Caring for people disclosing sexual assault
Directive number: QH-HSD-051
Effective date: 28 June 2024
Review date: 28 June 2027
Supersedes: Version 2
On this page:
- Purpose
- Scope
- Principles
- Outcomes
- Mandatory requirements
- Compliance
- Human rights
- Aboriginal and Torres Strait Islander considerations
- Related or governing legislation, policy and agreements
- Supporting documents
- Business area contact
- Review
- Approval and implementation
- Definitions of terms used in this directive
- Version control
Purpose
This Health Service Directive requires Hospital and Health Services to take a consistent approach to managing the clinical and psychosocial needs of people who have experienced sexual assault. This includes the person-centred provision of forensic medical examinations.
Scope
This directive applies to all Hospital and Health Services.
Principles
- Compassion - everyone disclosing sexual assault will be treated with respect, courtesy, compassion and dignity and their clinical care and any forensic medical examination will be responsive to their particular needs including access to, or referral to counsellors and support services.
- Person-centred care - everyone disclosing sexual assault will have access to trained clinicians who can provide timely and confidential clinical care and a forensic medical examination after presentation to hospital.
- Information - everyone disclosing sexual assault will be given clear information about their options relating to having a forensic medical examination and the level of involvement of police.
- Collaboration - HHSs will work effectively with the Queensland Police Service, other government agencies as well as community organisations to ensure a responsive, supportive and integrated approach to caring for people disclosing sexual assault.
- Timely - access to care and a forensic medical examination is provide in a timely manner. If transport to a more suitable clinical setting is required, this is also done in a timely manner and in a caring way.
Outcomes
Hospital and Health Services included in the scope of this directive shall achieve the following outcomes:
- Compliance with Queensland Government Interagency Guidelines for Responding to People Who Have Experienced Sexual Assault.
- Compliance with the Queensland Health Guideline: Guideline for management of care of people 14 years and over disclosing sexual assault.
- Compliance with the Department of Health Guideline: Acute medical care of paediatric patients who have experienced alleged sexual abuse/assault.
- Compliance with the informed consent requirements detailed in the Queensland Health Guide to Informed Decision-Making in Healthcare
In doing so, HHSs will provide consistently high-quality, compassionate and person-centred services to people disclosing sexual assault who present to public hospitals.
Mandatory requirements
Hospital and Health Services (HHS) will:
- Provide 24-hour access to clinical care and forensic medical examinations for people 14 years and over disclosing a sexual assault in accordance with the Guideline for the management of care of people 14 years and over disclosing sexual assault.
- Ensure everyone who discloses that they are the victim of a sexual assault is informed of their choices about forensic medical examinations and reporting the assault to police, including the benefits of early reporting.
- Provide forensic medical examinations to victims of sexual assault when victims choose to have a forensic medical examination regardless of whether victims decide to report the matter to police or decide to defer this decision.
- Ensure adherence to informed consent for all aspects of caring for people disclosing sexual assault, including clinical treatment, forensic medical examinations, evidence collection and storage, police involvement, referrals and the release of information to third parties. This includes the right to withdraw consent at any stage.
- Provide clear information about the storage, access and destruction of forensic medical examination samples to victims of sexual assault who have a forensic medical examination but choose to defer the decision to report the assault to police.
- Each HHS should provide a suitable care pathway to ensure appropriate care for paediatric sexual assault patients (under 14 years of age)
- Ensure all patients are referred to (with patient consent) and/or provided information regarding sexual assault counselling and support services.
- Ensure compliance with the Fees and Charges for Healthcare Services Health Service Directive (QH-HSD-045) provisions regarding care for people disclosing sexual assault.
Note there are separate requirements for reporting suspected sexual offences against children to police and to child safety under the Criminal Code and Child Protection Act 1999.
- Under the Criminal Code (s 229BC) all adults are required to report any belief held on reasonable grounds that a child sexual offence is being/has been committed against a child (a person under the age of 16), or a person under the age of 18 with an impairment of the mind) by another adult (18 years and over).
- Under the Child Protection Act 1999 (s 13E) relevant persons (including a doctor, registered nurse and teacher) must report a reasonable suspicion that a child has suffered/ is suffering or is at an unacceptable risk of suffering significant harm caused by physical or sexual abuse.
Compliance
Compliance with this directive will be determined via:
- Hospital and Health Service performance monitoring processes.
Human Rights
Human rights are not limited by this Health Service Directive, however, implementation of the requirements described above will support the Right to healthcare.
Aboriginal and Torres Strait Islander considerations
Implementation of this Health Service Directive is expected to improve access to compassionate, trauma-informed care statewide and as such, will not impact negatively on Aboriginal or Torres Strait Islander people.
Related or governing legislation, policy and agreements
- Hospital and Health Boards Act 2011 (Qld)
- Criminal Code Act 1899 (Qld) sch 1 (Criminal Code)
- Victims of Crime Assistance Act 2009 (Qld)
- Police Powers and Responsibilities Act 2000 (Qld)
- Guardianship and Administration Act 2000 (Qld)
- Public Guardian Act 2014 (Qld)
- Queensland Health Guide to Informed Decision-Making in Healthcare
- Charter of Victims’ Rights
- Child Protection Act 1999 (Qld)
- Human Rights Act 2019 (Qld)
- Domestic and Family Violence Protection Act 2012
- Powers of Attorney Act 1998 (Qld)
Supporting documents
- Queensland Government Interagency Guidelines for Responding to People Who Have Experienced Sexual Assault (as amended from time to time)
- Queensland Health Guideline: Guideline for the management of care of people 14 years and over disclosing sexual assault (as amended from time to time)
- Department of Health Guideline: Acute medical care of paediatric patients who have experienced alleged sexual abuse/assault (as amended from time to time)
- Queensland Health Guide to Informed Decision-Making in Healthcare
- Queensland Health Guideline: Access to public health care for Medicare ineligible victim-survivors of sexual assault and/or domestic and family violence
Business area contact
- Office of the Chief Medical Officer, Clinical Excellence Queensland.
Review
This Health Service Directive will be reviewed at least every three years.
Next review due by: 28 June 2027
Approval and implementation
Directive Custodian
Chief Medical Officer, Clinical Excellence Queensland
Approval by Chief Executive
Director-General, Queensland Health
Approval date: 28 June 2024
Issued under section 47 of the Hospital and Health Boards Act 2011.
Definitions of terms used in this directive
| Term | Definition / explanation / details | Source |
|---|---|---|
Hospital and Health Service | Hospital and Health Services are statutory bodies and are the principal providers of public sector health services. | Hospital and Health Boards Act 2011 |
Forensic Medical Examination | The forensic medical examination consists of obtaining a history as to the nature of the assault to guide the subsequent physical examination. It also includes documentation of injuries and the collection of forensic samples as it relates to the alleged sexual assault. (A Forensic Medical Examination Kit (FMEK) is used to collect DNA evidence) | Queensland Government Interagency Guidelines for Responding to People Who Have Experienced Sexual Assault. |
Child | Under the age of 18 years of age, noting distinct reporting requirements for children under 16 years of age and separate treating requirements for children under 14 years of age.
For child victims of sexual assault, under the age of 14 years, forensic medical examinations should be performed by a medical officer with appropriate paediatric skills including child protection and/or sexual assault medical examination training or skills. | Department of Health Guideline: Acute medical care of paediatric patients who have experienced alleged sexual abuse/assault |
Trained Clinicians | Forensic Examinations can be provided by:
|
Version control
| Version | Date | Prepared by | Comments |
|---|---|---|---|
| V 1.0 | July 2019 | Community and Scientific Support, Health Support Queensland | New directive |
| V 2.0 | 17 November 2023 | Chief Medical Officer, Clinical Excellence Queensland | HSD updated |
| V 3.0 | 28 June 2024 | Chief Medical Officer, Clinical Excellence Queensland | HSD reference to QH-HSD-045 included |