Thursday, 9 February 2017


Department of Health


 10 July 2015

The next few weeks are commonly known amongst anti-FGM campaigners, not without good reason, as the ‘cutting season’. This horrific name marks a time of year when many young girls are taken abroad to have FGM performed, in order that they can ‘heal’ over the long summer holiday period – mainly to avoid detection when they return to school.
Frontline staff are crucial in identifying and protecting against FGM, so the NHS must be even more vigilant in the coming weeks and take every possible action to prevent this abhorrent practice. Some of the signs to look out for are:

·         Young girls attending for inoculations to travel to countries with high FGM prevalence;
·         Young girls talking about travelling home for ‘special’ ceremonies or rituals;
·         Families planning absence from school that would extend the summer holiday period.

I would also like to remind you of the safeguarding requirements on the NHS as there have been a number of recent developments for health professionals around FGM (see Annexes). Please cascade this information amongst your staff and ensure they are fully aware of their responsibility to protect girls from this act, which is illegal in the UK and extends to cover girls taken overseas.
NSPCC helpline staff have now been trained by FGM health experts so that NHS staff can receive support from a 24/7 team of advisors who can discuss the often complex circumstances surrounding cases of FGM. The helpline number is 0800 028 3550. Please ensure that your staff are aware of this important source of information and assistance.
Please also make sure that your organisation has stocks of the ‘Statement Opposing FGM’ leaflet (a wallet-sized document sometimes known as the “health passport”) for families travelling abroad who may be pressured to allow girls to undergo FGM. These are availa-ble to download from or to order from in a wide range of languages.

 JANE ELLISON Parliamentary Under Secretary of State for Public Health ( Signed)

Thank you for your invaluable support in protecting girls.  

FGM e-learning training modules: Raising awareness of female genital mutilation. The five e-learning modules are free of charge to all NHS staff via the ‘e-learning for health’ platform and cover a range of issues in relation to FGM at all stages of a girl or woman’s life including:
- Introduction to FGM;
- Adult women both pregnant and non-pregnant;
- Children and young women;
- Communication skills for staff;
- Legal and safeguarding issues .
These e-learning modules have been developed by Health Education England and are available at:
Safeguarding guidance:
Female genital mutilation risk and safeguarding – guidance for professionals
Published by the Department of Health in March 2015, this provides support to NHS organisations when developing or reviewing safeguarding policies and procedures around female genital mutilation (FGM). It can be used by health professionals from all sectors, particularly designated and named safeguarding leads, and local safeguarding children board members. The guidance is available at:
‘Statement Opposing FGM’:
This wallet-sized leaflet is a preventive tool for families travelling to FGM practising
countries. It can be shown to family members who may be pressuring a girl to undergo FGM. It is signed by a number of government Ministers and clearly states that FGM is
illegal, details the health problems it causes and lists sources of support. Available in
English and ten other languages: and
Patient Information Leaflet:
More information about FGM - This leaflet is to be given to patients identified with FGM. It defines the different types of FGM, explains the health consequences and the help and support available, and provides information on the FGM data being collected in the NHS. Available in English and ten other languages: and 3

Safeguarding duties:
The forthcoming FGM mandatory reporting duty will require a referral to the police every time a confirmed case of FGM is identified in a child under 18 years of age. We will issue guidance and advice on this in due course and assure you that we will work with you to ensure the implementation of the duty across the NHS is as smooth as possible.
In the meantime, safeguarding responsibilities remain as before and as for all other forms of child abuse. This gives us the opportunity to protect girls and prevent FGM before it can take place. All NHS staff must take appropriate safeguarding action every time they identify a child with, or at risk of FGM following local safeguarding arrangements.
Recording FGM data:
Acute Trusts put in significant efforts during the last financial year to comply with the mandatory requirement to record FGM in a patient’s healthcare record and submit monthly returns, which were then published by the Health and Social Care Information Centre. I would like to take this opportunity to thank you all for your support and the work you have done to ensure compliance with this requirement within your Trust. Your engagement to date means we now have a much more informed picture of FGM across the NHS patient population. This is invaluable for commissioning the right services, targeted where they are needed. It also means that the NHS is in a better position to provide the right care for women living with FGM and to protect girls at risk.
On 1 April 2015, we published a new information standard, ‘SCCI 2026 FGM Enhanced Dataset’, which revised what information is collected, and the method and frequency of collection. It is now mandatory for acute Trusts to comply with these updates. The requirement to record FGM data has also been expanded to GP practices and Mental Health Trusts who will be required to submit information under the Enhanced Dataset when treating patients who have FGM, and ensure that they are compliant by October 2015 at the latest. Please ensure that over the summer and beyond this important and valuable information collection continues to develop in your Trust – it is vitally important that you maintain the good work done to date.
To support this we have sent every General Practice an FGM information pack containing a range of resources and materials.

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Our vision is of a society where no one should experience discrimination on the grounds of their mental health.

Mental health problems are extremely common across society, with one in four of us experiencing them in any year. Despite being so common, people from all communities will still experience discriminatory attitudes and behaviours that can prevent people from speaking out, seeking support and playing full and active roles in our communities. The impact of mental health stigma and discrimination will vary between communities as mental health has a cultural context that affects the way communities talk about the subject and engage with people who have mental health problems. In some cultures depression, for example, doesn't exist and in others an experience of a mental health problem can be attached to a sense of shame.

For the African and Caribbean communities a key issue is the overrepresentation of young African and Caribbean men in mental health services. Misconceptions and stereotypes have led to a perception that this group is more likely to pose a risk of violent behaviour and, as a result, they are more likely to be treated as inpatients and sectioned when compared to other groups. It is well documented that this has led to a fear of talking about mental health issues more openly and a fear of using mental health services. Research by the Race Equality Foundation (2011) also highlighted fears that discrimination against Black & Minority Ethnic (BME) communities and migrant service users will increase in the austerity climate and whilst commissioning arrangements change.

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