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.  

    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 

    Please go to the "Training and Education" tab for more details.

    The VFPMS Medical Evaluation of Suspected Child Abuse Seminar will be held on Wednesday 24th, Thursday 25th & Friday 26th of July 2024 at The Royal Children's Hospital in Melbourne.
    To register for this event, please complete the registration form.

    View the program outline for the seminar.

    The VFPMS Nursing Seminar on Recognising and Responding to Suspected Child Abuse
    will be held on Thursday 6th of June 2024 at The Royal Children's Hospital in Melbourne.

    This event is full and registrations are now closed.

    View the program outline for the nursing seminar.


    For more information on any of these events, please email VFPMS.enquiries@rch.org.au

    e-learning tool

    Visit the e-learning site

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    Mission statement

    The VFPMS will provide excellent 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 will assist and serve children, their families, Child Protection, Victoria Police and the Courts.

    The VFPMS provides

    • Face-to-face consultations for suspected child abuse and severe neglect.
    • 24 hour access to advice from medical experts regarding evaluation of all types of child abuse and vulnerability to abuse and neglect. This includes physical injuries, neglect, child sexual abuse and paediatric evaluation of children at risk for child abuse and neglect.
    • Forensic medical care for sexually abused Victorian children (via the VFPMS network).
    • Peer review of medicolegal reports regarding suspected child abuse
    • Training and education for
      • Victorian doctors working with abused children
      • Acute Health service staff
      • Other professionals working with abused children, particularly Child Protection practitioners and Police
      • Medical students attending University of Melbourne and Monash University
    • Research to contribute to the evidence base for identification and care of abused and vulnerable children.
    • Leadership in setting standards for paediatric forensic medical care. This includes the development and implementation of clinical practice guidelines. 

    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. The VFPMS is integrated with other paediatric health services. The VFPMS believes that each child should receive the right service, from the right professional, at the right time. Patient's medical needs and need for protection should determine the nature and timing of the service response.

    3. Investigations of suspected physical, sexual and emotional abuse and neglect should involve a multi-professional team comprising of Health professionals, Child Protection professionals and Police. All members of the team should respect professional roles ad responsibilities and maintain high standards of practice, especially in relation to inter-agency communication.

    4. Within the Health sector, situations of suspected physical, sexual and emotional abuse and neglect of a child a multidisciplinary response is considered 'best practice'.

    5. When there are no concerns for a child's safety, thus no legislative requirement for actions such as reporting to Child Protection or police, client choice will determine the involvement or non-involvement of aspects of the service system's response.

    6. Planning (and intervention) for each child's future physical, developmental and psychological wellbeing is a core function of the VFPMS.

    7. All members of the VFPMS should participate in professional development, peer review, research, education and training, advocacy and quality improvement.

    Credentialling

    Credentialing of forensic paediatricians

    Credentialling by the VFPMS is not yet operational in Victoria.

    VFPMS awards a Certificate of Competency to trainees who have demonstrated proficiency when evaluating children in relation to suspected child abuse. This is not a "credential". 

    The following information is for discussion only.

    Credentials are for the purpose of identifying doctors who have demonstrated competencies in the evaluation of suspected child abuse. These doctors have also demonstrated that they can competently provide high quality expert opinion evidence (as distinct from direct evidence - ie evidence about what they saw, heard etc) in relation to child abuse.

    Credentials are based on three factors:

    - Qualifications
    - Experience
    - Demonstrated skill (which impacts good reputation) and appropriate behaviours

    Qualifications in both paediatric medicine and forensic medicine

    - FRACP or equivalent
    - Grad Cert PaedForensMed, Grad Dip For Med, Master of Forensic Medicine or equivalent

    Doctors must be actively involved in clinical practice

    - Case work: Minimum of 5 children evaluated for child abuse per year - medical reports provided as proof of proficiency
    - Continuing professional education
    - Self-directed learning 30 hours per annum

    Demonstrated skill

    - Satisfactory presentation of evidence at case conferences or court
    - Written reports subjected to peer review
    - Chair case conferences (including SCAN meetings)

    (What is NOT suggested is a minimum number of years of clinical work post graduation)

    Scope of practice

    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.