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% 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/
 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