IRIS is a programme of training and support to improve the response to domestic violence and abuse (DVA) in general practice, which has been proven effective and cost-effective and is commissioned across areas of England, Wales, the Channel Islands and Northern Ireland. The IRIS model is delivered by IRISi, a not-for-profit organisation that also provides areas with training package, updates to the training, and support.
The imposition of a national lockdown in the UK in March 2020, and the need for social distancing thereafter, meant that the IRIS programme needed to move swiftly to provide remote training to primary care professionals and find new ways of providing services to IRIS service users. It also meant that the IRIS training sessions had to be rewritten to focus on training clinicians to safely identify, ask about and respond to DVA during telephone and online consultations.
Due to all those changes, IRISi decided to run a piece of rapid research to address a concern from commissioners and service providers around the lack of evidence in terms acceptability and effectiveness of the IRIS programme under new remote ways of working. We have explored the perceptions of the value of the IRIS programme under new ways of working, the acceptability and desirability of remote support to service users and the acceptability and desirability of online training for primary care clinicians.
In order to do this, we ran four surveys and carried out 15 interviews between June and August 2020. We designed the research using the Lean Impact approach, and analysed the data using a framework analysis. The full report can be found at the end of this article alongside a booklet we also produced to summarise all findings.
Rapid Research Highlights
- The relevance of the IRIS programme has increased as a result of COVID-19 for three reasons: (1) an increased reporting and prevalence of domestic abuse, as a result of lockdown and social distancing; (2) the quick response in the adaptation of training and advocacy support to remote or online by IRISi and the local IRIS teams; and (3) the fact that the usual routes to support are more difficult to reach or access or no longer available.
- All clinical leads and most clinicians feel at least as confident working over the phone and online, as compared to face-to-face, and that while there was an initial decline in referrals in March 2020, the level of referrals was back to pre-COVID levels by July 2020.
- Service users felt well supported remotely and attributed their good outcomes to the increased communication with AEs, and the speed of their response. Nearly two-thirds of AEs started offering new forms of support, including text and WhatsApp messaging, as a response to social distancing restrictions.⠀
- The flexibility of the programme and the responsiveness of IRISi and AEs, both in terms of increased frequency of communications as well as quicker responses, were considered the most important enablers of change.⠀
- The availability of new forms of support and the ability to train clinicians from different practices jointly and with increased frequency were considered the main benefits of the IRIS online and remote programme.
- “The learning and benefits of the COVID adaptations will be considered when we are able to resume face to face work and we expect to initially run a blended version of the programme.”, explains Medina Johnson, CEO at IRISi.