This paper describes the development of a designated in-house service for t
he management of adult female victims of sexual assault within the Departme
nt of Genitourinary Medicine (GUM) at St Mary's Hospital, London. This was
set up in 1994 as a need was identified by medical, nursing, psychological
and health advising staff for an appropriate streamlined service which woul
d provide comprehensive sexual health screening, psychological support and
therapy and adequate medico-legal documentation within the limitations of a
busy GUM clinic. A structured package of care consisting of medical and ps
ychological protocols with training for relevant staff and a specialist in-
house referral clinic was introduced. Fifty-four patients were seen during
the first 17 months of the service, the notes of 48 of these were examined
and relevant epidemiological and audit data are presented here. By auditing
the quality of documentation before and after the introduction of the prot
ocols specifically looking at the appropriateness and comprehensiveness of
the sexually transmitted diseases screen and the medico-legal documentation
it was clear that the quality of care to these patients was improved. We p
resent here the development of these protocols, a detailed description of t
he protocols themselves and the method of their implementation.