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Medical forensics specialist group minutes: 5 June 2019

Updated 5 July 2022

Minutes of the eighth meeting held on 5 June 2019, at 5 St Philip’s Place, Colmore Row, Birmingham

1. Welcome and introductions

1.1. The Chair welcomed all to the meeting. See Annex A for a list of representatives present.

2. Minutes from previous meeting and update on actions

2.1. The minutes of the previous meeting held on 9 January 2019 had been approved by members prior to the meeting and were published on the GOV.UK website.

2.2. All actions from the last meeting were complete.

3. Stakeholder updates

UKAS

3.1. UKAS were keen to engage with the medical forensics community and arrange workshops on gaining successful UKAS accreditation. Before this could happen, it was important for UKAS to meet with CQC and the Regulator, to address and clarify queries they had. It was confirmed that talks were already taking place between CQC, UKAS, and the Regulator and these were progressing well. It was agreed that workshops would be beneficial to the community and should happen sooner rather than later. It was suggested to aim for the workshops to be delivered by the end of the year.

Action 1: FSR/FSRU to arrange a meeting with UKAS, CQC, and the NHS to discuss what should be included within the workshops, and source suitable dates and venues.

NHS/Policing

3.2. The NHS representative provided a brief update. The NHS had been engaging with The Metropolitan Police, and other parties to discuss the change programme and cost concerns with the SARCs providers.

Action 2: FSRU to itemise the main costs for SARCs to gain accreditation and liaise with the group members to confirm specific costs.

4. Work plan

Update future work items

4.1. The members discussed the work plan for the group going forward, and possible future work items for the group to work on. It was suggested that more detailed guidance on environmental monitoring, cleaning, and Personal Protective Equipment (PPE) was required. The representative from Hampshire Constabulary mentioned to members their own experience concerning the cleaning process at their SARC. The representative explained they have evidence-based data that could assist in developing the SARC cleaning guidance. The Regulator emphasised it was important to reduce the risk of DNA contamination in the SARCs, and the guidance document could help SARCs to minimise the risk of contamination.

Action 3: FSRU to update the work plan, and members to send any further comments on the work plan to the FSRU.

4.2. The members discussed developing standards and guidance for examining suspects in custody. Members were reminded that FSR-G-207 guidance already provided to SARCs could also be applied to custody.

4.3. A member queried when the guidance for environmental monitoring, cleaning, and PPE would be developed. Updating FSR-G-207 anti-contamination guidance document was mentioned, and members were asked if these specific areas should be added to the current document. The members agreed these areas should be added to the FSR-G-207 document. The group was asked for volunteers to progress this work. The volunteers would scrutinise the FSR-G-207 document and identify what sections required more information, and what information was missing from the document. Members who volunteered included Hampshire Constabulary (CL)representative, Health Justice Group representative (VW), Faculty of Forensic Legal Medicine representative (CW), and The Havens representative (RA)

Action 4: FSRU to send the volunteers the FSR-G-207 document for review and comments on what additional information could be added to the document.

Nominations for the chair of the MFSG

4.4. It was confirmed the current chair of the MFSG would be stepping down as chair in September 2019. The Regulator thanked the chair for their work, and contributions to the MFSG. Members were asked to think about nominations for the new chair. It was suggested that it would be desirable if the new chair had relationships with the NPCC, or policing, to steer the group’s future work on custody. Members were advised to email their nominations to the Forensic Science Regulator (FSR). The Regulator would also be raising the matter with the relevant NPCC representative staff officer.

Action 5: Members to email nominations for the new MFSG chair to the FSR.

Action 6: FSR to discuss the new MFSG chair with NPCC representatives.

5. Contamination presentation

5.1. The Hampshire Constabulary representative presented to members the work and monitoring they were doing to minimise the risk of contamination in their in-house SARC.

5.2. In 2013 biological fluids had been identified on an environmental swab that had been submitted for testing. Further investigations revealed that the body fluids were identified on equipment used after they were cleaned. This led to a review of their cleaning practices in their SARC.

5.3. The review identified challenges in the cleaning practices. The contractual cleaners appeared to have had very little knowledge about cleaning to meet DNA clean standards, commonly referred to as ‘forensic cleaning’. The cleaners were provided with refresher training on forensic cleaning. Another challenge highlighted was that some members of the cleaning staff were heavy shedders of DNA. It was decided these members of staff should not clean the medical examination rooms. When DNA 17 profiling was introduced in 2014 the increased sensitivity detected lower levels of human DNA than the previous methods. Depending on which of their two FSPs was used for testing it was noted that there was some difference in the reporting levels used.

5.4. The validation of cleaning products was mentioned. The change to DNA 17 profiling did affect some of the cleaning products used in the SARC. DNA denaturing cleaning products were reviewed and tested.

5.5. A local SARC staff elimination database (SED) was created specifically for Hampshire. Individuals who were involved in the in-house forensic science services; had their DNA samples taken and were profiled and uploaded to the local SED database.

5.6. There were monthly deep cleans performed at the SARC by a contracted cleaning company. Cleaning was also completed between clients by the crisis workers. The environmental samples were taken the same day as the deep clean or the day after. There was a variable time delay between the samples been taken, and the results coming back from the FSP’s. Only the areas that were reported as failing to meet a certain DNA level were re-cleaned, and then new environmental samples sent to the FSP’s for testing.

6. Consultation feedback on the FSR SARC standard and guidance documents

SARC standard (FSR-C-116) document review

6.1. Members discussed the feedback received to date from the public consultation on the forensic medical examination: assessment, collection and recording of forensic evidence standard (FSR-C-116). Members were asked for further comments that should be taken into consideration.

6.2. Members had been provided with a document that contained further information that explained the reasoning on some of the responses and the decisions made regarding the consultation feedback. Members were asked if they had any comments on this document. The members confirmed they were happy with the information within the document. It was explained all feedback received pertaining to the standard and guidance had been responded to. There was some feedback that had been rejected or suggested changes provided. Members were asked if they had any final comments on the FSR-C116 SARC standard.

6.3. A member mentioned The Faculty of Forensic & Legal Medicine (FFLM) references within the standard were out of date and there was a newer version available.

6.4. The members discussed feedback received concerning the FSR-C-116 standard. A member raised a concern on feedback received regarding meeting the accommodation and environment requirements for this standard. It was agreed more guidance was required in this area despite it being outside of the remit of the Regulator. It was explained a meeting had been held between the FSRU, the Havens, St Mary’s and a Cellmark Forensic Services representative that discussed the basic requirements and potential issues that should be considered. It was agreed a simplified diagram would be included within the guidance. The diagram would highlight the minimum requirements for the accommodation and environment specially for SARCs. Once the diagram, and the guidance had been completed, it would be circulated as a separate document and members would be invited to comment before it would be inserted into the main guidance document FSR-G-212.

6.5. Validation of cleaning products used in SARCs was discussed by members. It was agreed by members it was important to inform the SARCs of the cleaning products they should be using to adequately remove detectable levels in DNA.

Action 7: FSR to contact the AFSP regarding cleaning products that had been validated.

6.6. The members discussed the Elimination DNA database. A member raised a concern on cost implications of paying for these samples to be added to the Elimination DNA Database. It was also queried on the progress of the Home Office Central Elimination DNA Database (CED) pilot. A member queried if the SARCs could have their own Elimination DNA Database, or would they have to use the CED one. The Regulator explained she would have no concerns if SARC’s used a local Elimination DNA database or the CED. The guidance would be amended to reflect that the samples could be uploaded to a local Elimination DNA database or the CED.

Action 8: The FSR will contact a representative at FINDS for an update on the CED pilot.

SARC guidance (FSR-G-212) document review

6.7. Members discussed the feedback received to date from the public consultation on the forensic medical examination: assessment, collection and recording of forensic evidence guidance (FSR-G-212). Members were asked for further comments that should be taken into consideration.

6.8. A member suggested adding adults at risk, within the safeguarding issues safety plans which specifically related to children within the guidance document. Members queried whether notes specifically pertaining to injuries would be considered within the medical or forensic remit, and who would view these notes for example CQC and/or UKAS. It was agreed that the notes could fall into both categories.

Action 9: The FSR, CQC and UKAS to provide further clarification on status of notes on injuries under each inspection regime.

6.9. A member suggested adding in Royal College of Paediatrics and Child Health (RCPH) under the Forensic Physician section of the guidance.

Action 10: RCPCH & FFLM paediatric representative (LT) to send the FSRU wording on section 7.116 of the guidance document.

6.10. A member suggested there should be additional information provided concerning the first account process as mentioned in 7.5.9 of the guidance.

Action 11: RCPCH & FFLM paediatric representative (LT) to send the FSRU wording on section 7.5.9 of the guidance document.

6.11. A member suggested it would be useful to add a link to the chain of custody form in the appendix.

Action 12: FSRU to add a link to the chain of custody form in the appendix.

Action 13: Hampshire Constabulary representative (CL) to send further comments to the FSRU.

Action 14: Health Justice Trailblazer group representative (VW) to send further comments to the FSRU.

7. AOB

7.1. The UKAS representative was seeking advice from the MFSG on sourcing technical experts from the medical forensic community. Members suggested clinicians, and retired health practitioners could be suitable candidates to consider.

Action 15: The UKAS representative to provide FSRU their requirements and for this to be circulated to the group for comments and suggestions.

7.2. The membership list for the group required updating. Members would be asked to provide their current representatives names, and email addresses.

Action 16: Secretariat to update membership list. Members would be emailed requesting up to date contact information.

8. Date of next meeting

8.1. The next meeting would be held on Monday 2 September 2019 in Birmingham.

Annex A

Organisation representatives present

• Independent National Forensic Advisor (chair) - MN
• UK Accreditation Service (UKAS) - DG
• Faculty of Forensic Legal Medicine - CW
• UK Accreditation Service - AB
• The Havens London - RA
• Criminal Case Review Commission - MT
• UK Association Forensic Nurses - MB
• Care Quality Commission - LD
• NHS England - Health & Justice – A H
• Royal College of Paediatrics and Child Health - LT
• Hampshire Constabulary - CL
• Hampshire Constabulary- SM
• Mountain Healthcare - VW
• Forensic Science Regulator - GT
• Forensic Science Regulation Unit - JG
• Forensic Science Regulation Unit - GW
• Home Office Science Secretariat – NR

Apologies

• NHS - CK
• General Medical Council - RM
• The Chartered Society of Forensic Sciences - AH
• Department of Health - AM
• Police Service Northern Ireland - UW
• Police Scotland - LR