The need and development of a forensic service in adults at risk of harm

Elizabeth Alton, Barry Tolchard, Margaret Stark

Research output: Contribution to journalArticlepeer-review


Purpose: The purpose of this study was to provide proof of concept and evaluate the project for the development of a forensic service in safeguarding adults at risk of harm who may have suffered a non-accidental injury as a result of physical abuse or neglect. Design/methodology/approach: This pilot project arising from a Safeguarding Adults Review was designed using an iterative process. Opinion from all partners of the Safeguarding Adults’ Boards in two adjacent areas as well as using expert forensic advice from the Faculty of Forensic and Legal Medicine was sought. Findings: All professionals recognised the need for a forensic service because at present decision-making around potential non-accidental injuries (NAI) may not be evidence based. The main barriers were seen as lack of knowledge and education combined with the area of work not being recognised as being needed and hence not commissioned. No similar service existed in England to aid the project being developed either academically or practically, other than reflecting what happens in children’s safeguarding. Practical implications: The knowledge and skills as well as the resources developed for this project will aid safeguarding professionals to make more informed decisions when working with adults at risk of harm who have sustained a potential NAI. Originality/value: This project has high originality with no other area in England offering a similar service or in the process of developing a service at present.

Original languageEnglish
Pages (from-to)189-198
Number of pages10
JournalThe Journal of Adult Protection
Issue number4
Early online date14 Apr 2023
Publication statusE-pub ahead of print - 14 Apr 2023

Bibliographical note

Funding Information:
Funding for this project was provided by the Humber Clinical Commissioning Groups.

Funding Information:
The FFLM was approached in March 2020, their expertise was seen as key to the success of the project. Working collaboratively and with financial support from NHSE, a course was devised to train a cohort of forensic medical examiners. The course was run over two half-days. The first session focused on describing and documenting injuries, with discussion around interpreting the causation of injuries. Attention was paid to writing a report for the purpose of an S42 enquiry. The second half-day covered working with adult social care and the police. Writing a report and appearing in court was covered. Feedback was collected from the course and on two subsequent courses taking a history from cognitively impaired adults has been included.

Publisher Copyright:
© 2023, Emerald Publishing Limited.


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