The scope of VFPMS work is determined by, and is aligned with the goals and strategic plans of, the funding source and governing body.  

The forensic paediatric medical service is funded by the Victorian Department of Health to provide forensic medical services to Victorian children. The Royal Children’s Hospital governs the operation of the VFPMS.  

1. In-patient in-person consultations 

Staff employed by the VFPMS work across both Royal Children’s Hospital (RCH) and Monash Children’s Hospital (MCH) sites.  

• Inpatients at RCH and MCH may be provided with inpatient consultations with VFPMS medical staff.  
• Inpatients at other metropolitan hospitals and all regional hospitals will not be provided with in-person consultations with VFPMS medical staff.  

Paediatricians and other medical and nursing practitioners employed by metropolitan and regional hospitals provide patient care to injured, abused and neglected children as set out in their contracts with their employers. These paediatricians may invoice the VFPMS for forensic medical services. 

2. Criteria for in-person consultations with VFPMS staff (RCH/MCH) 

In person consultations may be provided for children who  

• are injured AND physical abuse is a possible cause of the child’s injuries 
• have symptoms and signs that might be caused by child abuse (the child may or may not have an obvious injury at the time of VFPMS triage) 
• have a history of being subjected to recent child physical abuse (the child may or may not have an obvious injury at the time of triage)  
• report, or are suspected to be the victim of, a recent sexual assault. Triage decisions are based on a) optimal time frames for collection of samples for forensic analysis and b) medical evaluation by forensic medical staff (examination and evaluation requires the unique expertise of forensic paediatricians, trainees and forensically-trained paediatricians).  
• are suspected to have a sexually transmitted infection AND sexual abuse is a possible cause. 
• are suspected to be the victim of remote (in the past) child sexual abuse and a particular need for medical evaluation exists (criterion applies to only a small number of children when, based on the medical history, genital injury is deemed reasonably likely). 
• are suspected to be the victim of significant child neglect. This significant neglect could be of recent short duration in which case assessment of current situational and psychosocial factors will be prioritised or it might be of longer duration in which case assessment of growth, development, health, safety, cumulative harm and emotional neglect will also be assessed. 

3. Telephone advice (1300 66 11 42) 

The VFPMS provides advice for health professionals, child protection practitioners and police regarding child maltreatment, injury evaluation and forensic medical investigations.  

When (following triage) an in-person consultation with the VFPMS is not recommended, the VFPMS may provide advice about healthcare and pathways for accessing children’s health services. The approach taken and advice provided is cognisant of the whole health landscape and a public health approach, driven by a desire for efficiency and cost-effective use of front-line health service providers, while prioritising children’s best interests.  

Note that the after-hours service is provided (from home) by only a small number of on-call forensic medical staff who work longer-than-average shifts. It would be appreciated if calls between the hours of 22:00 and 09:00 could be limited to urgent matters only.  

4. Secondary consultations   

Most telephone enquiries to the VFPMS are from callers seeking information and recommendations about patient care and forensic investigations. Calls are triaged to determine the need for in-person forensic medical examinations. Advice is provided about forensic investigations that may be reasonable to undertake according to the children’s ages and case scenarios. Many callers who are health professionals are directed towards the information provided on the RCH website as VFPMS clinical practice guidelines https://www.rch.org.au/vfpms/guidelines/  

When the VFPMS provides secondary consultations to paediatricians and other specialists who are case-managing paediatric in-patients, the VFPMS partners with the case-managing doctors to support them in their investigations of suspected child maltreatment. This partnership involves the VFPMS providing advice regarding injury interpretation, medical investigations and communications with others (including Child Protection practitioners and police), assistance with the interpretation of results of investigations, report writing, and testifying in court.    

The VFPMS provides case consultations to Child Protection practitioners regarding concerns about childhood injuries, paediatric medical conditions, possible fabricated and induced illness, typical and atypical acquisition of developmental skills, child abuse and neglect in children who are engaged with child protection services.   

Most secondary consultations are provided in business hours.  

Case conferences are provided only in business hours. 

5. Attendance at multi-agency case conferences (this includes liaison meetings, SCAN meetings and discharge planning meetings)  

The VFPMS will host, attend and provide the secretariat for multiagency liaison meetings involving staff of the RCH (NWCALM) and MCH (SECALM).  

The VFPMS may attend multiagency liaison meetings held in regional Victoria at the invitation of paediatricians hosting these meetings. 

The VFPMS will attend multiagency Suspected Child Abuse and Neglect (SCAN) meetings regarding patients with whom the VFPMS has engaged.  

The VFPMS may attend SCAN meetings at the invitation of paediatricians managing inpatients at Victorian hospitals other than RCH and MCH.  

The VFPMS may attend discharge planning meetings regarding the safe discharge of RCH and MCH patients with whom the VFPMS has engaged.  

6. Expert (forensic medical) opinions when the opinion is based on interpretation of photographs or video-recordings 

Injury interpretation based on photographs or video recordings may, on occasion, be useful to service partners (child protection practitioners and police) when they are planning actions such as protective intervention or laying criminal charges.  

Requests for forensic medical opinions (also called ’expert opinions’) regarding the likely cause/s, timing and consequences of injury are made by contacting (in business hours, via telephone 1300 661142) the VFPMS triage nurse or the VFPMS.Enquiries@rch.org.au email address.  

• When an urgent forensic medical opinion is requested, callers should telephone 1300 661142 to arrange for an urgent medical opinion to be provided. This may be provided during a telephone conversation or via email. 
• When a non-urgent opinion is requested, an email may be sent to VFPMS.Enquiries@rch.org.au. This inbox is checked only during business hours and an automatic reply is generated which advises a telephone call to 1300 661142 when an urgent response is sought. The VFPMS will respond (usually via email) to email enquiries during the next business day.  

7. Expert (forensic medical) opinions regarding toxicology results  

The VFPMS team may, under limited circumstances, provide expert opinions regarding toxicology results, noting that no current VFPMS staff have specific qualifications in clinical pharmacology or forensic toxicology.  

8. Expert (forensic medical) opinions for the Coroner, Homicide Squad and others based on case file review of medical records of deceased children. 

The VFPMS may undertake a case file review for the purpose of providing an expert opinion report when coronial and homicide investigations are conducted and a paediatric forensic medical expert opinion is deemed to be of possible assistance to the Coroner or Victoria Police Homicide Squad detectives.  

Under exceptional circumstances when a request is made by a magistrate or judge of the Children‘s Court of Victoria (CCV) for forensic medical assistance, the VFPMS may provide an expert opinion report based on a case file review of medical records of a child who is subject to a CCV protective order.  

9. Expert (forensic medical) opinions about the seriousness of injury  

The VFPMS does not provide expert opinion reports about the seriousness of injury.  

Victoria Police are encouraged to seek expert opinion reports from the VIFM or other forensic service providers.  

Upon request, an opinion regarding the seriousness of injury may be provided for patients already assessed by the VFPMS.  

10. Opinions regarding a person-of-interest’s fitness for interview  

The VFPMS does not provide evaluations regarding persons-of-interest’s fitness for interview.  

11. Forensic photography 

The VFPMS does not provide a forensic photography service.