Definition: CSE involves those under 18 in exploitative situations, contexts and relationships where young people (or a third person or persons) receive something (for example, food, alcohol, cigarettes, affection, gifts) as a result of them and/or another or others engaging in sexual activities. It is an abuse of power by those exploiting by virtue of their age, gender, intellect, and physical strength and/or economic or other resources.
- 1 in 20 children in the UK have been sexually abused
- Sexual exploitation accounted for 26% of trafficked children in 2017
As GP trainees, front line in primary care, we have noticed how medical, social and technological development in a population can affect our patients, how they present and what they present with. These developments have had a profound impact on how CSE cases have evolved over the years, though unfortunately our training has not been updated to fit the ever-changing demographics, signs and risks of CSE in a particular population. We have highlighted only two of many statistics that reveal the disturbing prevalence of CSE in the UK, and cemented our passion for this project.
How do we reach our vision?
Our vision is to improve health outcomes of CSE in our local area, Hillingdon, by focusing on four key elements:
- Identification – Improving awareness of warning signs of CSE and at risk populations. Improving consultation technique to tackle difficult questions in relation to CSE.
- Documentation – Use of written prompts, based on the BASHH/Brooks CSE proforma and NICE guidelines, to ensure thorough history taking and documentation. Eg. EMIS, SystemOne, A&E clerking booklets
- Integration– Horizontal and vertical integration through an MDT approach.
- Support – Mobilising support mechanisms for patients, family, friends and healthcare professionals when handling cases of CSE
Displayed on our mind-map, we want to tackle this vision by concentrating on three areas in our local healthcare system; Primary care, GUM clinics and Trainee teaching schemes. As GP trainees, we feel we have easy access to these key areas to make a positive change in the way CSE is managed. We both have also rotated through General Practice, GUM, Paediatrics and Obstetrics and Gynaecology, and have had first-hand experience on how these teams manage CSE cases. We have observed the importance of an MDT approach and realized the gaps in both medical and social care.
We expanded on this by interacting with colleagues, using quantitative data through our audit, alongside qualitative surveys. Through this ongoing research we have identified our 3-point plan as displayed.