Decision details

Background
The Saint Mary’s Sexual Assault Referral Centre (SARC) provides a comprehensive and co-ordinated forensic, medical and aftercare service to men, women and children living in the Greater Manchester area who have experienced rape or sexual assault, whether this has happened recently or in the past.

GMCA and NHSE Greater Manchester (with delegated responsibility for NHSE Health and Justice budgets) jointly commission the SARC service.

Demand for SARC counselling has been increasing steadily over the past 5 years. However, St Mary’s have struggled to recruit additional counselling staff leading to capacity issues with therapeutic support for both adults and CYP and waiting list pressures. Key issues:

• no capacity to regularly monitor waiting lists, to review suitability, assess risk, and refer to more appropriate services where necessary.
• no local protocols in place between SARC and Children’s Services/CAMHS (apart from in Manchester)
• unsuccessful recruitment over the past 2-3 years of counselling staff to permanent roles in St Mary’s SARC team


1) Adult counselling capacity

As of December 2023, 1260 adult clients were awaiting a counselling start date and 348 adult clients awaiting an assessment.

Noting these issues, NHSE Greater Manchester were successful in bidding for emergency nonrecurrent funding in order to introduce measures to mitigate and alleviate pressure in this system. An Investment of £67k has been secured to create a team of Band 6 Bank Counsellors via NHS Professionals, who will support the SARC Adult Counselling team to:

• Undertake a full comprehensive review of the adult counselling waiting list and attempt to contact all clients to determine continuing suitability for SARC counselling, to assess if clients still require/want SARC counselling, to review current risks and needs, to identify the type of counselling required and method of delivery. This will increase the number of counselling starts and reduce the waiting list times
• Complete a comprehensive review of the SARC Counselling Service, to examine current processes and provision and identify opportunities to refine and release efficiencies focused on patient outcomes. This will allow time for review, redesign and establishment of a sustainable counselling service provision with clearly defined pathways of care into SARC and also out of SARC to local support services. This will result in more effective, streamlined process, which will improve access to support and recovery outcomes and ensure counselling wait lists are maintained at a manageable level.

This will require additional 6 WTE Band 6 Counsellors and a band 6 Business Analyst. (working flexibly via NHSP)

• 4 x WTE at Band 6, 37.5 hours per week for 2 months
£31k (Wait List)
• 2x WTE at Band 6, 37.5 hours per week for 2 months
£16k (Business Process Change)
• 1 x WTE at Band 6, 37.5 hours per week for 2 months
£8k (Business Analyst)
• Provision of laptop and homeworker package for bank staff members £12k

Total cost of investment requested: £ 67k

£67k be committed from funding secured by NHSE GM Health & Justice Budget to Increase capacity at St Marys SARC for adult counselling for victims of rape and sexual assault. The additional staff capacity will increase the number of counselling starts and reduce the waiting list times leading to a sustainable counselling service provision with clearly defined pathways of care.