The NHS should not adopt One (FGM) Question

Nursing Times ran a survey in July and August 2023 in partnership with an FGM charity, The Vavengers. It is the charity’s view that all nurses need knowledge of FGM/C and wanted to identify whether they had it.

The Vavengers also believe that all female NHS patients should be asked about FGM as a standard in order to identify more survivors and to remove the risk of discrimination. So it is lobbying for the question ‘have you been subjected to female genital mutilation/cutting?’ to be added to all appropriate NHS forms.

I wrote about my misgivings in regard to this here.

FGM/C has been a topical issue within the NHS and nationally for almost a decade and I’ve written extensively and critically about it on this blog.

England’s NHS policy stipulates that its 1.27 million full-time equivalent staff need some knowledge of FGM/C. That just a few need specialist skills.

Survey responses

Nursing Times has 25,000 paid subscribers and is ‘the largest international nursing journal read by over a million people every month’. But only 690 people responded to the survey. They included nurses, health visitors, midwives, nursing associates, healthcare assistants, and nursing and midwifery students. Seventy five per cent were based in England and the largest group, 38.31 percent, were over 55.

We don’t know what proportion believed that they needed to know about FGM/C.

Findings

The findings were mostly presented negatively in the Nursing Times report. The header read ‘‘Nurses lacking training and confidence in FGM care’’ and then revealed that “More than a third of nursing professionals in the UK have received no training on female genital mutilation (FGM) and many would not feel comfortable speaking to patients about this topic’.

But in fact respondents demonstrated a reasonably high level of awareness. Many reported they had undergone training about FGM/C and felt confident in asking people about it. In summary:

• almost all knew what FGM was
• 63 per cent reported they would feel confident asking female patients about FGM even if they suspected the patient to be a survivor
• 27 per cent said they would not feel fully confident asking female patients about FGM even if they suspected she was a survivor
• over a third had received extensive or adequate training on the practice 
• 30 per cent had received limited training
• 36 percent had not received any training
• only six percent said they had a limited understanding of it

Yet The Vavengers assessed that the findings “provided us with a clear insight into the lack of training and support available to frontline workers”.

On the basis of the small sample size and limited findings I hope the NHS would not begin to consider asking all women accessing NHS care whether they’ve been subjected to FGM. My many additional objections to it can be accessed here.

NHS Policy in England already states that all staff working in the NHS need some knowledge of FGM. Safeguarding training could easily address the 36 percent who had not received any – if they really needed it.

Update April 2024

The Department of Health and Social Care recently commissioned NHS England “to carry out a review of the Female Genital Mutilation (FGM) Enhanced Dataset to ensure it is still fit for purpose, the information is provided in a simple and sensitive manner, and to improve the completeness and quality of the data.”

Included were two questions, presumably directed at female respondents when accessing the NHS?:

1. As a patient, would you mind being asked if you have been subjected to FGM every time you fill in a health registration form?

Yes. No. Unsure.

2. Would you expect a trained professional to follow up this with you?

Yes. No.