Any sexual activity under 13yr classifed as assault, according to RCPCH. Not the same rules as capacity and consent for medical treatment.  Sexual offences Scotland act 2009.  Consent must be “free agreement” so sleep, coercion, under influence not allowed.  Disclosure of child protection concerns is tricky due to fear of disengagement with service.

Police (family protection unit) refer for forensic medical viz joint police surgeon and paediatrician. Video colposcopy and swabs. Consent incl data protection important. Bloods only if high risk.  Rapid HBV immunisation.

Social work can consent if guardian is perpetrator.

Disclosure of child protection concerns is tricky due to fear of disengagement with service.

Difficult to exclude internal injuries since speculum/rectal exams not acceptable for pre-pubescents: relies on details of history.

ULIPRISTAL (ellaOne) new post intercourse contraception, window of 5 days. IU device not suitable for poorly oestrogenised.

Support services: advice leaflets, SW follow up, GUM clinic at 1/52, CAMHS.