The ADViSE programme (Assessing for Domestic Violence and Abuse in Sexual Health Environments) has helped nearly 100 patients affected by domestic abuse and/or sexual violence in its first full year at St Mary’s Hospital in north-west London. Alongside supporting survivors, the programme has provided specialist training to 65 members of staff within the hospital’s sexual health team, equipping them to identify and respond to domestic abuse and sexual violence.
The pilot at St Mary’s Hospital is a partnership between the Imperial College Healthcare NHS Trust, Advance and IRISi, with funding from London’s Violence Reduction Unit for an initial two-year period. The programme is hosted by the hospital’s Jefferiss sexual health service.
ADViSE is delivered day-to-day by a full-time Advocate Educator, who provides ongoing training for staff and direct, in-house specialist support for patients. In its first full year of operation in 2024, the ADViSE programme at St Mary’s received referrals for 94 patients experiencing domestic abuse and/or sexual violence. Of those who provided feedback, 100% reported that they were pleased to be referred to a specialist domestic and sexual violence support worker.
The programme will continue to be embedded within the hospital, ensuring ongoing training for new and existing staff, including resident doctors who rotate every six months. This will strengthen the hospital’s ability to support survivors and create a sustained, trauma-informed response to domestic abuse and sexual violence.
Why healthcare needs to respond to domestic abuse and sexual violence
Domestic abuse affects one in four women in the UK and can have severe health consequences, including links to increased rates of sexually transmitted infections (STIs), including HIV, and unintended pregnancies. Despite its prevalence, domestic abuse is often hidden, and many survivors do not access specialist support. Healthcare settings like sexual health clinics provide a crucial opportunity to identify and support patients who may not otherwise disclose their experiences.
ADViSE was first developed and piloted by IRISi to bridge this gap, providing healthcare professionals with a structured pathway to refer patients to specialist services. The programme ensures that gender-based violence is recognised and addressed as a health issue, reaching diverse populations who are often overlooked by traditional support systems.
What partners say about ADViSE at St Mary’s Hospital
Dr Ali Mears, Consultant in Sexual Health at Imperial College Healthcare NHS Trust, said:
“We are thrilled to be hosting this programme and to have the opportunity to identify and support more patients affected by domestic abuse and sexual violence. Anyone can experience domestic abuse and sexual violence, regardless of gender, age, ethnicity, socio-economic status, sexuality or background. Working with our partners, we want to provide a safe space for patients to access non-judgemental, comprehensive, and expert support and advice. Whether the abuse is currently happening or happened many years ago, we want to be there to help. Being able to support and empower our patients is invaluable. I’m grateful to all our partners for making this programme possible, including our domestic abuse Advocate Educator and the wider team supporting patients.”
Ramisha Patel, Senior Service Manager – Health and Children Social Care at Advance, said:
“Advance is dedicated to improving healthcare responses and outcomes for survivors of domestic abuse. Collaborating with Imperial College Healthcare NHS Trust and IRISi through ADViSE marks a significant step forward. This London pilot excites us, as it expands survivor access to crucial services. Our partnership builds on previous work supporting survivors before and during the pandemic. The presence of an ADViSE Advocate Educator ensures survivors receive specialist care in familiar healthcare settings while healthcare professionals are equipped to respond effectively to disclosures of abuse.”
Lib Peck, Director of London’s Violence Reduction Unit, added:
“We are committed to working in partnership with the healthcare sector and domestic abuse specialists to intervene at critical moments and provide vital support for those affected by domestic abuse. Our funding will help train staff to better identify and support those who are not usually recognised or connected with the services they need.”
The Advocate Educator’s perspective
The ADViSE Advocate Educator at St Mary’s Hospital, who remains anonymous due to the sensitivity of the role, said: “My role supports both patients and professionals in recognising and responding to signs of domestic abuse and sexual violence. Education around healthy relationships is a key part of my work, as many survivors do not realise they are experiencing abuse. It’s common to hear patients say, ‘I never even realised what I was going through was abuse—I thought abuse was only physical.’ Helping them understand their experiences and access support is incredibly powerful.”
