About VFPMS

  • The Victorian Forensic Paediatric Medical Service (VFPMS) is a statewide coordinated medical service providing assessment and care for abused, assaulted and neglected children and young people.

    Our services are provided using the most efficient and effective aspects of the Health system. We work collaboratively with Victoria Police and Child Protection to ensure service integration.

    VFPMS offers 24 hour access to expert medical opinion regarding possible child abuse and neglect. We encourage early consultation as this may minimise complications and reduce any angst experienced by children and young people.

    Our services are provided at The Royal Children's Hospital and Monash Medical Centre. Appointments can be arranged by calling 1300 66 11 42.

    We strive to provide a comprehensive and effective service at all times and warmly encourage your feedback on our service.

    Commonly used tools and templates

    Requests for clinical photographs

    Events

    • A child's eye view of family violence one day seminar - Friday 24 June
    • Medical needs of neglected children one day seminar - Monday 01 August
    • Court skills two day seminar - Monday 07 and Tuesday 08 November

    e-learning tool

    Visit the e-learning site

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    Mission statement

    The VFPMS provides paediatric medical care for children and young people when child abuse, assault and neglect is suspected. The children's safety, health and wellbeing are paramount. The service functions to assist the children, their families, Child Protection, Victoria Police and the Courts.

    The VFPMS provides

    • 24 hour access to medical expertise for the evaluation of all types of suspected child abuse, including physical injuries, neglect, child sexual abuse and paediatric evaluation of children at risk for child abuse and neglect.
    • 24 hour telephone advice and consultation.
    • Coordination of all Victorian paediatric forensic medical services.
    • Integration with existing paediatric and forensic services to facilitate access to a broad range of health services for investigation and treatment, including mental health treatment, for the child and their family.
    • Training and education for
      • all Victorian doctors working with abused children
      • Acute Health service staff
      • Other professionals working with abused children, particularly Child Protection workers and Police
      • Medical students attending University of Melbourne and Monash University
      • Research to contribute to the evidence base for identification and care of vulnerable children.

    Principles governing practice

    1. In line with Victoria's Child Youth and Family Act, the 'best interests of the child' are paramount and guide all decision-making.
    2. Policy direction is informed by scientific principles related to levels of evidence. The VFPMS policies and practices are reviewed regularly to ensure monitoring of quality, and updating as necessary.
    3. All investigations of suspected physical, sexual and emotional abuse and neglect of a child or young person involve a coordinated, multi-professional team comprising Health professionals, Child Protection professionals and Police. All members of the team respect professional roles and responsibilities and maintain high standards of practice, especially in relation to inter-agency communication.
    4. Within the Health sector, in all situations of suspected physical, sexual and emotional abuse and neglect of a child or young person a multidisciplinary response is considered 'best practice'.
    5. When there are No concerns for a child/young person's safety, client choice will determine the involvement or non-involvement of aspects of the service response. (Clients and their guardians have the right to decline the involvement of either or both medical and/or counselling professionals)
    6. Client need determines the nature and timing of the service response. For example, when the probability of child abuse is low, and the diagnosis of child abuse can be excluded promptly by VFPMS evaluation, the child/young person's need for a prompt diagnosis may occur without a concurrent counselling response. (For example, evaluation of suspected Mongolian Blue spots.) When a child and their care-givers request counselling in relation to past child abuse, and the child is currently asymptomatic, a counselling response may be provided without a concurrent VFPMS response.
    7. The VFPMS is integrated with all other paediatric health services. The VFPMS ensures that each child receives the right service, from the right professional, at the right time (regardless of location within the health sector).
    8. Planning (and intervention) for each child's future physical, developmental and psychological wellbeing is a core function of the VFPMS.
    9. All members of the VFPMS participate in professional development, peer review, research, education and training, advocacy and participate in quality assurance activities.

    History

    Victoria has been in a unique position during the last 40 years, benefiting from the shared expertise of paediatricians and forensic physicians to evaluate abused, injured and neglected children.

    In 2002 doctors who for ten years had been meeting regularly for peer review formalized their association with a Memorandum of Understanding and formed the Melbourne Paediatric Forensic Medical Group (MFPMG). This MOU created a unifying agreement between the three service providers in Melbourne: Monash Medical Centre, Victorian Institute of Forensic Medicine and The Royal Children's Hospital.

    A working party was formed in 2004 to look at funding and service options. In November 2005 the Premier announced funding of $6.4 million over four years to redevelop the forensic paediatric medical services. A steering group with representation from the Department of Human Services, Victoria Police, The Royal Children's Hospital, Monash Medical Centre and Victorian Institute of Forensic Medicine was formed to develop and implement the service model.

    The new service commenced in July 2006 with three service providers working together to coordinate forensic paediatric medical services statewide. The service is governed by a coordinating group with representation from the Department of Human Services, Victoria Police, Monash Medical Centre, the Victorian Institute of Forensic Medicine and The Royal Children's Hospital.

    In 2010 The Royal Children's Hospital became responsible for the governance of the Victorian Forensic Paediatric Medical Service, which has state-wide responsibilities with services delivered in Melbourne at The Royal Children's Hospital and Monash Children's at Monash Medical Centre.

    Credentialling

    Clinical practice standards

    VFPMS team members must adhere to workplace policies and procedures at all times
    All data collection and data entry must be completed promptly and accurately.

    Responsiveness

    • Reply to all telephone messages within 24 hours.
    • All inpatient assessments should be performed on the day of request. This includes all referrals that are received by counsellors in relation to children admitted because of suspected child abuse and/or neglect.

    On call

    • Doctors must be available to respond promptly (within 10 minutes) to telephone enquiries at all times that they are on call.
    • Doctors should (except in an exceptional circumstance) be able to attend a hospital to see a child within two hours of initial contact.
    • For inpatients, discuss the timing of the VFPMS consultation with the General Medical Consultant.
    • For children seen in Emergency Department, discuss the evaluation and management of children with the ED Consultant or Registrar.

    Consent

    • Examination must not proceed in the absence of valid consent and (where relevant) assent.
    • Consent must be documented.
    • Ideally, this should be in writing and detail the precise nature of the actions for which consent is provided. When consent is provided verbally or consent has been obtained by another professional, this too must be documented.
    • The Gillick principle may apply for mature minors.

    Documentation

    • Contemporaneous notes must be prepared.
    • Diagrams are a useful adjunct to a detailed description of an examination finding. Photographs are an even more useful adjunct.
    • Use of the proforma is strongly encouraged.
    • All notes relating to your evaluation must always remain in the patient’s file.
    • NEVER take original notes away from a hospital or clinical setting. (You are permitted to take photocopies for the purpose of preparing your report.)
    • NEVER alter, backdate, destroy, or otherwise interfere with patient related documents. NOT EVER!
    • Maintain the integrity of the patient records at all times. Don’t write anything inappropriate, critical or discriminatory. Work notes can be subpoenaed and examined in court.

    Examinations

    • Consider the appropriate use of a chaperone or support person.
    • Always wear gloves for examination of genitalia (male and female).
    • All measures should be taken to minimise discomfort and prevent pain (e.g. moisten cotton tipped swabs, use warm water to lubricate speculum).

    Reports

    • A report must be prepared for each child seen.
    • ALL reports must be read by a supervisor BEFORE release from the VFPMS.
    • Reports should be completed in the shortest possible time. A delay of more than two weeks is not acceptable.

    Leave

    All requests for leave should be made with adequate notice must be approved prior to taking leave. (Otherwise absence is considered abandonment of one’s job – this could have very significant consequences on one’s employment!)

    QA and peer review

    • A minimum of four peer review sessions must be attended each year.
    • All abnormal video/DVD colposcopy findings and all abnormal clinical examination findings must be reviewed by at least one other team member (preferably subjected to peer review).
    • All staff must participate in annual staff appraisal.

    Court

    • Always respond appropriately to subpoenas by telephoning the person who subpoenaed you.
    • Attend court as required. Be prepared. Seek advice.
    • Always inform the courts of any proposed absences e.g. leave.