At IRISi, we’ve taken our time before responding to the newly published Fit for the Future: 10 Year Health Plan. As pioneers in this field, we needed a moment. Because we are frustrated. Deeply frustrated.
Let’s start with the facts. According to the Department of Health, 80% of women experiencing domestic abuse turn to health services for support, often as their first or only point of contact. This is the government’s own data. And yet, domestic abuse, sexual violence and gender-based violence are virtually absent from the NHS’s 10-year vision.
Do you see the contradiction? Labour has pledged to halve violence against women and girls within the next decade. Yet the government’s own ten-year health plan includes just one, isolated mention of domestic abuse, and says nothing about gender-based violence or sexual health. How is that supposed to work?
The evidence is already here
We already know that healthcare environments play a pivotal role in identifying violence and abuse early, intervening effectively and saving lives. That’s not speculation. It’s the reality we see every day through our own interventions. The Identification and Referral to Improve Safety (IRIS) programme, embedded in general practice, and the ADViSE programme, tailored for sexual health clinics, have been continuously reaching survivors and changing lives. As of March 2024, IRIS had received 43,535 referrals and ADViSE 1,051.
This didn’t happen from scratch. For over a decade, IRISi has built and scaled a model that works. IRIS, our flagship programme, was first trialled in 2007 and has been independently evaluated again and again. It works because it’s grounded in reality:
- Clinicians are trained to recognise signs of abuse, including those that are not physical.
- They refer patients to expert, local, trauma-informed support services.
- Survivors receive holistic, ongoing care, without adding to the clinician’s workload.
On average, every trained clinician identifies at least one patient. Imagine the scale if the entire system took this seriously.
If you don’t believe our words, believe our data
In the last year alone, IRIS and ADViSE supported 8,728 patients across 52 sites in England, Wales and Northern Ireland. The overwhelming majority of referrals (90%) were for women. Within the same period, 74% of service users told us the IRIS programme improved their mental health, while 80% said the support helped them feel safer.
The wider evidence is just as compelling. General practices that implement IRIS are 30 times more likely to refer patients to specialist support services. The programme is 4.8 times more cost-effective than the flu vaccine, saving £14 per woman. In areas where funding was cut, referrals dropped by 70%. When funding was reinstated, referrals rose by 49%. And, if this is about saving money for a broken system, this is all you need to know: each £1 invested in IRIS generates a public cost saving of £16.79, with a social return of £10.71.
The IRIS programme is not just a model that works. It is a model that should be at the centre of any serious health strategy or violence against women and girls strategy, because it delivers effective results across both areas.
What must happen now
Right now, we are witnessing a glaring contradiction in public policy. The NHS 10-Year Plan outlines bold, measurable targets to tackle cervical cancer, as it should. But when you compare the figures, the imbalance is staggering. One in 130 women will experience cervical cancer in their lifetime. One in three women will experience domestic abuse. Both issues are serious. Both deserve attention. But why is one embedded at the core of women’s health planning, while the other is almost entirely invisible?
We sincerely hope that the upcoming national strategy on violence against women and girls, expected later this year, will do what the NHS plan failed to do. It must recognise healthcare as a frontline space for prevention and early intervention. It must engage with proven, scalable programmes like IRIS and ADViSE. It must set clear, measurable targets and ensure accountability across departments.
And, most importantly, it must listen. It must listen to survivors. It must listen to the professionals already carrying out this work with care, expertise and persistence. And it must connect the dots between departments that continue to operate in siloes. Labour’s pledge to halve violence against women and girls cannot be realised while health remains excluded from the conversation. You cannot end something you refuse to name.
We are running out of time. And if action doesn’t follow, everything we’ve built could be lost.
