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From November 1st, 2022, patients in England and over the age of 16 will be able to access more detailed information from their medical records through online apps. Access to this will become automated so that all patients, unless restricted by the general practice, can access the service.  Currently, patients request access which allows decisions to be made by practices about whether it is safe for a patient to have access or not.

Unless access to the record is restricted by GPs, all patients will be able to see consultation notes and codes which are added to the record after the launch date.

GP practices can decide to restrict access to the online records, either for individual patients, or groups of patients. For example, patients with learning disabilities, or patients who have a history of domestic violence. But we are aware that this will create additional work for practitioners.

There is already guidance which has been produced for practitioners by a number of organisations.  This includes a document written by named Safeguarding leads who have outlined safeguarding considerations and concerns (click here to see it).   

NHS England have also produced a GP readiness checklist for practices to identify actions which might need to be taken before November the 1st (click here to see it).

General practices who have already been IRIS trained will already be aware of how they should be recording DVA in their patient’s medical records. This includes the very clear guidance that when documenting DVA clinicians should:  “Use the online visibility function to hide this consultation from patient online access”, this is covered in both Clinical 1 and Clinical 2 training. Clinicians should continue to adhere to this guidance. Clinicians might also want to hide other medical information from online visibility for those patients in abusive relationships. For example, information about sexual or reproductive health. 

However, it is likely that IRIS Advocate Educators and Clinical Leads will be asked about the new automated access when discussing documenting DVA within IRIS training. We want clinicians to continue to document DVA but to do this safely by hiding online visibility.

General practices can decide to prevent automatic access to ALL patients who have DVA coded on their records. This can be achieved by adding the SNOMED code “Enhanced review indicated before granting access to own health record” (the “104 code”).  This can be done by practices for individual patients or for groups of patients where there might be a risk associated with granting online access (see links above).

We have some concerns about the visibility of third-party communications received by general practices, for example, letters from other professionals which might refer to DVA or issues of concern.  We recommend that AEs raise this with clinicians, as well as within reception and admin, in training. 

IF IN DOUBT – DOCUMENT IT – THEN BLOCK IT OUT

IRISi’s key message is that they should continue to document abuse as this is very important, especially to document the impacts of abuse which might not be collected elsewhere, particularly in cases of coercion and control.  But if clinicians have any concerns, they should document and then block it out by removing online visibility. 

If you belong to the IRIS network, we will be providing an online training session/drop-in for AEs and CLs on Monday 31st October to outline this information in more detail. This is to make sure you are comfortable discussing the changes with clinicians if they ask in training.

We are happy for you to forward this outline to your local GPs if they ask about the changes, and if you do not feel comfortable responding to a specific query, you can always ask your Regional Manager.

Please note, this change is only relevant, presently, to practices in England.

Finally, we will be holding an information/drop-in session for AEs and CLs, details of how to book onto that will follow.

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Partners

AVA
AVA
AVA

AVA is an expert, groundbreaking and independent charity working across the UK.

Their vision is a world without gender based violence and abuse. They aim to  inspire innovation and collaboration and encourage and enable direct service providers to help end gender based violence and abuse particularly against women and girls.AVA’s work is focused around those areas where they can make the best contribution to ending violence and abuse. They do this by making sure that survivors get the help and support they need in the here and now, through providing innovative training that has a proven direct impact on the professional practice of people supporting survivors of violence and abuse

developing a range of toolkits, e-learning and other material that supports professionals to provide effective and appropriate support to survivors of violence and abuse

using our influence and networks to ensure survivors voices are heard. We work closely with AVA in many areas including the Pathfinder project

https://avaproject.org.uk

SafeLives
SafeLives
SafeLives

SafeLives are a national charity dedicated to ending domestic abuse, for good. We combine insight from services, survivors and statistics to support people to become safe, well and rebuild their lives. Since 2005, SafeLives has worked with organisations across the country to transform the response to domestic abuse, with over 60,000 victims at highest risk of murder or serious harm now receiving co-ordinated support annually. SafeLives are members of the Pathfinder consortium.

http://www.safelives.org.uk/about-us

IMKAAN
IMKAAN
IMKAAN

Imkaan is a UK-based, Black feminist organisation. We are the only national second-tier women’s organisation dedicated to addressing violence against Black and minoritised women and girls i.e. women and girls which are defined in policy terms as Black and ‘Minority Ethnic’ (BME). The organisation holds nearly two decades of experience of working around issues such as domestic violence, forced marriage and ‘honour-based’ violence.

They work at local, national and international level, and in partnership with a range of organisations, to improve policy and practice responses to Black and minoritised women and girls. Imkaan works with it’s members to represent the expertise and perspectives of frontline, specialist and dedicated Black and minoritised women’s organisations that work to prevent and respond to violence against women and girls. Imkaan delivers a unique package of support which includes: quality assurance; accredited training and peer education; sustainability support to frontline Black and minoritised organisations; and facilitation of space for community engagement and development. They are a part of the Pathfinder Consortium.

https://www.imkaan.org.uk

The University of Bristol CAPC
The University of Bristol CAPC
The University of Bristol CAPC

The Centre for Academic Primary Care (CAPC) is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research.  It is part of Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

A dedicated team of researchers at the Centre work on domestic abuse projects and IRISi is a co-collaborator and partner on some of these projects including ReProvide, HERA and DRiDVA.

The Health Foundation
The Health Foundation
The Health Foundation

The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The Health Foundation’s Exploring Social Franchising programme aims to generate a deeper understanding of the potential of social franchising models for scaling effective health and social care interventions within the NHS.

We are one of four project teams participating in the programme to develop a social franchise to enable the sustainable spread of our intervention, the IRIS Programme. We receive funding and support from the Health Foundation, including technical expertise on social franchising, and attend programme learning events. The Health Foundation has also commissioned a programme-wide evaluation to support understanding of the use of social franchising in the UK health and care system. We and our franchisees will support the evaluation through co-designing data collection requirements, providing access to data as requested, hosting site visits and attending learning events.

https://www.health.org.uk

STADV
STADV
STADV

Standing Together Against Domestic Violence is a UK charity bringing communities together to end domestic abuse. They bring local services together to keep people safe

Most public services weren’t designed with domestic abuse in mind, and they often struggle to keep people safe. Poor communication and gaps between services put survivors at risk.

STADV aim to end domestic abuse by changing the way that local services respond to it. They do this through an approach that they pioneered, called the Coordinated Community Response. The Coordinated Community Response brings services together to ensure local systems truly keep survivors safe, hold abusers to account, and prevent domestic abuse.

Their model of a coordinated local partnership to tackle and ultimately prevent domestic violence is now widely accepted as best practice. They are also a part of the Pathfinder consortium.

http://www.standingtogether.org.uk

Spring Impact
Spring Impact
Spring Impact

Spring Impact is a not-for-profit social enterprise born out of the frustration of seeing social organisations constantly reinventing the wheel and wasting scarce resources. Spring Impact uses a combination of tested commercial and social principles and extensive practical expertise to support organisations to identify, design and implement the right social replication model to scale their social impact.

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