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New FGM guidance for health professionals

The UK government has announced new measures to encourage and help doctors, nurses and other frontline health workers to play a greater role in the fight against female genital mutilation.

The United Nations Children's Fund (UNICEF) estimates there are 130 million girls and women across the world who have been subjected to some form of female genital mutilation (FGM). Here in the UK the government has recently announced a range of measures to help combat this illegal procedure which, according to the World Health Organisation (WHO), 'has no medical or health benefits and violates the human rights of girls and women'. These new measures include initiatives to provide improved FGM training and guidance for health professionals, such as doctors, nurses and midwives. Launching the initiative, Health Minister Jane Ellison said, "FGM devastates the lives of women and girls and we are committed to ending the brutal practice in one generation." 

One of the key innovations is a new system to allow clinicians to note on a child's health record that they are at risk of FGM. This is backed up by new mandatory recording requirements for GPs and mental health trusts, requiring them to record cases of FGM in the same way that NHS acute trusts do already. Data will be published annually by the Health and Social Care Information Centre.

Responding to the promise of legislation to enforce the new mandatory reporting requirement, Royal College of Nursing Chief Executive Dr Peter Carter commented, "The government's focus on mandatory reporting is an important step towards ensuring that nurses, midwives and other health professionals act as they would with any suspected abuse and report it."

"Many nurses and midwives may be unaware of their legal and professional responsibilities when it comes to the reporting of FGM," said RCN Director of Nursing Janet Davies in an interview with The Guardian. "This important guidance will bring them up to date and make clear what they can do to help tackle FGM and help protect their patients."

Training is another key focus of the new measures. A new online resource has been developed by HEE e-Learning for Healthcare, supported by the Department of Health's FGM prevention team, and is provided free to all healthcare professionals, including nurses, doctors and health visitors. Made up of five 20-30-minute sessions, it's designed to improve the knowledge and awareness amongst healthcare professionals of some of the issues which affect FGM victims throughout their lives.

The RCN has recently updated its own guidance on recognising and tackling FGM, which covers nurses' legal and professional responsibilities, the different types of mutilation, how nurses can identify girls at risk and the procedures for referring people to appropriate agencies. 

Announcing the new guidance to nurses, doctors and academics at an FGM conference in February 2015, RCN professional lead for midwifery and women's health Carmel Bagness called on nurses to demonstrate 'professional curiosity'. "Healthcare professionals could ask simple and generic questions of their patients during appointments, regardless of how busy they are," she suggested. "If a woman is not coming in for a smear test, they should be asking why."

The British Medical Association (BMA) currently has its FMG guidance under review to take into account the recent legislative and policy developments. New guidance is due to be published in summer 2015.

Sanctuary Training is running an FGM and Forced Marriage training course in London on 13th May. The course provides practitioners with the skills to recognise and assess victims of honour based violence and then manage and minimise safety risks for victims and their children in the UK. You can register for this course on the Sanctuary Training website or by calling Harriet Cadman on 0333 7000 028.

Are you a doctor, nurse or other health professional with views on the issues raised in this article? Leave your comments below.

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