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.
