hours
Quality standards
Forensic Medical Examiners will work to quality standards and guidelines in accordance with the Faculty of Forensic and Legal Medicine. The provider will operate within the Standards for Better Health framework.
2. Scope
2.1 Service Description
Portsmouth City teaching Primary Care Trust (Provider Services) provide the SARC for Hampshire and the Isle of Wight situated in the Treetops Centre at Cosham, Portsmouth. The service is primarily for residents of Hampshire and the Isle of Wight but is available to anyone, male or female, age 13 years or over who has been a victim of rape and/or serious sexual assault in Hampshire and the Isle of Wight.
The SARC Centre Manager is employed by Portsmouth City teaching PCT (Provider Services), together with a Young Persons Worker and Administrative/Database support worker. Project workers are employed by Portsmouth City Council. Hampshire Constabulary provides funding for the Forensic Medical Examiners, who are overseen by the Clinical Director.
2.2 Accessibility / Acceptability
The service is available 24 hours, 7 days a week for forensic medical examinations of acute referrals. Project workers are available on site between the hours of 0800-1800 to receive clients. During the hours 1800-0800 an on-call service is available via Hampshire Constabulary and the project workers.
The service will be open between the hours of 0800 hours until 1800 hours, when project workers will be available on site for:
· historic referrals (when an incident of rape or sexual assault has occurred more than 14 days prior to presentation at the SARC),
· self referrals who do not wish to report to the police
2.3 Whole System Relationships
The Hampshire and Isle of Wight SARC is a partnership between Portsmouth City tPCT, Hampshire Constabulary and Portsmouth City Council. In addition the SARC has close relationships with the CPS and the voluntary sector. Joint training days are held allowing all agencies to network, co-operate and understand and respect the role of other agencies.
2.4 Interdependencies
The three main partner agencies of the SARC are interdependent, and in addition close working relationships ensure all agencies involved in the SARC are part of the SARC team.
2.5 Relevant networks and screening programmes
National SARC Steering Group
Regional SARC Steering Group
SARC Management Board
SARC Management Group
SARC Provider Service Review
2.6 Sub-contractors
Forensic cleaning and general cleaning are undertaken by sub-contractors
Maclelland will undertake the cleaning of the Unit, apart from the forensic examination room and shower.
The SARC Manager will undertake regular monitoring of the services provided. Problems or issues regarding the service will be fed back to the Maclelland supervisor and/or the Portsmouth City tPCT Contracts Manager.
Rattue will forensically clean the forensic examination room and shower after completion of each forensic examination. The project worker on duty is responsible for calling the forensic cleaner on the number provided immediately the forensic examination is finished, in accordance with the agreed Forensic Cleaning Protocol.
It is acknowledged that the forensic cleaning schedule may take approximately 1 -1.5 hours, depending upon the cleaning regime used.
The SARC Manager will undertake regular monitoring of the services provided. Problems or issues regarding the service will be fed back to the Rattue supervisor or the Hampshire Constabulary Contracts Manager.
3. Service Delivery
3.1 Service Model
3.1.1 Forensic examination with police involvement.
· This may be via police referrals.
· Self referrals or via a third party - centre staff can contact police on behalf of the client and arrange for the police to meet with the client at the SARC.
3.1.2 Self referral with forensic examination.
A forensic examination is undertaken, without police referral at the client’s request. The Forensic Medical Examiner (FME) will assess the immediate medical needs of the client and decide on which forensic samples need to be taken. The client does not wish to have contact with the police at that time, but would like to have a forensic examination and to hand over the samples and/or intelligence anonymously to the police for DNA investigation and link crime investigation. The evidence will be stored securely in a room kept locked, with restricted access, and the key secured in a key safe, while the client decides how best to proceed. Clients can choose to be contacted with the results.
3.1.3 Intelligence Only
The client chooses to pass on only intelligence to the police.
3.1.4 Police referral without forensic examination
A forensic examination is not carried out; the client is seeking support following an experience of rape, sexual assault that may also involve domestic violence.
The Centre will provide advocacy support and signposting to clients who have experienced rape or sexual assault. The Centre will provide information of other resources available to the client.
3.1.5 Support and advocacy only
The client is seeking support following an experience of rape or sexual assault. The client does not wish to have any forensic or criminal justice involvement but will be supported by the EIP workers and medical arranged if required.
3.1.6 SOIT Clinic
A Sexual Offence Investigation Trained Officer (SOIT) from Hampshire Constabulary is available to speak to clients who have not reported to the police, and wish to have the criminal justice process explained to them in more detail by a police officer.
3.2 Care Pathways
Guiding Principles
· The physical and emotional welfare of the client is paramount
· Clients will be treated with respect, dignity and support and advocacy will be offered whether or not a client requires forensic or criminal justice intervention
· Each client should be viewed in an individual, holistic manner
· At no time should the collection of trace or corroboration evidence take precedence over the client’s wishes and need for medical treatment
SARC Pro Forma
Each client who attends the SARC is given a Unique Reference Number and will have the relevant SARC form completed enabling the care pathway to be documented.
· PR1 – police referral with medical
· PR2 – police referral without medical
· SR1 – self referral with medical
· SR2 – self referral without medical
4. Referral, Access and Acceptance Criteria
4.1 Geographic Coverage/Boundaries
The service is primarily for residents of Hampshire and the Isle of Wight but is available to anyone age 13 years and over, male or female, who has been a victim of rape and/or serious sexual assault in Hampshire and the Isle of Wight.
4.2 Location(s) of Service Delivery
The SARC for Hampshire and the Isle of Wight is situated in the Treetops Centre at Cosham, Portsmouth.
If a high volume of calls is reported at one time, consideration can be given to using a standby forensic medical room and interview suite that is available at Havant. This would be in exceptional circumstances and is primarily available for business continuity.
4.3 Days/Hours of Operation
The service is available 24 hours, 7 days a week for forensic medical examinations of acute referrals. Project workers will be available on site between the hours of 0800-1800 to receive clients. During the hours 1800-0800 an on-call service is available via Hampshire Constabulary and the project workers.
4.4 Referral Criteria & Sources
The service is primarily for residents of Hampshire and the Isle of Wight but is available to anyone, male or female, aged 13 years and over who has been a victim of rape and/or serious sexual assault in Hampshire and the Isle of Wight.
4.5 Referral Route
· Forensic examination with police involvement
· Self referral with forensic examination
· Intelligence Only
· Police referral without forensic examination
· Support and advocacy only
· SOIT Clinic
·
4.6 Exclusion Criteria
The service is not available to young people under the age of 13 years.
4.7 Response Time & Detail and Prioritisation
· Police referral with medical
· Self referral with medical
· Police referral without medical
· Self referral without medical
Forensic medical examinations are undertaken in accordance with the Guidelines from the Forensic Science Service and the Faculty of Forensic Medicine, maximum forensic recovery period being 7 to 10 days. A Forensic Medical Examiner (FME) will see a client within 1 hour of the request/as agreed within the investigative process.
5. Discharge Criteria & Planning
· Information packs are available for clients on leaving the Centre
· The Young Persons worker will undertake follow up with clients aged 13-18 and in some cases up to the age of 24 across Hampshire and the Isle of Wight
· The project workers (PCC) will undertake a follow up call within 72 hours and continue to work with clients aged 16+ from the Portsmouth City area
· Clients will be referred to relevant services throughout Hampshire and the Isle of Wight (e.g. Rape Crisis)
6. Self-Care and Patient and Carer Information
· Adult Information Packs
· Young People Information Packs
7. Quality and Performance Standards
The provider will achieve the quality indicators included within the main NHS Contract for Community Services, as agreed by Commissioners, plus the service specific indicators attached as Appendix One.
Quality Performance Indicator / Threshold / Method of Measurement / Consequence of Breach / Report Due
Infection control
Service User Experience
Improving Service Users & Carers Experience
Reducing Inequalities
Reducing Barriers
Improving Productivity
Access
Care Management
Outcomes
Additional Measures for Block Contracts:
Staff turnover rates
Sickness rates
Agency and bank spend
Contacts per FTE
8. Activity (Refer to SLA Activity and Finance Schedule)
Quality Performance Indicator / Threshold / Method of Measurement / Consequence of Breach / Report Due
Refer to SLA schedule
Activity Plan
9. Continual Service Improvement Plan
10. Prices & Cost (Refer to SLA Activity and Finance Schedule)
10.1 Price
Basis of contract / Unit of Measurement / Price / Thresholds / Expected Annual Contract Value
Block/cost & volume/cost per case/Other * / £ / £
Total / £ / £
* delete as appropriate
10.2 Cost of Service by CommissionerTotal Cost of Service / Co-ordinating PCT Total / Associate PCT Total / Associate PCT Total / Associate PCT Total / Total Annual Expected Cost
£ / £ / £ / £ / £ / £
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Appendix 1
KEY PERFORMANCE INDICATORS – Sexual Assault Referral Centre
KPI / Indicator / Threshold / Rationale / Description / Comments & LinksKPI 1 / Infection control / Forensic medical room forensically cleaned and sealed after each client. Deep clean undertaken every month. / 6 monthly de-contamination check/swabs sent to Forensic Science Service.
Exceptions reported to the Service Review. / Exceptions reported quarterly at Service Reviews
KPI2 / Service User Experience / All clients will be given a Victim Satisfaction Card to complete; returned cards to be evaluated and an action plan drawn up. / Report presented once a year; action plan reviewed/ refreshed after six months. / Annually at Service Review
KPI 3 / Improving Productivity / Statements requested by police from FMEs and project workers will be completed within 10 working days. / Nos. statements requested; nos. and % completed within 10 working days.
Exception reporting for non-achievement of 100% target / Quarterly at Commissioning Service Reviews
KPI 4 / Care Management / Clients who have requested follow-up contact by the either a Project Worker or the Young Persons Worker will be contacted within 72 hours. / Nos. of clients requesting contact by Project Worker or YPW; nos. and % contacted within 72 hours; reasons for any non-achievement of 100% target.
Report split by Project Worker and Young Persons Worker; monthly breakdown. / Quarterly at Commissioning Service Reviews
KPI 5 / Access / An FME will be available 24 hours a day, 365 days of the year
For all clients requiring a forensic medical examination, the FME will be available to undertake the examination at the Treetops SARC within 1 hour of being called out. / Nos. of FME callouts; nos. and % where FME arrived within 1 hr of being called to attend.
Exceptions reporting for non-achievement of either target. / Quarterly at Commissioning Service Reviews
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