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). 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 was 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. Phase 2 sites went into hibernation. They were eventually launched in October 2020 and recruitment and training of the trainers was completed in November 2020.
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.
The operational delivery of IRIS in 7B programme ended last 31st March 2022, and to celebrate our achievements, we asked the IRIS Advocate Educators and the Clinical Leads from Brent, Ealing, Westminster, and Hammersmith and Fulham to share their experiences with the IRIS Programme. We also invited clinicians trained by the IRIS Programme to speak out about the initiative. These are their words!
[Advocate Educators]
“I have felt the training to be very beneficial for practices. I received interest in IRIS training from staff because they could understand the benefits of it and how this learning is needed. Clinical Lead has been very supportive with linking in with practices resulting in attendance at a couple of meetings and staff have been interactive during training and felt the training was useful.”
“The last three months, for me personally, has been an extremely positive experience. This period has enabled me to connect more with clinicians over the last three months. My confidence with the training material has made it easier to work directly with GPs and give more time to answer GP queries and open more discussions around their individual practice.”
“Our partnership with the specialist service organisation has allowed me to learn a lot around harmful traditional practices, forced marriage, FGM and different cultures and I was able to project this onto the training which has made me more confident in answering questions. Their input has positively influenced our training as it incorporates all aspects of Domestic Violence and Abuse – especially different cultural practices that before we were less familiar with.”
[Clinical Leads]
“The IRIS programme has been invaluable in providing busy clinicians a succinct and practical reminder of how Domestic Abuse is permeating through the lives of the patients they see. As a Clinical Lead, it has been heartening to hear feedback from my GP colleagues on how relevant and useful they have found the training aspect of the IRIS programme. I have also found the adaptation of the IRIS model to reflect more virtual consultations has been a welcome update for clinicians, along with a timely reminder of the potential risk posed from disclosure to potential perpetrators through virtual consultations or online access to records.”
– Saral Anand
“The IRIS Clinical lead role is my first role as a Clinical lead. It has been an invaluable experience in developing leadership skills as a newly qualified GP and the flexible working has allowed me to do so alongside other personal and professional responsibilities. It has also given me the opportunity to network with a wide range of practices and GPs in my local area, whom I may not have met otherwise.
Most importantly, it has helped to continue my professional development and understanding of domestic violence and abuse and the associated safeguarding issues in addition to giving me the opportunity to influence the healthcare response to these locally.”
– Amisha Babla
“As a clinical lead, the IRIS programme continues to be an excellent opportunity to further enhance my DV knowledge to support clinicians around presentations to primary care. This has enabled me to provide confidence to clinicians with the tools to support sensitive questioning, risk assessment and how to respond to consultations appropriately. As a single point of contact and safeguarding expert, clinicians are grateful for the holistic advice and signposting”.
– Lesley Tilson
[Clinicians trained by the IRIS Programme]
“’Having received our initial training, those that attended felt it immediately changed their practice. The session highlighted the prevalence of DV, particularly within the COVID era and very much put it at the forefront of our minds when speaking to patients. We were able to discuss the challenges that phone consulting poses and discussed ways to overcome these. In the space of 6 weeks, I have referred two patients to the service and on both occasions both the patient and I have only positive feedback to give. The speed of response from both our nominated advocate and the service management was as promised within 24 hours. I received email updates when contact had been made with the patient, which given the context of the referral, I have found to be hugely reassuring”
“After the session, the team sent us some very useful prompts to help initiate these conversations with patients and we have all used these in our practice. A nominated individual whom I can contact by both email and telephone is invaluable. I would highly recommend any surgery engage in the teaching so that they may utilise the service.”
“Thank you so much, this has already impacted my practice and I have had a disclosure from a patient in a culturally sensitive situation where I have felt equipped to help.”
“Such a difficult area to draw patients to disclose and not be sure of what to do if they do. Now a better idea and not so fearful of asking and opening Pandora’s box!”
[VRU Sites – Phase 02]
- Launch: October 2020
- Delivery start date: November 2020
- Partner agencies: Advance in partnership with Asian Women’s Resource Centre (AWRC)
- Number of Practices fully trained*: 63
- Number of Patients referred into IRIS service*: 202
*[data from November 2020 – December 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.
