This section contains information for professionals from Child Protection, Victoria Police and Health. It aims to provide a better understanding of how the Victorian Forensic Paediatric Medical Service works, how decisions are made and how to contact the service.

In Melbourne, regular outpatient clinics are available at the Royal Children's Hospital and Monash Children's Hospital. 

In other regional cities children are seen on an 'ad hoc' basis as the need arises. 

Children who require a non-urgent assessment may be offered an appointment during working hours where this is available. In regional cities a non-urgent assessment may be provided in an outpatient clinic, an emergency department or, in limited circumstances, in a paediatrician's private rooms. 

Children who require an urgent evaluation may be offered an after hours service by the multidisciplinary team.

Criteria for referral

1. Forensic evaluation of injury or suspected injury
2. Allegation of sexual assault
3. Symptoms and signs that generate concern regarding possible child abuse, assault or neglect
4. Risk of harm based on psychosocial circumstances and co-existing concerns for a child's health, safety, growth, development, behaviour or relationships; this may include concerns around fabricated and induced illness in children (FIIC).
   

Prioritisation for urgent face-to-face assessments will be given to children under the following circumstances:

• Medical symptoms such as pain and bleeding require urgent assessment and possible treatment of injury
• Collection of samples for forensic analysis (e.g. rape kit); note the recommended maximum times for collection of forensic samples 
• Medical treatment is required but cannot be provided elsewhere (e.g. provision of post-coital contraception and antibiotics to prevent STI including HIV). Note that under most circumstances such medical care can be provided by medical services other than VFPMS.
• A forensic opinion is required regarding the cause and timing of injury (or differentiating a medical condition confused with injury from true injury) in order to make decisions regarding health, protective and legal interventions for the index child and/or siblings
• Urgent paediatric assessment of safety (particularly involving an assessment of health and adequacy of healthcare) is required in order to make decisions regarding the index child's and/or siblings' safe placement
• The current social situation places a child at temporary risk that might be mitigated or resolved as a result of a medical consultaiton. For example, a significant level of care-giver's emotional distress and/or anger might pose a risk to the child's (or another individual's) safety and/or emotional wellbeing.

Criteria for determining urgency

Telephone advice is available 24/7 by telephoning 1300 66 11 42.

Urgent consultations at RCH and MCH will be provided under the following circumstances:

• A face-to-face consultation will usually be provided for the collection of forensic samples following recent sexual assault
• A face-to-face consultation will be provided for an inpatient at RCH and MCH about whom there are concerns regarding non-accidental injury

Non-urgent face-to-face consultations will usually be offered to all other children for whom a VFPMS face-to-face consultation is deemed necessary. Most children will be seen within 1-2 weeks of the referral. 

Neglect

The VFPMS welcomes the opportunity to provide forensic medical opinions in relation to children who might have experienced serious negative effects of child neglect. We are particularly keen to provide comprehensive assessments of young children and children with complex health needs who may have suffered because of care-giver neglect of their medical needs. 

A small number of sibling groups may be assessed per annum. When several children in one family may have been affected by child neglect then younger children and children with complex health needs will be prioritised. The VFPMS may not accept all children in one family for individual forensic medical assessments. 

In situations of child neglect the amount and quality of information provided by Child Protection to the VFPMS is of paramount importance. The VFPMS expects to work in partnership with Child Protection practitioners regarding the evaluation of suspected child neglect.

Sexual abuse

Children may be referred to the VFPMS because of allegations of sexual assault, concerns regarding child sexual abuse and for evaluation of symptoms and signs (including sexualised behaviour) that generate concern regarding possible sexual abuse. 

The VFPMS provides assessments for the purposes of:

• Healthcare (including injury evaluation and treatment, prophylaxis of STI and prevention of pregnancy)
• Criminal investigations (including genital examination and collection of samples for forensic DNA analysis) and production of medicolegal reports that might be used in the criminal justice system
• Protective assessments (including production of medicolegal reports that might be used in the Children's Court of Victoria)

The VFPMS will provide a service to children when sexual assault/abuse is suspected but police are NOT investigating possible criminal behaviour and Child Protection are NOT investigating possible child abuse or neglect. In other words, the involvement of Victoria Police and/or Child Protection is not a requirement for referral to the VFPMS. 

Referral process for regional Victoria

For information regarding all rural and regional referrals, please go the Rural and regional page.

Remember – advice and consultation is available 24/7 on tel: 1300 66 11 42