Read Standard 5: Access to coordinated healthcare and support: adults

Rationale

NHS boards should ensure the national clinical pathways to provide ongoing care and support for people who have disclosed rape, sexual assault or historical child sexual abuse are implemented. Pathways describe the options available following disclosure that reflects the time since the assault happened.

People should be supported to access care and support that is right for them. All assessments and onward referrals to other services (such as mental health, housing, GP or the third sector), should be made in line with the clinical pathway and guidance for healthcare professionals.

For adults, this care and support may be provided in a range of settings, including SARCS. Each NHS board has a dedicated SARCS that offers specialist healthcare, support and advice to people who have disclosed a rape or sexual assault. SARCS should work in partnership with other services to ensure people get the care they need, and at a time and place that is right for them.

SARCS staff are trained to provide a holistic, person-centred and trauma-informed health and wellbeing needs assessment to ensure people receive the care that is right for them. This will include an assessment of the person’s immediate healthcare, safety and wellbeing needs. Staff will also assess any follow-up healthcare, support and care that the person might need. Where a person does not attend a SARCS, SARCS staff should provide advice and support to enable the person to access the services that meet their needs.

A nurse coordinator (or equivalent) should coordinate any onward referrals and support for the person. This should be documented and shared with the person in a way that is right for them.

If a person discloses a rape or sexual assault more than seven days since the assault, it may not be appropriate for them to have a forensic medical examination (see Standard 6). However, they may be able to access coordinated care and support, including signposting, through a SARCS.

People should be provided with information about how to get back in touch with services, including SARCS, if they wish to re-engage or require further support.

For children and young people, refer to the additional considerations Standard 7 and the Bairns’ Hoose standards.

Criteria

5.1

NHS boards provide timely and coordinated healthcare and wellbeing in line with national guidance and pathways. This includes, where appropriate:

immediate and follow-up healthcare, including sexual health and support for psychosocial wellbeing
access to responsive, person-centred and trauma-informed care and support services, safety planning and onward referral
consideration of time since incident.

5.2

NHS boards ensure the timely completion of national documentation for any healthcare assessment undertaken at a SARCS.

5.3

Appropriate psychosocial risk assessment for immediate and future safety is undertaken, regardless of setting, which may include:

an offer of early referral to support services
ensuring that the setting is psychologically safe
consideration of the need for referral to appropriate counselling
information sharing and/or referral to other agencies.

5.4

For non-recent incidents, and based on the person’s individual needs, staff can:

advise on assessment of any physical or medical needs, where appropriate
provide advice on how to access specialist services
signpost to support organisations.

5.5

Where there is an assessed need, the SARCS nurse coordinator ensures coordinated referrals to other services, for example, social work and the third sector where appropriate.

5.6

People know who to contact for further advice, support and access to services if required.

What does this standard mean for...

What does the standard mean for people receiving care and support?

You will receive the healthcare and support you need after a rape or sexual assault.
No matter how long it has been since the assault occurred, you will be able to access care and support.
Staff will support you to feel safe and able to trust everyone involved in your care.
You will be listened to and supported in your choices.
You will be supported to access SARCS, if that is right for you.
If you access a SARCS, you will be supported by specialist staff who are trained in helping people who have experienced the trauma of rape or sexual assault.
You can decide to pause or stop any aspect of your care at any time.

What does the standard mean for staff?

Staff, in line with roles, responsibilities and workplace setting:

follow local pathways of care to support people to access the care and support they need
are trained and competent to undertake assessments of healthcare needs
discuss the limits of confidentiality in the process to support decision making
support onward referral to other services where appropriate
signpost to information and support organisations.

What does the standard mean for the NHS board?

NHS boards:

have clear pathways of care for people, including into SARCS, for people who want to access this service
provide equitable and consistently high-quality care and support for people whenever they access services
ensure staff providing specialist care and support are trained and knowledgeable
ensure timely access to assessment at SARCS in line with scheduled, pre-planned care arrangements.

Examples of what meeting this standard might look like

Documentation detailing decision making relating to a person’s care and onward referral.
Local protocols and referral pathways to other services such as adult mental health.
Local protocols detailing service response depending on how long after the incident the person seeks care and support.
Completion of the SARCS national healthcare assessment form.