Pathfinder Toolkit: New Model Launched to Transform Health System’s Response to Domestic Abuse

Domestic Abuse Commissioner joins NHS England Safeguarding Clinical Lead and Minister for Mental Health to unveil new model and launch a toolkit for healthcare leaders

The domestic abuse charity Standing Together, along with its partners Against Violence and Abuse (AVA), Imkaan, IRISi, and SafeLives, is today announcing a first-of-its-kind model for responding to domestic abuse in the health system, drawing on results from a three-year, government-sponsored pilot project. The group is also launching a toolkit to enable healthcare leaders to implement the model in their clinical settings.

The unveiling takes place today at a virtual summit hosted by Standing Together CEO Gudrun Burnet, with speakers including the Minister of State for Patient Safety, Suicide Prevention and Mental Health, Nadine Dorries MP, the Domestic Abuse Commissioner for England and Wales, Nicole Jacobs, and Safeguarding Clinical Lead for NHS England and NHS Improvement, Rebecca Reynolds.

The Whole Health Model and toolkit were informed by findings from the Pathfinder project – a pilot running from 2017-2020 in health settings across England, funded by the Department of Health and Social Care and the Department of Media, Culture and Sport.

A consultation Pathfinder conducted with domestic abuse survivors found there is widespread lack of confidence in the ability of health services to provide effective support, with just 15% saying their local services were adequate. Similarly, less than 20% of respondents thought GPs could identify signs of violence and abuse.

Pathfinder concluded that the nature of health settings as trusted environments, used by everyone, can allow more domestic abuse survivors from more diverse groups to be identified and supported when there is a coordinated, consistent response model in place. Over three years, the pilots created referral pathways to domestic abuse support services for 633 survivors identified in health settings, who may otherwise have been missed. Over 90% of them felt safer following support, with dramatic reductions in their abuse, according to survivor data.

The Pathfinder project brings together best practice on responding to domestic abuse in health and was led by Standing Together as part of a consortium of expert partners including Against Violence and Abuse (AVA), Imkaan, IRISi, and SafeLives.

Speaking at the summit, Domestic Abuse Commissioner for England and Wales, Nicole Jacobs, said:“Pathfinder shows what is possible when tackling domestic abuse is seen as core business for a health setting, when the exceptional practice of a few becomes the common practice of all. This is not just about staff training or even co-location of specialist practitioners. Transformation requires clear and consistent commitment from senior leaders supporting policy development, data collection, patient voice, and other mechanisms to promote practice improvements as part of the core safeguarding work of the Trust. This is the kind of sustainable, systemic change that is needed everywhere.”

Standing Together CEO, Gudrun Burnet, said: “Domestic abuse is a public health issue and health services play a crucial role in responding to it. Findings from the Pathfinder project show that when supporting domestic abuse survivors is fully integrated into how health services operate, we can identify more survivors who would otherwise be missed and offer them the specialist support they need.

“The Whole Health Model reflected in the Pathfinder Toolkit we’re launching today aims to ensure a coordinated and consistent approach to domestic abuse across the health system, so that survivors get the same level of support everywhere. We urge leaders at all acute and mental health trusts and GP practices to apply this toolkit and speak to us to learn more about how we can work together.”

NHS England Head of Safeguarding, Kenny Gibson, said: “We know that 80%^[1] of women experiencing domestic abuse seek help from health services, and for many it’s their only point of contact. That’s why domestic abuse is a strategic priority for NHS England. We are delighted to support the launch of the Pathfinder Toolkit, which will help promote a strategic, consistent response to domestic abuse in every part of our healthcare system.”

Pathfinder pilot data suggests the model could also help health services identify more domestic abuse survivors from minority groups. Approximately 36% of Pathfinder clients were Black, Asian or Minority Ethnic compared to the national average of 18.5%. While around 4% of Pathfinder clients identified as Lesbian, Gay or Bisexual, compared with just 2% referred to domestic abuse services through a community route.

Pathfinder was similarly effective in identifying older survivors, with those aged 61+ representing 12% of Pathfinder clients, versus just 3% of survivors referred through the community.

Cardiff University is producing an independent evaluation of the Pathfinder project, due to be published in August 2020.

About the Pathfinder Toolkit

The interventions and approaches pioneered and tested across sites participating in the Pathfinder Project highlight the benefits of a Whole Health Model. The Pathfinder Toolkit brings together the key components of this model into a comprehensive and sustainable response to domestic abuse in health. The Toolkit provides detailed guidance for health leaders on how to deliver the model, including: organisational structure and strategy; policy development; the co-location of a Health Based Idva, the establishment of a Domestic Abuse Coordinator and Domestic Abuse Champions Networks; specialist guidance around how to respond to the needs of BAME, LGBT+, older and disabled survivors; staff training; data collection; patient information campaigns; and establishing referral pathways to local services.

Download the Pathfinder Toolkit to learn more at http://www.standingtogether.org.uk/

^[1] Department of Health (2010) Responding to Violence against women and children – the role of the NHS. Accessible at: www.health.org.uk/sites/default/files/RespondingtoViolenceAgainstWomenAndChildrenTheRoleofTheNHS_guide.pdf

Partners

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 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 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 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 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

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 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.