The IRIS Programme is effective – and the study that shows it has just won the “RCGP Research Paper of the Year” award

The IRIS Programme is effective even outside a clinical trial, when implemented in ‘real world’ General Practices, according to the study “Improving the healthcare response to domestic violence and abuse in UK primary care: interrupted time series evaluation of a system-level training and support programme”. The study, funded by the National Institute for Health Research (NIHR) and published in BMC Medicine in March 2020, has just been awarded the “2020 Royal College of General Practitioners’ Research Paper of the Year”.

Led by Dr Alex Sohal from Queen Mary University of London in collaboration with Medina Johnson, Annie Howell and Dr Estela Barbosa from IRISi, Professor Gene Feder and Dr Natalia Lewis from the University of Bristol’s Centre for Academic Primary Care (CAPC) and others, the research found that the IRIS Programme improves considerably the response of GPs to Domestic Violence and Abuse: after being trained by the initiative, 205 general practices in London reached a 30-fold increase in referrals for women identified as possible victims of DVA.

IRIS (Identification & Referral to Improve Safety) is a specialist domestic violence and abuse (DVA) training, support and referral programme for General Practices that started as a randomised controlled trial led by Professor Feder. In 2017, after being positively evaluated, became the flagship programme of IRISi, a social enterprise focused on improving the healthcare response to gender-based violence.

“To December 2020, over 22,000 women were recognised by their GP as being affected by domestic violence and abuse and referred into their local IRIS programme for specialist support. During the last four years, we have expanded our services and we are currently successfully delivering the IRIS Programme to over 40 areas across the UK, which means that the initiative is reaching patients in around 15% of the general practices across England and Wales. This study provides us with a very good proposal to decision-makers when negotiating the funding needed to enable the local commissioning of the IRIS programme. We are not only supporting women, but we are also doing it in a very effective way”, explains Medina Johnson, CEO at IRISi.

RCGP Research Paper of the Year

The RCGP Research Paper of the Year gives recognition to an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care.

The three categories are Clinical Research, Health Services Research (including Implementation and Public Health) and Medical Education with relevance to primary care. Papers are scored on the criteria of originality, impact, contribution to the reputation of general practice, scientific approach and presentation. The reviewing panel felt that this paper, submitted to Category 2 (Health Services Research) was particularly relevant in the light of COVID restrictions and widespread reports of increased domestic violence during ‘lockdowns’.

Professor Feder said: “In this study, we wanted to find out if a programme that improves care in a randomised controlled trial would continue to benefit patients when implemented in everyday general practice. Happily, the answer was a resounding ‘yes’. The evidence from this study is a compelling argument for further commissioning of IRIS nationally in the UK.”

Alex Sohal said: “This is revolutionary research as it’s about changing the world, including the GP consultation – our research shows clinician behaviour can be changed: improved listening, identifying and discussion of patients’ experiences of domestic violence & abuse in relation to their health. This happened when clinicians were supported by IRIS – Identification & Referral to Improve Safety – a system-level intervention – that’s equivalent to a Rapid Access Chest Pain Clinic to which GPs can refer patients with chest pain.”

Winning paper: Improving the healthcare response to domestic violence and abuse in UK primary care: interrupted time series evaluation of a system-level training and support programme by Alex Hardip Sohal, Gene Feder, Kambiz Boola, Anna Dowrick, Richard Hooper, Annie Howell, Medina Johnson, Natalia Lewis, Clare Robinson, Sandra Eldridge and Chris Griffiths. Published in BMC Medicine. March 2020.

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.