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Domestic Violence

Violence Against Women Initiative Health Projects

Project List:

More on the Violence Against Women Initiative

Standing Together Health

SUMMARY

Standing Together has run a successful co-ordinated response to domestic violence victims calling Fulham Police since November 1998. This project will incorporate health related issues into ST’s co-ordinated community approach by offering immediate referrals to the Advocacy Project and by offering our expertise to aid participating Heath facilities in developing their own practice with regard to domestic violence.

INTERVENTIONS

  • We propose to bring into the Standing Together co-ordinated response women referred by the Health Authority, beginning with one Hospital A&E Department & one of the new ‘Walk-In’ Centres in Fulham [which people can walk in to, to be seen by a Health professional between 6am & 11pm].

  • Form an interdisciplinary team nominated from the health centres [e.g. 1 doctor, 1 nurse, 1 administrator, 1 social worker, 1 health visitor, 1 midwife etc. work with a ‘Standing Together’ Health & Domestic Violence Development Worker.

  • Train a cross section of key staff to ‘ask the question’; how to respond to likely victims; to make appropriate referrals; to record & monitor this incident and any previous visits to A&E.

  • Develop a procedure for Health staff re. Domestic Violence similar to the one they have found helpful for Children AT Risk.

  • Identify problems in supplying prompt medical evidence for prosecutions & test solutions.

  • Secure services of a Health Professional to provide expert reports for victim impact statements to Court.

  • Change the role of the Advocacy Project to accept direct referrals from Health Service[in addition to the police]: establish safety procedures for a public phone contact.

  • Offer wide range of Advocacy re. Housing, Welfare, Child safety, Immigration.

  • Train Advocates to counsel women to approach the police; support charges.

  • Offer Group work in rolling programme of workshops & group support run by DVIP to help women come to terms with their experience, extending current service to a workshop per week.

  • Monitor cases from first contact with Health Authority, through interventions by Advocacy Project to possible attendance at DVIP Women’s Groups.

  • Consult women on their perceptions of increase in their safety.

ACTIONS ALREADY TAKEN

  • DV Forum has set up training in DV Awareness for health visitors, midwives, community nurses over 2 years & produced with them a Guidance & Good Practice pack for local health workers.

  • H Women’s Aid set up the Advocacy Project in 1998 to support women in the community referred through ‘Standing Together’. So far this has been for Police referrals from Fulham only.

  • Standing Together have developed a framework for co-ordination and monitoring cases referred from the Police in Fulham & are now ready to extend this to the whole Borough.

  • Health Professionals have produced National guidelines for Midwives & for Health Professionals in consultation with Women’s Aid Federation England [WAFE].

  • Standing Together have developed a Domestic Violence Tracking & Monitoring System, ‘STATS’, funded by H Women’s Aid with Daphne Programme funding from the EEC. This will be tested in practice on criminal justice system cases during 2000.

AGENCIES INVOLVED

Met. Police, Hammersmith & Fulham, Hammersmith Women’s Aid, Hammersmith Women’s Aid Advocacy Project, Hammersmith & Fulham Community Law Centre, Crown Prosecution Service West London Branch, West London Magistrates Court, Inner London Probation Service, Domestic Violence Intervention Project (DVIP), London Borough Hammersmith & Fulham Community Safety Unit, LBHF Information Technology Services Department, LBHF Social Services Department,. Awareness In Practice, Camden Women’s Centre, Fulham Parents & Children (FULPAC). Chair of H&F Domestic Violence Forum.

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North Devon and Torridge Early Intervention

SUMMARY

This project will enable victims of domestic violence to know about, and feel confident to utilise, the support services available when they are being treated medically by the health services. The project will initially be run in the AE department at the district hospital, screening for domestic violence, and offering support from Victim Support. The project will then be expanded to cover GP surgeries and smaller hospitals.

INTERVENTIONS

The project will initially involve health staff dealing with a woman victim who attends for treatment at the district hospital, identifying that she is a victim. Once treated she will be offered direct contact with Victim Support who will be either in attendance of will be available to attend via contact by mobile telephone. Victim Support will provide support on a 24-hour basis. They will be present during peak times at the AE department and contactable on a rota by mobile telephones.

Victim Support will support victims and inform them of all the options available to them from the support services: Women’s Aid, legal advice through solicitors, consequences of reporting to the police and support available from the domestic violence officer, support available form other agencies e.g. housing providers. Victim Support will then support victims directly if they choose to go on to use the services available from other agencies.

Victims declining support will be offered a Victim Support Pack with helpful advice, contact names etc. Victims will be encouraged to read this before leaving the hospital.

After a 6-month pilot phase in the district hospital, the project will be expanded across the two districts to local GP surgeries, and medical centres at smaller local hospitals. A part-time Outreach Worker will be employed to provide direct support to victims from Women’s Aid in addition to the support workers from Victim Support.

Training will be given at the commencement of each phase of the project and will be provided by the Police DV Officer and a nursing Sister from the AE department of the district hospital. Training will be given to all nursing staff and the Victim Support staff.

A single questionnaire has already been produced by the Project Team for use by medical staff and Victim Support when dealing with suspected victims. This will be completed for each victim dealt with. Issues of confidentiality for health staff have been addressed and their involvement when completing the document is limited to three questions. Information gathered will be collated by the Community Safety Partnership Office who will aggregate information, disseminate it to the agencies involved, but will not divulge details to individual agencies without the prior agreement of victims.

AGENCIES INVOLVED

Northern Devon Healthcare Trust, Devon and Cornwall Police, North Devon and Torridge Community Safety Partnership, North Devon Women’s Aid, Victim Support/Witness Service, AE Department, Taw and Torridge Domestic Violence Forum.

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Birmingham Health Development

SUMMARY

This project aims to create conditions in which the health services can recognise, count and respond consistently and appropriately to domestic violence, starting from a low starting point. These conditions will enable health professionals and health services to deal with survivors of domestic violence in a more proactive and co-ordinated way. The aim is to encourage disclosure in those agencies that come into early contact with survivors of domestic violence in the Northfield Constituency area of Birmingham.

INTERVENTIONS

Infrastructure Development:

  • Establishment of a project steering group and practitioners to oversee the project and ensure cooperation of agencies

  • Marketing of project by steering group

  • Appointment of a locality domestic violence programme manager

  • Establishment of local advisory board

  • Establishment of mentoring system for programme manager

  • Auditing data systems of key agencies using a standardised audit tool

  • Auditing strategic partnerships between the agencies

  • Auditing the procedures of key agencies

  • Auditing baseline of training, interagency referrals, early detection of repeat victimisation in health units and extent of involvement of users in safety planning

  • Baseline survey of survivors satisfaction concerning disclosure, safety and options either by action research, focus group or interview methodologies.

  • Produce strategic plans for data collection, infrastructure development, interventions and evaluations.

Implementation details will depend on the findings of the audit but will be guided by the following essential principles:

  • Safety, including ensuring involvement of users in safety planing

  • Confidentiality

  • Appropriateness to clients social context and needs

  • Appropriateness to health care setting

  • Utilise a range of triggers

  • Recognise links between domestic violence and child protection

Examples of possible Interventions:

  • Multi-disciplinary awareness programme

  • Commissioning training and education programme

  • Integrated policy and procedures to be developed for each of the helath services units

  • Protocol development abased on known good practice which will encourage early disclosure and ensure appropriate responses.

  • Strengthening of relationships and information exchange between existing agencies

  • A strategic approach to service development based on any identified gaps

  • Monitoring and evaluation of protocols by clinical audit procedures within Clinical Government procedure in the health settings

AGENCIES INVOLVED

Birmingham Health Authority, Domestic violence task Group, Women’s Aid, Northfield Primary Care Group, University Hospital NHS Trust, Women’s Hospital, Birmingham Specialist Community Trust.

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Wakefield Primary Health Care

SUMMARY

This project aims to work with primary care to reduce repeat victimisation in women who are experiencing domestic violence, but who are not reporting assaults to the police. It also aims to improve the quality of evidence collected from primary care sources and the voluntary sector with a view to encouraging criminal or civil action. This will be done by running a pilot in 12 GP practices identifying domestic violence and offering support. The results of this pilot will be used to develop a primary care strategy to identify victims of domestic violence, develop training for primary care and other health staff, establish an effective referral route to Support and Survival, develop evidence gathering protocols for all involved in the process and establish effective data collection systems to monitor referral, uptake and repeat victimisation.

INTERVENTIONS

In 1995, the report of the Director of Public Health for Wakefield highlighted the necessity for action from health services to address the issue of domestic violence. Subsequent research recommended continued support for the voluntary agency Support and Survival and the development of clear referral protocols for primary care workers.

In 1998 a pilot study in a general practice conducted with very women over the age of 16 years during a one-week period, showed that 1 in 3 women had experienced domestic violence. Support and Survival worked with primary care staff and were able to take immediate referrals of offer appointment s to women who wanted advice or support.

This project will extend the pilot into 12 GP practices in the district to establish base line data on the local problem. The project will:

  • Provide training in identification of domestic violence to health care staff

  • Establish referral routes to the voluntary sector

  • Improve the quality of evidence collected by the voluntary sector

  • Increase the number of referrals to the police and subsequent prosecutions so reducing repeat offending

  • Establish data bases in community care and the voluntary sector that will collect data on the number of women identified as victims by primary care teams, numbers referred to Support and Survival, interventions, numbers of reports to the police ad prosecutions.

AGENCIES INVOLVED

Wakefield Health Authority, Wakefield Community Safety Partnership, Support and Survival, Domestic Violence Forum, STAR project, Wakefield District Women’s Consortium, Wakefield Health Action Zone, Wakefield European Partnership.

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Salford GP Evidence Gathering

SUMMARY

The project will run an enhanced evidence gathering scheme to provide support to women with regard to the court process, reducing the need for dependence on their testimony. The scheme will operate within four GP surgeries within the city of Salford.

INTERVENTIONS

An enhanced evidence gathering scheme has been piloted on the Salford Division of Greater Manchester Police, The scheme used the ‘Polaroid instant evidence gathering’ kit to record and document assaults and damage cause during domestic incidents. These photographs can be used as evidence at both criminal and civil courts, They can corroborate written statements, add significant impact and credibility to victim and witness statements, refreshing the memories of all concerned. Alternatively the photographs can be taken and stored with no further action until the victim is ready to do so.

It is intended to introduce the scheme into four GP surgeries within the city to be delivered by GPs and Health Visitors.

  • They would explain the scheme and give victims the opportunity to record and document injuries.

  • If the victim consented, photos would be taken and each photo signed for by the victim.

  • The photographs can then be used as evidence in criminal and civil courts, or stored with the victim’s medical records with no further action taken. If the victim decides at some point in the future to take action against the perpetrator, the photos would be available for use.

  • Details of available support will also be provided: freephone domestic violence information line, domestic violence unit in Salford Division of Greater Manchester Police, Women’s Aid refuges and Women’s Support Group.

  • All staff will be trained, recording systems will be put into place, systems for storing photographs will be developed, publicity material will be disseminated and information sharing protocols will be developed.

A domestic violence co-ordinator and information officer will be employed to help develop data systems, collect data, link victim data to perpetrator data, track the outcomes of cases submitted to the CPS, develop definitions, a city policy for domestic violence and a good practice framework for agencies, re-map support services available to victims, develop a training policy and plan for multi-agency training, map information currently stored on domestic violence by individual agencies, collate individual agency policies, designate persons as main contacts for each agency, agree targets for reductions in domestic violence, develop systems to enable analysis of costings, disseminate information about services available in Salford, communicate project findings to senior managers and practitioners, develop agreed information sharing protocol, consistent data collection methods etc.

AGENCIES INVOLVED

Safer Salford, Salford Community Health Care NHS Trust, Housing Directorate Homeless Persons Unit, Greater Manchester Police Force, Salford and Trafford Health Authority, Salford West Primary Care Group, Greater Manchester Probation Service, Salford East Primary Care Group, Salford Royal Hospitals NHS Trust, Salford Women’s Aid, Victim Support.

Last update: June 2003

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