This toolkit provides busy practitioners with an easily navigable resource to ensure excellence in safeguarding practice in Primary Care.
We are awaiting a review before updating this resource. Please use with caution.
Child Sexual Exploitation (CSE)
Awareness of child sexual exploitation (CSE) is essential for GPs and their staff especially in the provision of contraception and sexual health services to young people who may be victims of this form of abuse. Co-existence with substance misuse is often a feature, as is an increased risk to those who have a history of adverse experiences in childhood, including interfamilial maltreatment and being in care.
The NSPCC defines CSE as:
"Child sexual exploitation (CSE) is a type of sexual abuse. Children in exploitative situations and relationships receive something such as gifts, money or affection as a result of performing sexual activities or others performing sexual activities on them."
"Children or young people may be tricked into believing they''e in a loving, consensual relationship. They might be invited to parties and given drugs and alcohol. They may also be groomed and exploited online.
"Some children and young people are trafficked into or within the UK for the purpose of sexual exploitation. Sexual exploitation can also happen to young people in gangs.
"Child sexual exploitation is a hidden crime. Young people often trust their abuser and don'' understand that they''e being abused. They may depend on their abuser or be too scared to tell anyone what'' happening.
"It can involve violent, humiliating and degrading sexual assaults, including oral and anal rape. In some cases, young people are persuaded or forced into exchanging sexual activity for money, drugs, gifts, affection or status. Child sexual exploitation doesn't always involve physical contact and can happen online.
It is vital to acknowledge that a groomed child is not consenting to sexual activity."
Summary of 'Spotting the Signs' – a framework to help professionals detect CSE
CSE is an abuse of power and can take many forms such as:
Factors that put young people at risk of CSE:
Potential risk factors:
Migrant, refugee or asylum seeker • Financially unsupported • Changes in behaviour • Death, loss or illness of a significant person • Staying out overnight with no explanation • Substance misuse by parents, carers or child • Experiencing homophobia • Being groomed on the internet • Disappearing from the 'system' with no contact or support • Being taken to clubs and hotels by adults and engaging in sexual activity • Disclosure of serious sexual assault and then withdrawal of statement • Being moved around for sexual activity • Abduction and forced imprisonment
Although in the UK the age of consent is 16, a 16 or 17-year-old can still be sexually exploited. Irrespective of age, a person's ability to give consent may be affected by a range of other factors, including alcohol, drugs, threats of violence, grooming or an imbalance of power between perpetrator and victim.
Asking about CSE
Have they ever:
If they're having sexual contact:
This Child Sexual Exploitation Risk Questionnaire (CSERQ) (Word) is a useful tool for practitioners working with young people.
One of the challenges for primary care is that clinicians may lawfully prescribe contraception for sexually active children under the Fraser guidance. It should be remembered that this was intended to give advice on consenting children who were sexually active. In CSE, the child is not consenting due to the fact they are being groomed or coerced.
Professionals working with children need to consider how to balance children's rights and wishes with their responsibility to keep children safe from harm.
Resources for identifying CSE
- The British Association for Sexual Health and HIV (BASHH) and Brook have developed a child sexual exploitation (CSE) proforma, Spotting the Signs, to help health professionals across the UK identify young people attending sexual health services who may be at risk of or experiencing sexual exploitation.
- Department for Education: Child sexual exploitation: definition and guide for practitioners
- This is a useful and informative video (15 mins) on spotting the signs of child sexual exploitation produced by Health Education England.
- A child's experience of sexual exploitation: Fixer's film - Stopping Sexual Exploitation