Performing female genital mutilation (FGM) is prohibited within the UK by the FGM Act of 2003. A mandatory reporting duty for FGM requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. An application to the court for an FGM protection order (FGMPO) can be made to keep individual women and girls safe from FGM. This paper reveals the significant disconnect between the number of FGMPO applications and known recorded cases of FGM. The introduction of FGMPOs requires critical exploration as there is insufficient evidence to show that FGMPOs are effective in protecting women and girls from FGM. It is therefore unclear what impact, if any, FGMPOs are having upon the protection of women and girls at risk of FGM. The barriers to the implementation of FGMPOs and possible solutions are discussed.

About the reportThe Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.Health Data Research UK (HDR UK) is the UK's national institute for health data science. HDR UK's mission is to bring together the UK's health and care data to enable discoveries that improve people's lives by uniting, improving and using data as one national institute. HDR UK's Better Care programme aims to equip clinicians and patients in the UK with the best possible data-based information to make decisions about their care. 1 Over the past 2 years, as part of this wider programme, the Health Foundation and HDR UK have been working in partnership to deliver the Better Care Catalyst programme. This has funded three projects to develop data-driven tools that aim to improve health care decision making 2 and also supported three workstreams to set out the training, knowledge mobilisation and policy actions required to support data-driven learning and improvement in health care. This report is the final output of the Better Care Catalyst programme's policy and insights workstream, which researched the barriers and enablers for implementing learning health system approaches in the UK. It supports the wider Better Care programme and community by providing analysis and advice to further the use of data to improve health care services. It also identifies a range of opportunities and actions that policymakers and organisational and system leaders can take to advance the learning health systems agenda across the UK. 3

COVID-19 presented a huge unplanned pressure on health resources worldwide. Across the NHS, different approaches have been utilized to respond to the crisis. Leadership figures across services were faced with difficult decisions with potential scarcity of resources never before seen by NHS providers. In the medium-sized District General Hospital where I am based, one of the key changes implemented, was the placement of a Junior Doctor into Hospital management and Leadership teams. Under direct supervision from the Medical Director and Associate Director of Medical Education, I was released from a significant proportion of my clinical work to provide leadership and oversight into decisions affecting junior doctors. As a Foundation Doctor in my final rotation of Foundation Year 2, this provided a unique experience to not only observe senior policy and strategic decision making, but also to lead on several projects. Coming from a Trust with historically poor performance metrics in trainee experience, it was recognized that this was an opportunity to instigate both structural and cultural change across divisions. This article will discuss the lessons learned from this experience, highlighting areas for improvement, with the hope of empowering junior doctors to take senior leadership roles in the future.