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In the fourth of our 16 blogs for 16 days, Jess Asato, Head of Public Affairs and Policy at SafeLives discusses the crucial role of Independant Domestic Abuse Advisors (Idvas) in hospitals.

In 2016 SafeLives launched our report A Cry for Health which argued that every acute hospital in the UK should host an Idva service. The findings reflected four years of research into hospital-based Idvas in five English hospitals who had located specialist domestic abuse services in their A&E and Maternity units. Tragically, three years on, we still do not have enough Idvas in hospital to provide this vital service for the four out of five domestic abuse victims who don’t call the police. 

Our research found that hospital Idvas were supporting victims on average six months earlier than Idvas in community settings.  In the year before the hospital Idva service started, 56% of hospital victims had accessed A&E because of the abuse, compared with only 16% of victims who accessed a community service. This shows opportunities to intervene are being missed, especially for those victims who do not have any contact with other agencies.

Hospital-based Idvas can also play a crucial role in safeguarding children. We know that around 30% of domestic abuse begins during pregnancy, and some 40–60% of women experiencing domestic abuse are abused during pregnancy. Of course, NHS staff are already under a duty to safeguard children at risk of harm and a hospital Idva service is well placed to help them fulfil those duties with identification, referrals and support, including ensuring mothers at risk are identified early on.

Since the launch of the research, we have been encouraging the Department of Health and Social Care and other health agencies to support the roll-out of more hospital Idva services. However, our 2019 Practitioner’s Surveyshows that the number of Idvas based in a health setting is still less than a quarter of what we need. Our ‘Cry for Health’ research recommends that two Idvas are based in each acute NHS provider, which would equate to more than 300 hospital based Idvas in England and Wales. But there are  just 37 full time equivalent Idvas based in health settings, including GP surgeries and community health, therefore even more concerning. 

We continue to make the case for health-based links with domestic abuse specialists, as  one of the partners in the Pathfinder Project alongside Standing Together, IRISi, AVA, Imkaan and the University of Bristol. This project brings together domestic abuse service and systems leaders, working across eight UK sitesto establish comprehensive health practice in relation to domestic abuse in acute hospital trusts, mental health trusts and GP practices.  We are identifying and sharing  good practice and linking local specialist services to health to create a truly coordinated community response, so victims and survivors get the right support the first time.

We want to see health given a central place in the Domestic Abuse Bill which we hope will return to Parliament next year. We were pleased that the government’s responseto the first reading of the bill referenced NHS England’s plan for access to Idvas to be part of the NHS Standard Contract. We need to understand a little more about what that means in practice, but it would be a huge step towards ensuring the large numbers of victims accessing health services receive the specialist support they so desperately need. 

We will continue to campaign for the Government to view domestic abuse as a public health epidemic and to fund a national campaign to raise awareness and change  public attitudes to domestic abuse. Just as campaigns around seat belts, drink driving and smoking have helped to save lives, so can a long-term campaign to make domestic abuse inexcusable. 

Jess Asato is Head of Public Affairs and Policy at SafeLives. She can be contacted at Jessica.asato@safelives.org.ukor follow her @Jessica_Asato.

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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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