At Scale are working with NHSE/I to transform the way Sexual Assault Referral Centres (SARCs) operate in south east England. This challenging project comes at a time when the issue of sexual violence is being highlighted nationally.

SARCs offer confidential support to people who have been raped or sexually assaulted. NHSE/I co-commission SARCs with local Police and Crime Commissioners, and police forces. Operating out of 47 SARCs across England, service provision is very specialist. SARCs deal with paediatric, young people and adult cases, and those with vulnerabilities. Police forces work closely with each SARC to ensure those who are the victims of rape or sexual assault have the best opportunity to obtain justice.

By 2023, changes to the judicial system will mean SARCs must have a new (UKAS) accreditation before forensic evidence they gather can be used in a court case. NHSE/I and its co-commissioners across the country are working with their SARC providers to ensure they achieve that accreditation. Our work identified current SARC premises across the south east did not support the required changes, and in some instances, new sites were needed. The premises are a vital part of achieving accreditation, without which forensic material will be inadmissible in court.

The trauma of following rape or sexual assault is unimaginable. Victims must feel safe and secure from the moment they enter a SARC. They will be aware that the clinical activity about to occur is likely to be unpleasant and intrusive. It comes on top of the trauma they have already experienced. It is vital the environment, décor, and approach within a SARC are sensitive and reflect those fears – the atmosphere in which the activities are undertaken plays a crucial part in reducing understandable anxiety.

We started with a review of the current circumstances and the extent to which current premises could be adapted to meet UKAS accreditation. We asked how secure that investment in the upgrading of these facilities would be. To help inform those decisions, NHS Property Services (NHSPS) helped us assess the circumstances at all six south east locations. All had differing ownership arrangements, and all had adaptation challenges. In some cases, we concluded new premises would need to be found and adapted.

Working with the NHSE/I, five south east OPCCs and police forces, clinical experts, and NHSPS and their specialist architects, we developed a premises specification that provided an outline for a UKAS compliant SARC. That specification was used to produce a series of refined designs that met victim and co-commissioner needs and supported UKAS compliance. The needs of victims have always led our thinking. The whole team is passionate about ensuring our output delivers appropriate accommodation and sensitive activity flow for patients at each SARC.

After a lot of engagement and multiple refinement discussions, we agreed a baseline design. Through our clinical specialist, we sought the endorsement of the design by The Faculty of Forensic & Legal Medicine (FFLM). That organisation develops and maintains the standards of competence and professional integrity in forensic and legal medicine. Our final design allowed us to localise the layout at each location and finalise costs.

While all this activity was ongoing, we worked with NHSPS to undertake discussions with landlords to secure long term occupation arrangements at each location and improvement capital options. We have identified new premises where the existing ones were unsuitable, subject to public consultation. We have a programme plan that aims to complete all adaptation works by April 2023, six months before the UKAS accreditation date of October 2023. This will allow our SARC providers to adapt their services within upgraded premises six months ahead of the accreditation deadline. The approach and material developed by NHSE/I in the south east are transferrable to other areas, and we would be delighted to connect you with NHSE/I and NHSPS colleagues.

If you want to know more about this programme or any of At Scale’s projects, mail us at info@at-scale.co.uk. And find out more about NHSE/I south east and NHSE SARC services by at https://www.england.nhs.uk/south-east/about-us/ and https://www.england.nhs.uk/commissioning/health-just/sexual-assault-and-abuse/