Provided by IRISi, the IRIS Programme is a specialist domestic violence and abuse (DVA) training, support and referral programme for General Practices that has been delivered thanks to funding from the Violence Reduction Unit (VRU) in 7 boroughs in London since January 2020. The initiative is one of many supported by the Mayor’s Office for Police and Crime in London (MOPAC). Set up in 2019, the VRU was originally established to take a different approach towards tackling violence, including DVA. Using IRISi’s expertise and know-how in this field, the VRU commissioned the organisation to deliver a 12-month programme divided into 2 phases: the first designed areas to receive the IRIS programme were Tower Hamlets, Croydon, and Barking and Dagenham; then, the initiative also reached Brent, Ealing, Westminster, and Hammersmith and Fulham in its second and final phase. As always, the IRIS programme is delivered in partnership with local, specialist DVA organisations.
The first three sites were launched just before the first lockdown, which brought up several challenges, especially because the programme had to be immediately adapted from face to face to online training, advocacy and support. The commissioning was originally scheduled to finish on 31st of March 2021, but after all the difficulties imposed by COVID-19, the VRU agreed to extend the delivery timeframe and budget to allow the finish to be by 31st March 2022, with final reports and evaluation by June 2022.
“Due to the commitment and ongoing support from the VRU, we are able to continue delivery of the IRIS Programme for a few more months and we are hoping that we can increase the number of identification and referrals into the service whilst there is funding and AEs in post. We are working hard with local partners to ensure re-commissioning happens at all 7 sites so that the referral pathways remain open to all patients beyond the VRU funding”, explains Dr Shim Vereker, Contracts and Programme manager at VRU sites.
Only one quarter away from finishing the partnership with the VRU, we asked the IRIS Advocate Educators and the Clinical Leads from Tower Hamlets, Croydon, Barking and Dagenham to share their experiences with the IRIS Programme up until now. These are their words!
“As an AE I empathised with the health care professionals, as the pandemic put additional pressures and responsibilities on an already busy healthcare system, during a very challenging time. We worked with an open mind, provided more flexibility, and offered to take referrals from all GP Practices to ensure all survivors were being supported during this challenging time. (…) We were in touch with GPs via email and telephone for advice and exchange of professional insights, reminding them of safeguarding, giving our perspectives for cases and updating them about referrals. A few GPs in the IRIS trainings fed back that AEs had done good work in some difficult cases. (…) Occasionally during the pandemic, I was able to meet with Clinicians as well as service users at the GP practices. This is a good way to connect and keep our presence visible.”
“It has been a challenge to build a relationship with clinicians. Not only because of the lack of the possibility to visit the surgeries and being able to just make a conversation with the surgeries staff but also because, since the pandemic started, all clinical and non-clinical staff have been struggling to find the time to receive training. However, it has been really important to appreciate that during these hard times all surgeries that have signed with the programme so far, have made the time to increase their awareness in DVA. They play a vital role for survivors, and it is essential to promote surgeries as a safe space to talk and look for help if in a situation of DVA. I feel grateful for those surgeries I have trained and those women we have been able to help so far. The beginning of the programme was really uncertain because of all the fluctuations society has suffered since the first lockdown, but I feel proud of these achievements and being able to work with the other Advocate Educator to make the best we can to support and help women.”
“I’ve really enjoyed supporting and learning from the women who have engaged with the IRIS service, which is really what it’s all about! Coming alongside them in their journeys, they really become advocates for themselves. Trust and confidence are so important when supporting clinicians to develop their understanding of domestic violence and abuse in their patients (and even colleagues). Asking practices to keep DVA on their agenda, amongst the multiple challenges and conditions they have been managing during a pandemic, has not been an easy task; but it is one that many have risen to! I have really appreciated engaging with and responding to the different on-the-ground experiences of our clinicians and practice staff.”
“IRIS was set up completely virtually in B&D as the programme commenced right at the start of our COVID pandemic, in total lockdown. The response of our GP colleagues has been heartening and all attendees have feedback on how valuable and useful the training was for them. It is clear that an IRIS activated area provides a really robust primary care friendly resource for GP practices to use and empowers clinicians to ask the questions, knowing there is someone. The two most empowering take-home messages I have been able to assure GPs about in raising the possibility of DVA during a consultation are:
• ‘You don’t ask, you don’t get’? – Always ask the question.
• Asking the question does not lengthen the consultation to beyond manageable levels and expected 10 minute parameters which is often a concern about opening Pandora’s box and the time it will take clinicians to handle.
Dr Richard Burack
“Many victims of domestic violence mention feeling increasingly depressed and anxious especially after the repeated lockdowns and closures during the pandemic. As GPs we saw a spike in cases of domestic violence increasing health inequalities locally and often the clinical response is reported to be inadequate. I attended the IRIS training and found it really helpful as it supported me in making clinical enquiries and also evoked my professional curiosity and after training you would not feel as if you were opening a can of worms because the training will increase your confidence about asking the questions and how to respond and record. I found it so transformative I went on to become a Clinical Lead to make a difference and train others on how to enquire about Domestic Violence appropriately by safely asking, adequately and responding.”
Dr Farah Bede
[VRU Sites – Phase 01]
- Launch: March 2020.
- Delivery start date: April 2020.
- Partner agencies: Solace Women’s Aid for Tower Hamlets, BCWA and FJC in partnership for Croydon, nia for Barking and Dagenham.
- Number of Practices fully trained*: 42.
- Number of Patients referred into IRIS service*: 411.
*[data from April 2020 – September 2021]
[ABOUT THE IRIS PROGRAMME]
IRIS is a specialist domestic violence and abuse (DVA) training, support and referral programme for General Practices that has been positively evaluated in a randomised controlled trial.
IRIS is a collaboration between primary care and third sector organisations specialising in DVA. Core areas of the programme include ongoing training, education and consultancy for the clinical team and administrative staff, care pathways for primary health care practitioners and an enhanced referral pathway to specialist domestic violence services for patients with experience of DVA.
Click here to find out more about the programme.