Sexual health clinics in Manchester, Stockport, Tameside and Trafford will take part in the training to learn how to better identify, respond and refer patients who have experienced Domestic Violence and Abuse (DVA) and Sexual Violence (SV)
IRISi has joined forces with more organisations than ever before to improve the healthcare response to Domestic and Sexual Violence and Abuse. These numbers help us to understand why the effort has become paramount: according to the ONS, in the year ending March 2020, the police recorded 758,941 domestic abuse-related crimes in England and Wales, an increase of 9% compared with the previous year. The victims were female in 77% of these cases, while 16% were male. Furthermore, in the same period, there were 773,000 adults aged 16 to 74 years who were victims of sexual assault (including attempts), with almost four times as many female victims (618,000) as male victims (155,000) – which clearly evidences that domestic and sexual violence and abuse are gendered issues.
To tackle the problem, Greater Manchester has recently launched a new strategy setting out plans for a radical transformation in the city region’s approach to gender-based violence. This aims to challenge the attitudes and social conditions behind the issue and deliver whole system improvements in responses to those affected by it. These new actions include interventions provided by IRISi, like ADViSE (Assessing for Domestic Violence and abuse in Sexual health Environments), which aims to equip sexual health clinics to identify and support victims of domestic and sexual abuse.
The ADViSE Programme supports sexual health clinicians to identify and respond to women affected by DVA and SV and provides them with a simple referral pathway to specialist services. Recently launched by IRISi, the initiative is now ready to be implemented for the first time as a year-long pilot in four Greater Manchester districts, thanks to funding from the Greater Manchester Health and Social Care Partnership. In total, 10 sexual health clinics in Manchester, Stockport, Tameside and Trafford will take part in the training sessions scheduled to begin from October 2021. In recognition that – while the most pervasive forms involve violence against women and girls – there are many facets to gender-based violence, in the four localities where ADViSE will launch in Greater Manchester the programme will also include training to identify and support male victims.
All these clinics are covered by The Northern Contraception, Sexual Health & HIV Service at Manchester Royal Infirmary (MRI), which is part of the Manchester University NHS Foundation Trust (MFT).
“Following the success of initial pilots in London and Bristol, the Northern’s partnership with IRISi and their ADViSE programme will last for twelve months. We hope this will provide our staff with extra support in dealing with these often complex issues, giving staff more confidence when handling disclosures of DVA and SV”, says the MRI Team.
Dr Chitra Babu, Clinical Lead for the Northern Contraception, Sexual Health & HIV Service, said:
“As the largest provider of sexual and reproductive health services in Greater Manchester, we are already trusted by our patients with highly confidential, potentially stigmatising information and are adept at working in diverse populations and with vulnerable groups, who may not access other health care services. As a service we identified that there was a need for both our staff and our patients to enhance our screening and support for domestic violence and abuse (DVA), rates of which have escalated during the COVID-19 pandemic. IRISi have a proven track record in delivering successful evidenced-based DVA interventions in primary care and we felt the adapted ADViSE framework was a good fit for our patients. We are excited to work with our local partners who will be supporting us to deliver an enhanced staff training package as well as tailored support and signposting for our patients.”
Greater Manchester commissioning process
ADViSE has grown from IRIS (Identification and Referral to Improve Safety), a successful evidence-based programme that has been implemented in Manchester since 2012, amongst many other areas of the UK. This initiative promotes a collaboration between primary care and third sector organisations who specialise in DVA to provide training, support and a referral programme for General Practices. ADViSE works in a very similar way.
To start with, the programme for sexual health clinics relies on commissioners committed to funding the initiative and this, consequently, enables IRISi to find a specialist organisation operating in each area. In Greater Manchester, ADViSE was commissioned by the Greater Manchester Health and Social Care Partnership (GMHSCP) with the direct participation of Manchester, Tameside, Trafford and Stockport councils.
“This pilot is an opportunity to evaluate roll out of ADViSE across four Greater Manchester districts which requires partnership between sexual health services and four separate voluntary sector specialist partners. A proportion of patients attending sexual health services actively choose to access clinics outside their hometown. However, their preference for location of domestic abuse advocacy support may be closer to home. This pilot will monitor patient preference for advocacy location and will identify key success factors that enable efficient coordination and collaboration between voluntary, community and social enterprise (VCSE) partners so that specialist advocacy can be tailored as required. GMHSCP is committed to ensuring that all health and care settings offer a safe, trusted and supportive environment for disclosure of domestic abuse”, says the GMHSCP team.
Four areas, four social partner organisations to provide the proper assistance
Training health care professionals to identify and respond to Domestic Violence and Abuse (and, in the case of ADViSE in Greater Manchester, Sexual Violence) is core to both IRIS and ADViSE, but there is another key part in both interventions that enables their success. The partnership with a specialist organisation guarantees that each women referred can be properly assisted and supported by an Advocate Educator who is embedded in the health care setting where they work. The Advocate Educator works in a patient centred, trauma informed way to support each patient practically and emotionally. In this area, as explained before, male patients will also be able to access the programme.
“IRISi’s vision is a world in which gender-based violence is consistently recognised as a health issue. Our mission is to improve the health care response to gender based violence through health and specialist services working together. To achieve this, we are building a network of specialist partners who share our vision and have the drive to create sustained change. As a second-tier organisation IRISi does not support patients directly. We work with the frontline domestic abuse services that deliver the ADViSE Programme in local areas, our ADViSE Partners. We are delighted to be working in partnership with organisations and colleagues across Greater Manchester and to be launching this work”, explains Medina Johnson, CEO at IRISi.
IRISi has recruited 4 specialist organisations to work with in each area of Greater Manchester:
- Manchester Women’s Aid;
- Stockport Without Abuse;
- Trafford Domestic Abuse Services (TDAS);
- And JIGSAW Support (Part of the Jigsaw Homes Group).
The ADViSE Advocate Educators have been appointed already and will take part in a Train the Trainers course, delivered by IRISi, alongside both Clinical Leads of the Programme, Dr. Tom Hesse, Specialist Registrar, and Hayley Heapy, Senior Nurse, both working from The Northern Contraception, Sexual Health & HIV Service at Manchester Royal Infirmary (MRI).
“The Pankhurst Trust (Incorporating Manchester Women’s Aid) has delivered the IRIS project in Manchester to an exceptionally high standard for the past 9 years. All 88 GP practices in Manchester have received training and update training and referrals from GPs are consistently high. Sexual health and gynaecological problems are the most consistent, longest lasting and largest physical health difference between abused and non-abused women. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA) and sexual violence. Our aim is to train, support and offer a simple referral into the ADViSE service which aims to improve identification of patients experiencing domestic and sexual violence and abuse and their referral for specialist support.”
Nabeela Hussain, Health Lead/Ops Manager
Trafford Domestic Abuse Services (TDAS)
“The ADViSE project enriches the existing TDAS community outreach offer to achieve timely intervention for service users to support them to break free from domestic abuse. Sexual health clinics are key for earlier identification of domestic abuse and sexual violence. TDAS feel privileged to be a partner in the ADViSE programme pilot to educate professionals to improve their response to domestic violence and abuse, providing them with the appropriate knowledge and tools to refer into specialist services. ADViSE will enable victims to access services sooner and receive the support they need to break free from domestic abuse.”
Samantha Fisher (CEO) and Anita Pluckwell (Community Team Leader)
Stockport Without Abuse
“We are really excited about the ADViSE programme and in particular working with the sexual health teams locally. We hope that by increasing awareness and knowledge amongst both professionals and patients attending clinics, we can work with more victims to prevent domestic violence and contribute to ending the cycle of abuse at the earliest possible opportunity.”
Stephanie Mallas (CEO)
“Jigsaw currently run the Domestic Abuse service on behalf of Tameside MBC, we work with all victims of Domestic Abuse from Standard to High Risk. We feel the ADViSE Programme will enhance our response to domestic violence and abuse in sexual health clinics, by increasing the number of staff enquiries about domestic violence and abuse, and will also improve the responses to patients who disclose abuse whilst visiting the specialist clinics. In turn, this will improve referrals to specialist support services. Our expectations would be that after the training sexual health staff will feel confident about asking about domestic violence and abuse and will improve their ability to manage disclosures.”
Kerrie Pryde, Operational Director
Pieces of the puzzle all working together
Women affected by DVA are three times more likely to have gynaecological and sexual health problems. 47% of women attending sexual health services will have experienced Domestic Violence and Abuse (DVA) at some point in their lives and these services can be the first point of contact for support. At the same time, the latest estimates from the Crime Survey for England and Wales showed that fewer than one in six (16%) female victims and fewer than one in five (19%) male victims aged 16 to 59 years of sexual assault by rape or penetration since the age of 16 years reported it to the police.
Sexual health practitioners can have a key role in supporting patients to access advocacy services, but most have not had much training in identifying and responding to DVA or SV. ADViSE increases DVA and SV enquiry, response and referral, and staff confidence regarding DVA and SV. It strengthens local networks between sexual health services and the DVA and SV specialist sector and can increase safety for those women affected by DVA and SV.
If you want to know more about the ADViSE Programme, please get in touch: firstname.lastname@example.org.