FGM Hub

This page is for information and guidance on managing concerns related to female genital mutilation (FGM).

Index

 

What is FGM?

The World Health Organisation (WHO) defines female genital mutilation (FGM) as all procedures that that involve partial or total removal of the genitalia or other injury to the female genital organs for non-medical reasons. FGM is recognised as a violation of human rights (WHO 2017). There are no medical reasons to carry out FGM, several health implications can result following it including, difficulties in; urinating, menstruation and complications in birth (National FGM Centre 2017). Some women have been brave enough to speak out about FGM, listen to Khadija’s experience.

In the UK, it is against the law to practice FGM or to support a child going overseas to have FGM carried out. Regulated health and social care professionals have a duty to report known cases of FGM (Home Office 2016, Mandatory reporting of female genital mutilation: procedural information). There are four different types of FGM:

     Type 1: Clitoridectomy

     Type 2: Excision

     Type 3: Infibulation

     Type 4: Other

As part of a piece of work on hidden harms Suffolk Refugee Support and students from the University of Suffolk's games design course have produced Hidden Crimes: an online interactive resource available in English, Polish, Kurdish and Arabic to provide information about hidden harms including FGM that also reflects back on users understanding.

Incidence of FGM 

The National FGM Centre map contains information about the prevalence rates for various countries across the world including local information (National FGM Centre 2019). 

Information about prevalence in the UK can be accessed by the current NHS FGM Dataset and Annual Report. Most of the cases are reported via NHS organisations (obstetrics, gynaecology and midwifery). 

Suffolk annual statistics reported 2018/19 reported between 8-12 FGM related attendances, with between 3-7 new cases (NHS Digital July 2019). The previous reporting period noted 12 cases.  In Suffolk, there is no longer a clear picture of countries, areas or ages associated with FGM (NHS Digital, FGM dataset 2019).  Prevalence of FGM remains below national levels. In 2015 Public Health Suffolk reported on FGM. This Health Needs Assessment informed work in this area.

Safeguarding 

FGM is a safeguarding issue and the NSPCC provide some useful information on recognising the risks of FGM. The Home Office provides advice on preventative measures. See here for the Department of Health's National FGM Safeguarding Pathway

In Suffolk the Local Safeguarding Children’s Board (LSCB) coordinates this work. The Multi-Agency Safeguarding Hub (MASH) addresses concerns about abuse including FGM. If you would like to discuss a situation/safe guarding referral, please contact the MASH Consultation Line on 0345 606 1499.

Local FGM referral pathways are also in place. 

Local FGM Safeguarding Pathway for over 18s:

• If you believe a women over the age of 18 is to be a RISK of FGM - Report to Customer First on 0808 800 4005
• If a women over the age of 18 discloses she has undergone FGM, carry out a risk assessment to assess the risk to other girls e.g.. siblings or children
  • If there are others at risk, follow safeguarding practice and refer through Customer First on 0808 800 40005 
  • If deemed there is no risk to others, ensure the women feels supported. Suffolk Refugee Support are able to link survivors of FGM in with various mental health support services, please contact Liz Wood for further details. Please note all safeguarding concerns must be reported through to Customer First. 

Local FGM Safeguarding Pathway for under 18s: 

• If you believe the young person under the age of 18 to be at risk of FGM or may have undergone FGM, report to Customer First on 0808 800 4005
• If a young person discloses she is at risk of or has undergone FGM, report to the police on 101 and make Customer First aware 
• If a relative of the young person discloses that the girl is at risk of has undergone FGM, report to Customer First on 0808 800 4005. If you feel the girl is in immediate danger it is advisable to report to the Police on 101
• You have observed physical signs appearing to show the young person has undergone FGM, report to Police on 101 and make Customer First aware

An FGM Protection Order  is a legal document issued by the family court, intended to protect girls and women who are risk of the procedure of FGM. You do not have to pay to apply for the order or reveal your identity. A person at risk of FGM, the local authority or anybody the court gives permission to, such as police or teachers, can apply for a FGM Protection Order.

Organisations offering information and resources

National Organisations

• World Health Authority (WHO) FGM webpage
• National FGM Centre, NSPCC FGM webpage and Child-line Female Circumcision, FGM and cutting webpage 
• Home Office FGM prevention resources and Home Office Home Office FGM campaign materials. The Department of Health and Social Care, Department of Education and the Home Office updated the Multi-agency statutory guidance on female genital mutilation in July 2020.
• NHS England Female genital mutilation information sharing, Royal College of Nursing FGM webpage 
• Daughters of Eve, an non for profit organisation support women and girls at risk from FGM
• Equality Now, END FGM webpage,
• FORWARD, FGM campaign webpage

Local Organisations

• Suffolk Police FGM information 
• Make a Change Team, working with young people at risk of exploitation. Contact the Make A Change for more details 
• The Source FGM webpage information for young people on FGM and how to access support
• iCaSH Suffolk’s integrated contraception and sexual health service
• Suffolk Refugee Support working with at risk groups
• Bal Kaur Howard Training local training provider on FGM and various topics

Further Resources 

• Barnardo's FGM assessment tool and good practice guidance specifically for social workers.
• National FGM Centre legal fact sheet to highlight the different FGM legislation in the UK.
• NHS Safeguarding App for healthcare professionals . To view and download the app, visit the Apple App Store NHS Safeguarding App or for Android users please visit Google Play NHS Safeguarding App 

Mandatory reporting, safeguarding and guidance documents

Acute Hospitals FGM Policies

• Ipswich and East CCG useful information and guidance webpage has downloadable policies and information of FGM
• James Paget University Hospital Safeguarding Adults webpage has a downloadable copy of the Female Genital Mutilation FGM Reporting And Safeguarding Policy
• West Suffolk Hospital Policies and Procedures webpage has a downloadable copy of the safeguarding policy which contains an information section on FGM.

Guidance for Professionals

• Department of Health  and Social Care – FGM risk and safeguarding guidance
• Department of Health and Social Care – FGM dataset requirements for NHS staff 2015
• Home Office Fact sheets on Reporting and procedure for health, social care and teaching staff 

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Page Reviewed: August 2020. Next Review January 2020