“Clinicians are having to creatively consult in different ways to still assess and manage tricky situations as best they can”. IRISi interviewed leading researchers and key specialists to talk about the impact of the pandemic on Domestic Violence and Abuse in the UK – and here are 3 responses to our Look Beyond campaign questions from Dr. Lucy Potter, Academic GP
As we continue with our “Look Beyond the Pandemic” campaign, IRISi interviewed leading researchers and key specialists to talk about the impact of the pandemic on Domestic Violence and Abuse in the UK. Here is what Dr. Lucy Potter, academic GP, told us. She also runs an outreach clinic for street sex working women as part of the Homeless Health Service and conducts research into domestic and sexual violence and health, and access to primary care for women with complex needs.
1) How did the pandemic change the health care response to domestic violence and abuse? What were the main difficulties that clinicians had to face once the lockdown was put in place?
It is exceedingly rare for a patient to present outright that the issue they want to discuss is domestic violence and abuse. It generally needs to be sensitively and skilfully elicited, often over a period of time or a number of consultations. Healthcare services had to respond quickly to limit transmission risks of COVID-19 by quickly switching to remote access (phone or video call) to triage and limit who needed to physically come to the space. The immediate loss of routine face to face interaction meant healthcare professionals lost a key aspect of communication we rely on. It is now much harder to see those ‘soft’ signs that might alert us to consider asking more. If we do consider asking more we have to navigate this with less certainty of who might be listening in the background and the very real safety concerns around this. Clinicians are having to creatively consult in different ways to still assess and manage tricky situations as best they can.
2) How did the pandemic affect marginalised women and women facing multiple disadvantage?
For many reasons the pandemic is worsening inequalities. Women facing multiple disadvantage often carry and manage a high level of risk. When they are well engaged with a service or professional that is meeting some of their needs this risk is, to an extent, shared and supported. Women facing multiple disadvantage are less likely to have both the practical capacity (phone with credit, computer with video access, safe space to have sensitive discussion, ability to perhaps wait for a while in this situation for a call back) and the trust/ rapport/ self-confidence necessary to be able to access meaningful remote support. The pandemic has brought challenges to everyone, but if you are already carrying a high level of complex disadvantage the impact is even greater.
3) What has the pandemic taught us about the primary care response to DVA, especially concerning this particular group of women? Were there any new findings that only became possible due to the pandemic?
Mainstream primary care is still incredibly busy, and will only be more so with potentially delivering the COVID-19 vaccination hopefully very soon! While healthcare professionals largely do their best to support more vulnerable patients who access primary care, they can’t see those who don’t make it over the hurdles. The pandemic has made these women less visible to mainstream services. As part of the Homeless Health Service I have shifted to reaching out further, by collaborating with One25 on their outreach van to provide support to some of Bristol’s most marginalised women on the street. The healthcare provision that is possible in this environment is certainly limited, but it has increased engagement with some highly vulnerable individuals. As we move away from lockdown and indoor face to face services become more normal again, it is vital that we do not forget those who struggle to even get through the doors.
Dr. Lucy Potter is an academic GP. She runs an outreach clinic for street sex working women as part of the local Homeless Health Service and conducts research into domestic and sexual violence and health, and access to primary care for women with complex needs.