IRISi is a social enterprise committed to improving the healthcare response to gender-based violence through health and specialist services working together. In 2021, IRISi’s “16 Days of Activism against Gender-Based Violence” campaign is themed as “16 ways for the 16 days of action: how health care settings can improve their response to Violence Against Women and Girls”. Our aim is to reinforce that health care professionals have an undeniable and fundamental role in identifying victims and perpetrators so we can end violence against women and girls.
In order to do this, healthcare interventions such as the IRIS and ADViSE programmes, which were developed by IRISi to enable these professionals to recognise Domestic Violence and Abuse, can make a big and lasting difference. The positive outcomes in terms of referral and identification levels, as well as the cost-effectiveness of these interventions, have already been confirmed by several evaluations led locally and nationally – and the fact that both rely on the role of a Clinical Lead is vital to consolidate its success.
This practising local GP is usually appointed by the programmes to be responsible for co-delivering the training and for offering peer support for clinical colleagues in each practice. Each Clinical Lead works closely with the Advocate Educator and works proactively to raise the profile of IRIS and ADViSE locally. They are the clinical champions for the programme in their area, reinforcing the importance of DVA being addressed as a health issue and the support that these interventions can offer to clinicians and whole practice teams.
Since our Clinical Leads have a profound understanding of the obstacles in addressing DVA in health care settings, we invited them to consider the following questions: “In your experience as a Clinical Lead, what are the main challenges that need to be understood and addressed so health care settings can improve their response to Domestic Violence and Abuse?”. These are the answers of those who responded and joined our campaign!
“As a Clinical Lead, I am acutely aware that Victims and Survivors regularly present to GP surgeries and other NHS settings. We need to provide compassion and a safe space for our victims and survivors within all healthcare settings. Never forget that any patient or member of the healthcare team can be a victim or survivor of domestic abuse, regardless of their background or how they may appear. The NHS is under immense pressure and demand for NHS services has never been greater. It is so vital that in the day-to-day business and stress of our current working lives that we as healthcare professionals don’t lose our professional curiosity. Taking that little bit of time to enquire ‘how things are at home’ can make all the difference to a victim or survivor. Giving them the opportunity to share their experiences with you could be the first step to improving, transforming, or even saving their life.”
– Dr Jen Standen
“As clinical lead for four years, I continue to be impressed with the work that our Advocate Educators do to promote and help share the voice of lived experiences of women who are victims of domestic violence. Despite the particularly challenging times, we are in with time constraints, remote working, I continue to encourage my colleagues to have the courage to ask the difficult questions around domestic violence towards women and families. I ask for more time and resources for professional curiosity about the interrelationships of these families as answers are often in notes or existing knowledge and experiences from clinical colleagues, patterns of behaviour that need the focused time to be pieced together and interconnected in structured practice settings. Strategically and carefully reducing the IT and organisational barriers to allow appropriate and wider sharing of information between local authority, police, health and education would be a step in the direction of supporting our professional curiosity. Domestic violence and its patterns of coercion and controlling behaviour in relationships is far more prevalent and far too often more accepted than we think as we scratch the tip of this iceberg.”
– Dr Joanna Yong
“The greatest change which could be made is to ask about domestic violence and abuse routinely in the way we ask about smoking or alcohol. The impacts on the mental and physical health of women are just as significant, yet this question is often missed in consultations.”
– Dr Amisha
“It now goes without saying that prevention and alleviation of DVA via IRIS training in General Practice is crucial. As a Clinical Lead in IRIS for my Health Board of 1.5 years training has been steady. I do feel, however, that Health Boards could do more to support the rollout of training by giving the hard-pressed clinical teams time away from clinical work and covering this with locums to allow the training to occur in a protected way. The work of training teams by IRIS is crucial and this support from Health Boards would signal its importance to the whole of Primary Care. This way the message would be of higher quality, more impactful and get help to this vulnerable group more quickly.”
– Heather Potter