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About VFPMS

  • The Victorian Forensic Paediatric Medical Service (VFPMS) operates as a Centre of Excellence for Child Abuse and Forensic Paediatric Medicine.  This means that the service

    • operates as a tertiary hospital referral centre,
    • provides 24/7 advice and secondary consultations for Victorian Health professionals, Police and Child Protection Practitioners,
    • has a leadership role in establishing standards, protocols and guidelines in relation to forensic paediatric medicine in Victoria,
    • serves as a central point for data collection and funding of fee-for-service consultations and
    • is a leading Victorian centre for teaching and research in the medical aspects of child maltreatment. 

    Please see our COVID-19 Changes to VFPMS Services here

    The service structure is a ‘hub and spoke’ model, with a Melbourne-based ‘hub’ at two sites – the Royal Children’s and Monash Children’s Hospitals – and ‘spokes’ in regional Victoria at the major hospitals and health services. The Royal Children’s Hospital, Melbourne, governs the VFPMS and provides administrative oversight.

    The VFPMS has state-wide responsibilities in relation to forensic medical assessments and care for abused, assaulted and neglected children (i.e. individuals aged less than 18 years).

    We aim to be efficient and effective while avoiding duplication in the delivery of Health services. We provide safe, high quality medical care as close as possible to the child’s residence, mindful of the need for forensic expertise in evaluating complex situations and multiple injuries.

    We work collaboratively with Victoria Police and Child Protection.

    We provide medico-legal reports and testify in court in relation to matters involving the Child Protection system and the Criminal Justice system.

    We encourage early consultation with the VFPMS when concerns arise regarding child maltreatment. Early conversations regarding concerns about child maltreatment may minimise later complications and reduce angst experienced by abused or neglected children, their family members and the professionals who care for them.

    Services provided at The Royal Children's Hospital and Monash Children's Hospital can be arranged by calling 1300 66 11 42.

    Commonly used tools and templates

    Guidelines

    Health and other professionals seeking guidance regarding the forensic investigation process are encouraged to consult the VFPMS guidelines

    Requests for clinical photographs

    Events

    • The Medical evaluation of suspected child abuse seminar - 23rd to 25th August, 2023
    • Nursing seminar: Recognising and responding to suspected child abuse, 20th July, 2023
    • To register your interest or for further information regarding any VFPMS events, please email VFPMS.enquiries@rch.org.au

    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 Children, Youth and Families Act (2005), 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. 

    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 promptly to all telephone messages within 24 hours at the latest.
    • All inpatient assessments (except in an exceptional circumstance) should be performed within 24 hours.

    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, document the interim forensic opinion/recommendations and promptly discuss 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. The use of the VFPMS 'mature minors consent form' to document consent provided by mature minors is strongly recommended.

    Documentation

    • Contemporaneous notes must always be prepared for each face to face consultation and whenever advice is provided (face to face, telehealth, via telephone or email).
    • Descriptions of physical examination findings should always be included. Diagrams are a useful adjunct to detailed descriptions. Photographs are an even more useful adjunct.
    • Use of the proforma is strongly encouraged.
    • Never alter, backdate, destroy, or otherwise interfere with patient related documents.
    • Maintain the integrity of 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 (and act in accordance with local hospital guidelines and protocols).
    • 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.

    Leave

    • All requests for leave should be made with adequate notice.
    • Time in lieu may be approved under limited circumstances with agreement from the Director. 
    • Leave 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 senior specialist (preferably subjected to peer review).
    • All staff must participate in annual staff appraisal.

    Court

    • Always respond appropriately to subpoenas. This might include telephoning the person who subpoenaed you.
    • Always inform a VFPMS Nurse Manager of a subpoena, particularly when a subpoena may result in an anticipated absence from VFPMS clinic. 
    • Attend court as required. Be prepared. Seek advice.
    • Always inform the courts of any proposed absences from work, e.g. annual leave.