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The IRIS Programme was first implemented in Sandwell in 2015. Two years later, the intervention was expanded to Walsall and then, in 2018, Dudley also came on board. More recently, in October 2022, IRIS was implemented in Wolverhampton, which means that it’s now running across the whole Black Country area with one main goal: to enable local General Practices to better identify and refer women being affected by Domestic Abuse to specialist support.

The launch is being celebrated not only by the IRISi team, the host organisation of the IRIS Programme, but also by the local healthcare professionals, who are happy to see the intervention expanding its reach, benefiting more and more people. Marie Kelly, Designated Nurse for Adult Safeguarding in Sandwell, said: “as it was previously commissioned in 3 of the 4 Black Country areas, we had developed professional relationships with regional and national leads within IRISi which aided discussions. Since IRIS was implemented in Sandwell, six years ago, and then rolled out across Walsall and Dudley, the ICB has seen tangible outcomes for survivors of domestic abuse accessing primary care services. There are 6 PCNs in Wolverhampton, which will be offered IRIS training and support.”

Sally Roberts, Chief Nursing Officer and safeguarding executive lead for NHS Black Country Integrated Care Board, said: “Home should be the safest place in the world, but sadly we know that for some people, whose lives are blighted by domestic abuse and violence, this is not the case. The NHS and our partners are committed to safeguarding the most vulnerable people in our community, and this means that we have a duty to identify domestic abuse risks and take the appropriate actions. IRIS is a high-quality, holistic package of training, support and referral pathways, which will provide local GPs with an essential tool to help them spot the signs of abuse and provide the right interventions at the right time – which could potentially save lives.”

In Wolverhampton, IRIS will be delivered in partnership with Black Country Women’s Aid, as it is in all other areas. Carol Kelly, Regional Domestic Abuse Operational Manager of this organisation, says that delivering IRIS has been a positive experience, “especially seeing that the IRIS Advocate Educator role has made a significant positive impact on the patients being supported. This is demonstrable from quantitative and qualitative data supplied on a regular basis to commissioners and the managing agent, and also from patient feedback records.”

IRIS offers a holistic and sustainable approach for women who are affected by Domestic Abuse

The IRIS Programme can be defined as a holistic intervention based on a two-step approach: firstly, it provides ongoing training and support to clinicians and admin staff, so they become better prepared to identify the signs of Domestic Abuse among patients; secondly, by embedding an Advocate Educator within the general practice setting, the intervention provides an essential direct referral to a named specialist.

For Carol Kelly, the AE role is integral for the success of IRIS, as it cements the link between awareness raising in Primary Care settings and the actual intervention needed for the empowerment of patient populations who have experienced domestic abuse and who need that support. “AE training helps GP staff to appreciate the impact of prolonged stress and/or experience of trauma on the body from living with domestic abuse – both current and historic. This also informs them of best practice methods of enabling patients to talk about their experience and also how they can respond effectively to a disclosure and ensure local effective support is made available.”

“AE support enhances the medical interventions which are taking place, or which are being awaited. Often the intervention of regular scheduled emotional support from the AE can retain stability for the patient who is on a lengthy waiting list for counseling and ’talking therapy’. The support of the AE reduces the need for GP appointments and prescriptions. The trauma-informed support of the AE can offer appropriate information, advice, and guidance which helps the patient understand the symptoms they are experiencing and reduce the need for GP appointment time. The local AE is the available expert to help all surgery staff develop their expertise and knowledge of DA.”, explains the Regional Domestic Abuse Operational Manager.

Latest reports confirmed that IRIS has already positively impacted the general practices across the Black Country area

A study produced by the University of Birmingham study between March 2019 and February 2021 has validated the effectiveness of IRIS in the West Midlands. The research “Evaluation of the Identification and Referral to Improve Safety (IRIS) Intervention in the West Midlands: A Focus on Health and Deprivation” revealed that women were overwhelmingly supportive of IRIS as an intervention and recognised its positive impacts on their health and those of their children.

Descriptive statistics indicated that the patients referred to IRIS had a variety of health conditions, like mental ill-health; suicidal ideation, self-harm, PTSD, Personality Disorder and also Gynecological conditions; and STI, among others. Considering mental health specifically, pre-IRIS, 57% of the sample had depression recorded, and 44% had anxiety recorded. These are consistent with rates recorded nationally, with 59.1% of women referred to IRIS experiencing mental ill health, mainly depression and/or anxiety. Insights from the evaluation also show that post-IRIS, depression and anxiety were recorded at 32% and 28%, respectively. The quantitative results of the study show similar positive impacts across a range of health conditions (including non-chronic ones) and these are all consistent with the qualitative findings.

BLACK COUNTRY AREA IN NUMBERS

AREALAUNCH YEARGP PRACTICES TRAINEDREFERRALS
Sandwell201546618
Walsall201751562
Dudley201846441

TRAINING FEEDBACK

“We are so grateful to have the IRIS team as our domestic abuse specialists. IRIS is such a valuable service to us” – Nurse

“Your input is incredibly helpful and reliable; I know that my patients are safe in your hands, and you will provide them with the necessary support” – GP

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The IRIS Programme provides specialist advocacy and support to patients registered at IRIS-trained practices who have experienced domestic abuse.

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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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