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Medical forensics specialist group minutes: 2 September 2019

Updated 5 July 2022

Minutes of the ninth meeting held on 2 September 2019, at 5 St Philip’s Place, Colmore Row, Birmingham

1. Welcome and introductions

1.1. The Chair welcomed all to the meeting. See Annex A for a list of representatives present.

2. Minutes from previous meeting and update on actions

2.1. The minutes of the previous meeting held on 05 June 2019 had been approved by members prior to the meeting and were published on the GOV.UK website.

2.2. Action 1: FSRU to arrange a meeting with UKAS, CQC and the NHS to discuss what should be included within the workshops and source suitable dates and venues. This would be discussed in the meeting under agenda item 8.

2.3. Action 2: FSRU to itemise the main costs for SARCs and liaise with the group to confirm certain costs. This would be discussed in the meeting under agenda item 9.

2.4. Action 5: Members to email nominations for the new MFSG chair. It was confirmed a new chair had been appointed to chair the MFSG. The new chair will start at the next meeting on 27 January 2020. The Regulator expressed her thanks to the current chair, and the contributions they have made to the MFSG.

2.5. Action 7: The Regulator to contact the AFSP regarding cleaning products that had been validated. This action is on-going.

2.6. Action 9: The Regulator and FSRU to provide further clarification on whether notes of injuries come under the medical or forensic remit. It was confirmed notes of injuries that were included within the contemporaneous notes that could be used as evidence should be within the remit of the FSR. A member mentioned often medical notes and forensic notes were not reviewed together during inspections, and this could result in missing any medical reasons for injuries. The UKAS representative stated the assessors would need to be appropriately trained.

Action 1: FSRU to review wording in Standard and Guidance on contemporaneous notes.

2.7. All actions from the last meeting were complete or were in progress.

3. MFSG Work plan 2019/2020

3.1. A draft version of the MFSG work programme for 2019-2020 was discussed by the group. The members agreed the milestone dates for the SARC guidance document, and SARC standard document were achievable. Members agreed the DNA anti-contamination document (FSR-G-207) required a thorough review, and more information should be added. It was suggested a working group should be formed to progress this work. The chair asked for volunteers to join the DNA anti-contamination working group. Representatives from Mountain Healthcare, Hampshire Constabulary, RCPCH & FFLM paediatric and UKAS agreed to be part of the group. It was agreed two meetings would be required.

Action 2: FSRU to set up sub group for reviewing G-207 (Anti-contamination guidance)

3.2. The MFSG would start to develop the standard and guidance for custody suites in spring 2020. The Hampshire Constabulary representatives mentioned to the group they were undertaking a custody suite project and would be happy to update the group on the progress of their project.

4. Review of document/feedback SARC standard (FSR-C-116)

4.1. The FSR-C-116 standard document had been sent out for consultation to the medical forensic community, and some useful feedback had been received. The members were asked if they were happy with the final version, and if they had any final comments and feedback they would like to be considered before the standard is signed off and published.

4.2. A FFLM reference within the document was identified as out of date, and updated versions were available. The UKAFN representative would provide the FSRU with the correct references.

Action 3: UKAFN representative to provide the FSRU with updated FFLM references.

4.3. The implementation dates within the document were discussed by the members. The original date for the deadline in gaining accreditation was October 2021. This was then extended to October 2022. The document sets out the different stages, and the implementation dates for these stages. The Regulator emphasised that these dates should be achievable, and asked members if they considered these dates as being achievable or should they be extended. Members agreed October 2022 may not be achievable for some organisations. It was proposed the final accreditation date could be extended to April 2023. It was suggested making organisations aware of how long the accreditation process can take to allow them to plan efficiently. The members agreed the final accreditation date should be extended to April 2023.

4.4. A member commented on the accommodation and environmental conditions section of the document and queried the term “cleaned to DNA standards” It was explained there was a full explanation provided in DNA Anti-Contamination – Forensic Medical Examination in Sexual Assault Referral Centres and Custodial Facilities FSRG207. It was suggested including a reference to the document within the text.

A member also highlighted some organisations were not included in the acknowledgments section of the guidance document.

Action 4: FSRU to review/check acknowledgements in the guidance to ensure no organisation/representative has been missed.

4.5. Members queried a section in the standard concerning the use of cleaning reagents. The guidance stated the cleaning reagents used should be effective in removing detectable levels of DNA. Members argued it was unclear what the detectable levels of DNA were. It was suggested the guidance should state cleaning reagents that would denature DNA would be more appropriate.

5. Review of document/feedback SARC guidance FSR-G-212

5.1. Members were asked to provide any final comments on the guidance document, before it is signed off and published.

5.2. The guidance document would be updated to state cleaning products should denature DNA instead of stating it should remove detectable levels of DNA.

5.3. It was suggested including a FAQ for SARCs who are new to the accreditation process. It would address the different ISO codes and how they relate to the SARCs and their accreditation.

5.4. Members were advised if they had any final comments, they would like considered this would need to be sent to the FSRU by Friday 06 September.

Action 5: Members to send final comments/feedback on the SARC Standard and Guidance documents to be received by COP Friday 06 September 2019.

6. Review of document/feedback SARC self-assessment questionnaire (FSRC116 Annex A)

6.1. It was confirmed further feedback from Lime Culture, and the Principle Scientist Group on the document had been requested. The Quality Standards Specialist Group (QSSG) will also review the document and provide their feedback. Once feedback had been received from all the groups this would then be circulated to the MFSG for their final comments.

7. Review of document/feedback Anti contamination FSR- G - 207

7.1. Members were asked to provide any comments they had on the document. The Regulator explained to the group the document was published in 2016 and was developed to address specific anti-contamination issues. It was anticipated the document would be replaced with a set of specific standards. Members were asked if this document should be for custody suites only. Members agreed the anti-contamination document was useful and a range of professionals could use it for example cleaners. It was also suggested it should be simple and easy to understand. A member mentioned there was another working group being formed for DNA anti-contamination work by the forensic science subcommittee, and this could cause duplication of work.

Action 6: FSRU to discuss anti-contamination sub group and document with the chair of the forensic science subcommittee on possible duplication of work.

8. SARC workshops

8.1. A draft agenda for the SARC workshops had been circulated to the group. It was confirmed the workshops would be held in Leeds and London. The workshop would be a free event for those attending (invite only). The dates were confirmed as 19 November in London, and 27 November in Leeds. Some members queried the arrangements as other dates had also been suggested.

Action 7: FSRU to confirm SARC workshop dates/location, and this would then be shared with the group.

8.2. It was suggested that lead clinicians at SARCs should be invited to attend the workshops. The members discussed the topics that should be included in the agenda for the SARC workshops. It was suggested having a mock case, which would show the different stages of a case, and would also include what areas the CQC, and UKAS would inspect. A teenager could be used in the mock case to ensure paediatricians were represented. It would also be useful to show the partnership between the CQC and UKAS. The session could also include timelines, and an overview of CQC and UKAS inspections, and next steps. A detailed presentation by CQC could be useful followed by a detailed presentation from UKAS on what they were expecting to see from SARCs in their inspections. The Regulator could also provide an update presentation on the standards and how they are connected to UKAS inspections.

A member suggested including a presentation on how to complete the quality manual. It was agreed that quality manuals are tailored specifically to each organisation. The Hampshire Constabulary representative would be happy to share their quality manual with the MFSG.

Action 8: The Hampshire Constabulary representative to share their Quality Manual with the group.

8.3. It was suggested using an app for the attendees to send their questions anonymously, or attendees can write their questions down, and put them in a box. A member queried when the invites would be sent. It was confirmed that the NHS would be sending out the invites once the dates have been confirmed.

9. Costs of SARC accreditation

9.1. Members were provided with the estimated costs of accreditation for SARCs. A member queried the application fee and was advised this fee was for new organisations applying for accreditation. This included background checks conducted on the organisation, resources, scope, and what competence is required to access the SARC.

9.2. A member queried the level of expertise of the technical assessors, and how this would be factored into costs. The UKAS representative stated it was too early to confirm this as this would depend on the number of technical assessors, they have available. If they had to employ external technical assessors there may be a higher cost for this. A member queried if an organisation had more than one SARC site that required accreditation, would the application fee be per site. It was confirmed the application fee would be per SARC site seeking accreditation.

9.3. Members agreed that UKAS technical assessors should have a mandatory forensic qualification, to inspect SARCs. It was also explained the technical assessors would be needed for 12-15 days a year. A member highlighted this may be a challenge for NHS employees who wish to become a technical assessor to be allocated this time from their current duties. The Regulator highlighted if SARCs could provide their own technical assessors this could make the process cheaper and provide useful experience to the technical assessor.

10. Stakeholder updates

10.1. A working group had been formed to look at the workforce in SARCs across the country. The group was made up of representatives from NHS England, Royal College of Paediatrics and Child Health (RCPCH), UK Association of Forensic Nurses (UKAFN). A meeting of the working group would be held in a couple of weeks.

10.2. The National Police Chiefs Council (NPCC) were conducting a review of the Criminal Justice Service response led by the Ministry of Justice (MOJ) on forensic medical examinations.

10.3. The National Institute for Health Research (NIHR) were conducting a project looking at the effectiveness of SARCs.

United Kingdom Association of Forensic Nurse and Paramedics (UKAFN)

10.4. Apprenticeships standards have now been approved for Advanced Practitioner (Custody or sexual offence) The first apprenticeship would be delivered in January 2020.

10.5. Scotland had developed their own DNA anti-contamination standards. It was mentioned the guidance issued on cleaning may differ from the Forensic Science Regulator guidance. The Regulator will be following this up with the relevant individuals.

Royal College of Paediatrics and Child Health update

10.6. The RCPCH had been working with the FFLM to support paediatricians undertaking licentiate (SLM) and continuing to maintain the forensic medical examinations standards for children.

Policing/scientific support

10.7. There were still some issues with contractual cleaning companies, and the lack of forensic awareness with some cleaners.

11. AOB

11.1. The Regulator wanted to remind members of the importance of their IT security for their organisations, and phishing emails that could contain viruses.

12. Date of next meeting

12.1. The next meeting would be held on Monday 27 January 2020 in Birmingham.

Annex A

Organisation representatives present

  • Independent National Forensic Advisor (chair)
  • UK Accreditation Service (UKAS)
  • Faculty of Forensic Legal Medicine
  • UK Accreditation Service
  • UK Accreditation Service (UKAS)
  • The Havens London
  • UK Association Forensic Nurses
  • Care Quality Commission
  • Royal College of Paediatrics and Child Health
  • Hampshire Constabulary
  • Hampshire Constabulary
  • Mountain Healthcare
  • Forensic Science Regulator
  • Forensic Science Regulation Unit
  • Forensic Science Regulation Unit
  • Home Office Science Secretariat
  • Home Office Science Secretariat

Apologies

  • NHS
  • NHS England - Health & Justice
  • Criminal Case Review Commission
  • General Medical Council
  • The Chartered Society of Forensic Sciences
  • Department of Health
  • Police Service Northern Ireland
  • Police Scotland