Domestic Violence & Health Practice Directory

 

This section contains examples of new domestic violence and health initiatives which are being undertaken within healthcare organisations throughout England. Information about the projects included within this Directory was collected during the course of the Women's Aid Health and Domestic Violence Survey 2000, funded by the Department of Health. The information was updated in March 2004. This survey included all health authorities within England and a representative sample of NHS Trusts and Primary Care Groups/Trusts.

 

Initiatives reported on here include:

Most of these initiatives are in their early stages and very few have yet been evaluated. All those whose contact details are included in the Directory have agreed to their inclusion and have approved the information printed here.

 

 

Kernow Women in Touch (KWIT)
Lancashire Teaching Hospitals NHS Trust
Leeds Inter-Agency Project: Health and Social Care Project
Leicestershire and Rutland NHS Trusts
Mansfield District Primary Care Trust: Appointment of Nurse Consultant, Domestic Violence
North Sheffield Primary Care Trust
Norwich Health Visitors' Domestic Violence Project
Nottinghamshire Domestic Violence and Substance Misuse Action Plan and Good Practice Guidelines
Nottinghamshire Domestic Violence Forum: Domestic Violence and Mental Health Action Plan
Pandora Project
Portsmouth Early Intervention Project
Salford Primary Care Trust
Sheffield Domestic Abuse Forum
South East Hertfordshire Primary Care Trust
South Manchester Primary Care Trust
Sunflowers Women's Domestic Violence Support Group
Sunlight Domestic Violence Project
Support and Survival Health Initiative
Support Group for Children 5-13 living in temporary accommodation due to domestic violence
Thames Valley Partnership
The Lantern Project
Wakefield Primary Care Domestic Violence Project
Yeovil Accident & Emergency Women's Health Project

 

Contact: Janice Bufton, Clinical Midwife Lead
Tel: 01254 293973
Email: janice.bufton@mail.bhrv.nwest.nhs.uk

Details of project: The Blackburn site of East Lancashire Hospitals Trust has a written Policy and associated protocols available for all staff. A group of staff meet monthly to discuss issues relating to domestic abuse, particularly focusing on training needs and staff awareness. The Clinical Audit department are also looking at ways of assessing the training needs of staff on domestic violence issues. Currently, A and E provide training for their staff, and the Midwifery department have had sporadic specific training, but this is in the process of being developed. The Consultant midwife in Public Health runs a regular clinic session to which midwives can refer women who have issues with domestic abuse. This clinic is run with the support of a mental health social worker. Representatives from the Trust are active within the Blackburn with Darwen Domestic Abuse Strategy Group.

 

Contact: Professor Marianne Hester, Nicole Westmarland
School for Policy Studies
University of Bristol, 8 Priory Road, Bristol BS8 1TZ
Tel: 0117 9546626
Email: marianne.hester@bristol.ac.uk
Email: nicole.westmarland@bristol.ac.uk

When did work on this project start? October 2002
Date project started to operate (if different) January 2003
Date project due to end (if relevant) June 2003
Funded by: Gateshead and South Tyneside Primary Care Trust
Details of project: The report is now available from research into a pilot programme that introduced routine enquiry about domestic violence into self-selected General Practices in Gateshead and South Tyneside. The aims of the pilot were to: raise the GPs' awareness of issues related to domestic violence; introduce in GP surgeries a routine method of asking about domestic violence; develop a simple monitoring system to evaluate the effect of GPs routinely asking about domestic violence and to provide a measure of prevalence and incidence of domestic violence; and monitor the implementation of the domestic violence enquiry programme.

Ten GPs and other practice staff from four surgeries in Gateshead and South Tyneside attended two training days to raise their awareness of domestic violence and to learn how to ask about domestic violence. The GPs were interviewed once before the training and twice afterwards on their knowledge about domestic violence and concerns about starting to ask about domestic violence. 621 patients from the four surgeries completed questionnaires about any experiences of domestic violence and their attitudes about being asked about domestic violence.

Evaluation: The patient survey showed that a quarter of women (25%) and just over one in ten men (11%) said that they had felt frightened because of the behaviour of a partner or someone at home and over a quarter of women (27%) and one in seven men (14%) had experienced violent behaviour by a partner or someone at home. Few patients (7% of women and 13% of men) said that they would feel offended if their GP asked them about domestic violence and the GPs generally expressed more concerns about asking about domestic violence than the patients actually had.

The monitoring of the use of domestic violence enquiry proved difficult in practice, and most surgeries did not provide the researchers with the required information. The one surgery that did provide complete information showed that one in ten of the women who were asked about domestic violence disclosed either current or previous domestic violence.

At the end of the pilot programme, time constraints and remembering to ask were the only issues remaining as difficulties. The GPs felt more comfortable about asking about domestic violence and recognised this as useful in terms of the doctor-patient relationship and in tackling the basis rather than just the symptoms of the patients' ill health. Although the GPs found it difficult when patients did not disclose violence when they suspected it was being experienced, they still recognised that it was useful to ask and be aware of the situation.

The programme is now in the process of being rolled out into GP surgeries across Gateshead and South Tyneside.

Publications:Westmarland, N., Hester, M. and Reid, P. (2004) Routine Enquiry about Domestic Violence in General Practices: a Pilot Project, Bristol: School for Policy Studies, University of Bristol.
Available here.

 

Domestic Violence and the Impact on Children
Contact: Val Elliott
Designated Nurse for Child Protection, North Hampshire Primary Care Trust
Community Services, Fairway house, Parklands Hospital, Basingstoke, Hampshire RG24 9RH
01256 376465/ 07850 140602
Email: val.elliott@nhpct.nhs.uk

When did work on this project start? 1998
Date project started to operate (if different) 1998
Date project due to end (if relevant) Ongoing
Funded by: North Hampshire Hospital Trust and North Hampshire Primary Care Trust
Details of project: The origins of this project stem from the Child Protection Training Module established by Val Elliott in 1998. This training, which is ongoing, idenitifed deficits in knowledge and skills around domestic violence, and the need to develop a more intensive training and resource programme in line with emerging social policy developments and Department of Health guidance, in particular the Resource Manual for health care professionals.

Following on from this, Val Elliott negotiated with the police for the Child/Youth at Risk Form to be shared with Child Protection nurses throughout the county. This includes all police responses to domestic violence incidents where children are known to live in the household. Health Visitors, School Nurses and doctors respond to the information by offering support and access to specialist help.

A combined Hospital and PCT Domestic Violence Policy was developed in April 2002. Resource packs were providerd for all clinical areas in the hospital, Community Mental Health teams, and GP surgeries by September 2002.

Training initiatives: A one-day training programme, led by two midwives, was developed in September 2002, facilitated by two trainers from different disciplines, one of whom is always a midwife. The sessions are open to any health professional from the three local Trusts. A one-hour awareness training pack was also developed for Primary Health Care Teams. 23 Health Visitors and Practice Nurses were identified as facilitators to deliver this awareness training in Primary Care.

"Cause for Concern" forms were developed for hospital and community settings. Val Elliott completed a research project in April 2003 (part completion for an M.A. in Applied Social Policy), investigating the attitudes and beliefs of midwives in relation to the asking of direct questions about domestic violence.

Inter-agency links have been established with the Area Child Protection Committee, the local inter-agency Domestic Violence Forum, the Family Group Conference Project (Dove Project) and the local Women's Support Group, for a service user perspective.

Therapeutic services for children affected by domestic violence were established in March 2004, and the post of Children's Worker for domestic violence within the community has been set up.

An Inter-Agency conference on Domestic Vioelnce and the impact on Children is planned for April 2004. Val Elliott was awarded a Nursing Standard Nurse 2003 Award (reference number 201) for this work.

An Impact Evaluation of an Education & Support Programme to promote Routine Antenatal Enquiry for Domestic Violence
Contact for Research Project Information: Debra Salmon, Principal Lecturer, Community Nursing, Faculty of Health and Social Care, University of the West of England, Glenside Campus
Tel: 0117 958 5655 ext. 8468
Email: Debra.Salmon@uwe.ac.uk
Contact for Training and Practice Information: Sally Price, Consultant Midwife,
Faculty of Health and Social Care, University of the West of England, Glenside Campus
Tel: 0117 958 5655 ext. 8798
Email: Sally2.Price@uwe.ac.uk
Kathleen Baird, Midwifery Lecturer, Faculty of Health and Social Care, University of the West of England, Glenside Campus
Tel: 0117 958 5655 ext. 8776
Email: Kathleen2.Baird@uwe.ac.uk

When did work on this project start? September 2002
Date project started to operate (if different) March 2003
Date project due to end (if relevant) March 2004
Funded by: Department of Health
Details of project: This project focuses on domestic violence training and the sustainability of routine questioning by midwives.
Domestic violence in pregnancy is a major public health issue with serious consequences for maternal and infant health. Domestic violence often starts during pregnancy and women may also experience an increase in the extent and nature of physical abuse at this time. Domestic violence is also a key issue in maternal deaths. Women rarely voluntarily disclose their abusive experiences to health professionals but the use of brief screening questions is known to lead to a higher rate of disclosure. A majority of women are in favour of routine questioning if asked by a well-trained health professional .

However it is clear that midwives face considerable challenges in implementing antenatal enquiry. A study exploring midwives' knowledge and experience of domestic violence in pregnancy found that midwives did not routinely ask and were reluctant to do so, feeling that they needed more education and support on the topic (Scobie and McGuire, 1999) This work was supported by evidence from North Bristol NHS Trust who found that when routine enquiry was voluntary, only 10% of the practitioners implemented this within their clinical practice (Price and Baird, 2002).

Routine antenatal enquiry for domestic violence has been endorsed by professional bodies (RCOG, 1997; RCM, 1997) and by the Department of Health (2000). However before the introduction of national routine antenatal enquiry for domestic violence (as recommended by NICE 2001) it is vital to establish to what extent education and ongoing support enables the successful implementation of such services. The implications for effective inter-agency working, the consequences for midwifery practice and service development and provision and pre and post registration midwifery education must also be considered. To date no evidence exists to evaluate any of these areas. This project, funded by the Department of Health and undertaken jointly between North Bristol NHS Trust and the University of the West of England, focuses on investigating these issues in depth.

References: Helton, A., McFarlane, A., amd Anderson, E. (1987) "Battered and pregnant: A prevalence study" American Journal of Public Health 77 (10) (pp.1337-9)
Hillard, P. (1985) "Physical abuse in pregnancy" Obstetrics and Gynaecology 66 (pp.185-90)
Bacchus, L. (2002) Report of the Joint Meeting of the All-Parliamentary Party Group on Maternity and Domestic Violence, 7th February 2002
Bacchus, L. Mezey, G. and Bewley, S. (2002) "Women's perceptions and experiences of routine enquiry for domestic violence in a maternity service" International Journal of Obstetrics and Gynaecology, Vol.109, pp.9-16
Department of Health (2000) Domestic Violence: A Resource Manual for Health Care Professionals
National Institute for Clinical Excellence, The Scottish Executive Health Department and Department of Health, Social Services and Public Safety, Northern Ireland (2001) The Confidential Enquiry into maternal deaths in the UK: Why mothers die, 1997-1999 (London: RCOG Press)
Royal College of Midwives (1997) Position Paper 19, Domestic Abuse in pregnancy (Cardiff: RCM)
Royal College of Obstetricians and Gynaecologists (1997) Violence against women: Recommendations arising from a Study Group (available at www.rcog.org.uk)
Scobie, J. and McGuire, M. (1999) "The silent enemy: Domestic Violence in pregnancy" British Journal of Midwifery April 1999, 7: 4 (pp.259-262)

Evaluation: No evaluation yet but there will be one at the end of the project.

 

Domestic Violence and Health Liaison Project
Contact: Kerry, Berkshire Women's Aid Domestic Violence and Health Liaison Officer
Tel: 0118 951 5785
Details of project: The Berkshire Women's Aid Domestic Violence and Health Liaison Officer can provide support to women experiencing abuse within a relationship, and who have had contact with health services. Health professionals can also seek advice regarding individual clients or issues surrounding domestic violence.
Women can be referred to BWA by GPs, A and E departments, midwives, ante- and post-natal clinics, Community Mental Health Teams, psychiatric wards, health visitors, sexual health clinics or other health professionals. Referrals should be made with the client's consent, or women can self-refer.

 

This project has now ended.
Contact: Jude Watson
Domestic Violence Project Worker
Contact details no longer available - sorry. But see additional contacts below for support, confidence building and counselling.
When did work on this project start? 1999
Date project started to operate (if different): 2000
Date project ended: March 2003
Funded by: Single Regeneration Budget 3 year funding 2000-3.

Details of project: This Project ran across Waltham Forest and Redbridge. There was a Multi-Agency Steering Group involving health representatives from Primary Care and Hospital NHS Trusts, refuges, Victim Support, local authorities, women's groups, and counsellors. Health staff were offered training to identify domestic violence and to make referrals to agencies within the DV Forum and to specialist support set up by the project.
Training included general awareness training for 462 staff (ranging from school nurses, A&E, health visitors and midwives through to health centres, district nurses, family planning and mental health teams); training on routine questioning (Health Visitors and midwives, 191 staff); and training to GPs (63), counsellors (27), trainers (19), and cultural awareness for trainers (10). From April 2003 routine questioning has been mainstreamed for health visitors and midwives.

Further Contacts: Patsy John and Carole Buchanan, Midwifery, Whipps X Hospital: 0208 539 5522 x 5065
Claire Homeyard, Midwifery, King George Hospital: 0208 983 8000 x 8750
Chris Timmon, Health Visitors, Redbridge PCT: 0208 983 8000 x 5129
Email: Christine.Timmon@redbridge-pct.nhs.uk

 

The project provided counselling, support groups and confidence building for idenitified survivors.
156 women were referred for counselling; 27 attended the support group and 56 women attended confidence building sessions. A Survivors Conference was held in January 2003, with 100 participants.
From April 2003: Counselling has been mainstreamed through Qalb Counselling Organisation: 0208 558 6241
Support group and confidence building through Family Service Unit: see Sunflowers Women's Domestic Violence Support Group. Contacts: Jane Spencer/Gordan Parker: 0208 509 0119
Email: gordan@wffsu.freeserve.co.uk
25 men were referred for counselling and eight voluntarily attended a self-help group.
From April 2003: Self help group can be contacted through Os Filmater: 07770 591728
Email: jmf@ukonline.co.uk

Evaluation: South Bank University Evaluation of Routine Questioning in Redbridge and Waltham Forest
Email: cantr@sbu.ac.uk
South Bank University Evaluation of Perceptions of women using the support services offered by the domestic violence holistic healthcare project
Email: a.r.taket@sbu.ac.uk
Publications: Two Annual Reports.
Leaflets are available in 12 languages.
Final report due: June 2003

Website: www.dvhp.org where training materials and the Annual Reports are downloadable.
Data from the project have been used in the national debate on routine questioning, and as a result have influenced the national position. Articles and letters have been published in SAFE and BMJ; a presentation at national WAFE conference on 22nd October 2002; and involved in running the National Domestic Violence Health Practitioners' Forum.

Domestic Violence Health Screening Project

Contact: Beryl Foster OBE - Director Standing Together Against Domestic Violence.
Room 44d, The 4th Floor, The Polish Centre, 238 -246 King Street, London W6 0RF
Tel: 0208 748 7571
Email: admin@standingtogether.org.uk
Web: www.standingtogether.org.uk

When did the project start?: October 2000, as part of the Home Office Crime Reduction programme.
Date project due to end: Standing Together will not be managing the project from Oct 2004. The project will continue to operate but will be managed internally by the management of each health site without the aid of a Development Worker from Standing Together. Standing Together will maintain links with the health sites participating in the project through their membership of the Standing Together Steering Committee.
Funded by: October 2000 - March 2004 the project was funded by the Home Office Crime Reduction Programme. The CRP grant in 2003/4 was at 50% of the previous year's funding. Funding for the project April 2004 - March 2005 is from a number of local charities - The Hammersmith Hospital Trust Amenities Committee Charitable Fund, and the Dr Edwards and Bishop King's Fulham Charity. Fund raising initiatives continue.

Details of the project:
Location: The health project is based at three health sites within Hammersmith and Fulham:
- Charing Cross Accident and Emergency Department (Charing Cross A&E)
- Charing Cross Emergency Primary Care Access Service (EPCAS)
- Parsons Green Walk In Centre (WIC)

Charing Cross Hospital forms part of the Hammersmith Hospitals Trust and is a large teaching hospital. EPCAS and the Parsons Green WIC are part of Hammersmith and Fulham Primary Care Trust and are Nurse Practitioner led Services, providing treatment for minor injuries and illnesses. EPCAS operates out of Charing Cross A&E Department.

Aims and objectives of the health project:
The aim of the health project was to create institutional change with regard to the health service's response to domestic violence. The essential elements of the project in 2003/4 were:
- To implement protocols on domestic violence that include screening, documentation and referral.
- To train staff on domestic violence as an important health issue, screening and the health protocols.
- To implement necessary monitoring and evaluation procedures, so that an outside evaluator can measure the change in practice and its outcomes
- To increase the profile of domestic violence as an important health issue within the medical facility.
The final phase of the project (July 2003 - March 2004) focused on exploring further the opportunities of mainstreaming domestic violence interventions within both the Hospital Trust and the Hammersmith and Fulham Primary Care Trust.

Screening Protocols:
The screening project is set down in detailed guidance in two protocols. The original protocols were written by Standing Together following extensive consultation with staff at the hospital and the Parsons Green Walk in Centre. The protocols have been endorsed by the management of each health site. The protocols outline how to ask the screening question, how staff are to "manage" a disclosure of domestic violence, how to refer to ADVANCE and how to document domestic violence related injuries. In addition the protocols contains domestic violence awareness information for staff to refer to.

The protocols set out the requirement for staff to routinely screen all female patients over the age of 16 regardless of their presenting medical condition, and any male patient who has indicators of abuse. When patients disclose DV, the practitioner is to try and facilitate a referral to the ADVANCE Advocacy Project. ADVANCE operates 24 hours a day, 7 days a week. They are a voluntary agency, affiliated to Women's Aid, who work exclusively with the police within Hammersmith and Fulham Police and the health sites participating in the project, supporting victims of domestic violence.
The screening protocols were updated in October 2003 to address monitoring difficulties and again in August 2004.

Due to the differences in how patients are seen at the Charing Cross A&E and the Parsons Green Walk In Centre, two protocols have been implemented. Walk in Centre staff rotate between Parsons Green and EPCAS every four weeks and so Nurse Practitioners need to be aware of both protocols. The protocols are essentially the same, except to accommodate the fact that EPCAS nurse have access to doctors at Charing Cross (unlike at Parsons Green), patients are assessed through a different system at Charing Cross and there are different administration systems.

Management of the project: The Health Steering Group meets on a monthly basis, its role includes:
- Monitoring and evaluating how the project is operating in relation to its objectives.
- Identifying problems and solving them if possible, (or at least identify issues and blockages in enough detail to provide information for agencies to take decisions about changes to policy/practice).
- Devising and implementing ideas for change to systems and procedures based on operational knowledge, as appropriate.
- Providing a framework to guide the work of Standing Together's Development Worker.
- Reporting to Standing Together's Steering Committee and to any other appropriate bodies.
The membership of the Health Steering Group is drawn from a wide range of health care professionals, including managerial and operational staff from the health sites. This group was a key factor in moving the project forward.

Project resources: The three health sites are stocked with a range of domestic violence help and advice leaflets, which are counted and restocked on a monthly basis. Posters are also displayed in the waiting areas, as well as the treatment/clinic rooms. Domestic Violence Resource folders have been produced and they are a ready and accessible resource for practitioners to refer to when dealing with a disclosure of DV. The packs contain protocol resources, referral information, leaflets and good practice information.

Staff are also given a laminated protocol "prompt" card when they attend the protocol training, in their training packs. The prompt card has been designed by Standing Together for staff to retain and refer to if they are dealing with a DV disclosure.
Monitoring information: The figures below are the key combined monitoring figures from three health sites:

Training delivered from July 2003 - July 2004:
- Total number of staff trained on Domestic Violence awareness: 39
Includes A&E Senior House Officers, Registrars, Consultants and Walk in Centre Nurses only.
- Total number of staff trained on Domestic Violence Screening Protocol: 66
Includes A&E Senior House Officers, Registrars, Consultants, Walk in Centre and A&E Nurses (including students). This figure also includes one member of staff from London Ambulance Service.
- Total number of health staff trained to be "in house protocol trainers.": 6
Includes three WIC nurses and three A&E nurses.

 

Screening rates from December 2003 - July 2004:
- Total number of patients screened for Domestic Violence: 665
- Total number of screened patients who did disclose Domestic Violence: 60

(Data source: Screening Recording Books located in the Clinical Rooms at Parsons Green, and in the Triage Rooms, and Major and Minors areas at Charing Cross A&E.)
Anecdotal evidence suggests that that the screening rate may be higher than the monitoring data indicates, due to the low recorded screening rate within the Charing Cross A&E Department but the high rate of referrals being made to ADVANCE.

Referrals and Information monitoring figures from July 2003 - July 2004:
- Total number of referrals made to ADVANCE from the health sites: 36 (29 direct & 2 self referrals)
Figure includes one referral from Hammersmith Hospital and one referral from Queen Charlottes Hospital.
This figure is the number of referrals made to ADVANCE by health. A direct referral is when the practitioner makes a referral on behalf of the patient. A self-referral is when the patient takes away information and later contacts ADVANCE. This figure is obtained directly from ADVANCE at the end of month.
- Total number of Domestic Violence leaflets taken: 993
This figure includes Women's Aid, and DVIP Women's Service leaflets taken from the public waiting areas, Triage and Clinical rooms. We are unable to track who takes the leaflets and what happens as a result e.g. contact to Women's Aid national advice line. From early July 2004 Home Office DV leaflets and Hammersmith and Fulham DV Forum leaflets were also provided at the sites for people to take.

 

Publications:
Health and DV: What can be done? A report on the implementation of a DV protocol at three health sites in West London (£5 per copy). Report contains a copy of the original screening protocol.
A Crime Reduction Programme briefing paper on the health projects which details the work carried out in the second phase of the project from April 2002 - March 2003 (£5 per copy).
Health and Domestic Violence: Improving safety through screening. A report on what has been achieved at three health sites in West London (£6 per copy). Contains copies of materials used.

 

Contact: Debra Young
Consultant Midwife
East Sussex Hospitals NHS Trust
01323 417400 x 4889; 01424 755255 x 6306
Email: Debra.Young@esht.nhs.uk

When did work on this project start? 1/11/01
Date project started to operate (if different) 1/4/03
Date project due to end (if relevant) ongoing
Funded by: East Sussex Hospitals NHS Trust
Details of project: Women are asked about domestic violence as a routine part of antenatal care. They are only asked if they are alone at booking and/or on antenatal admission to hospital.
Evaluation: Outcomes measured:-
Number of women asked
Number of women not asked
Number of disclosures
Number of Additional Support Forms (ASF)
Number of ASF where Domestic Violence is identified as an issue.
Domestic Violence Statistics at booking 1/4/03-31/3/04:
Eastbourne (and CBC):
Total bookings: 2276
Total asked: 1157 = 50.8%
Total not asked: 1119 = 49.2%
Of those asked:
Yes: 151 = 13%
No: 1005 = 87%
Unwilling to answer: 1
Total ASF: 60
DV identified as issue on ASF: 9
Hastings:
Total bookings: 1824
Total asked: 813 = 44.6%
Total not asked: 1011 = 55.4%
Of those asked:
Yes: 124 = 15.25%
No: 687= 84.5%
Unwilling to answer: 2
Total ASF: 78
DV identified as issue on ASF: 29
Midwives have now been asking about domestic violence as part of routine antenatal care for over a year. The above statistics demonstrate that around one half of women are asked at booking (which is quite an achievement!). Those that aren't asked are accompanied (and therefore it is inappropriate to ask). Very few women are asked routinely on antenatal admission (the reason given being "inappropriate to ask"). This is probably linked to a perceived lack of privacy afforded by the hospital layout (four bedded bays).

However, there have been disclosures made at antenatal admission.

Feedback from midwives is that questioning at booking often generates disclosures of past domestic violence and abuse other than domestic violence. Although this is still very relevant it has caused some difficulties with analysis in terms of isolating current domestic violence issues. Therefore an additional question will be added to the booking questionnaire (in the appropriate place) which asks specifically if there are current issues with domestic violence. Hopefully this will give us a clearer picture. In addition the guidelines now ask midwives to also consider questioning women post-natally (although there is no formal system in place to audit this practice as yet).

There has been no formal exploration of midwives' feelings/attitudes towards asking women about domestic violence and their experiences of doing so.

One of the hospital sites is also exploring introducing a scheme (coloured stickers on urine pots, accessible in ladies toilets) that allows women to signal a desire to be seen alone.

 

Contact: 1. Debra King 2. Jo Dutson
1. Project Manager 2. Clinical Services Manager
DK: 3, Cambridge Gardens, Hastings, East Sussex, TN34 1EH;
JD: 46, Cambridge Road, Hastings, East Sussex TN34 1DT
01424 716629 (DK); 01424 460066 (JD)
Email: hastingsdap@crinet.co.uk; jo.dutson@action-for-change.org

When did work on this project start?
Date project started to operate (if different) December 2003
Date project due to end (if relevant)
Funded by: Funding available for three years through the Public Service Agreement initiaive (PSA). This is a joint initiative between Alcohol Team (Action for Change), the Domestic Abuse Project (Crime Reduction Initiative), the Police (Anti-Victimisation Unit) and the Conquest District General Hospital.
Details of project: The aim of the project is to reduce the need for repeat attendances at the Accident and Emergency Department by those experiencing domestic violence. Emergency nurse practitioners will routinely ask questions about domestic violence and alcohol issues (following specified guidelines), will document injuries carefully, and will give information and offer appropriate help. If the patient agrees, A and E staff will make an appointment with a PSA worker for the next working day, and PSA workers will establish and maintain contact until client engages with the appropriate service.

Evaluation: the project will be monitored by a multi-agency steering group, comprising representatives from the Police, Hastings Borough Council, Hastings and St. Leonard's Primary Care Trust, East Sussex County Council, Social Services and Conquest Hospital. As a new project, it will be closely monitored and an evalution will be published in relevant journals.

Intercept: Tackling the Impact of Substance Misuse on Domestic Violence

Contact: Denise Baines
Eastern Wakefield Primary Care Trust
Castleford, Normanton and District Hospital
Lumley Street, High Town, Castleford WF10 5LT
01977 665712
Email: denise.baines@ewpct.nhs.uk

When did work on this project start? October 2002
Date project due to end (if relevant) September 2005
Funded by: Home Office Recovered Assets Fund
Details of project: Intercept is a specialist service offering advice, support and information to those affected by domestic abuse where there is also a substance misuse issue.
The project provides:
· Individual, groupwork and counselling for those experiencing domestic abuse
· Individual, groupwork and counselling for perpetrators of domestic abuse
· Multi-agency training packages
· Advice and support for health professionals, practitioners and voluntary sector organisations working with domestic abuse and substance misuse
The project covers the whole of the Wakefield district, and is based at Castleford, Normanton and District Hospital, managed by Eastern Wakefield PCT in partnership with the Community Safety Strategy. Additional funding through Health Inequalities has enabled the project also to process referrals regardless of accompanying substance use issues.
Publications: An interim progress report was published in 2004. This report: 'One year to go: Unlocking the door on domestic abuse' is obtainable from the project. There is also a training video.

 

Contact: Sally Cook
Women's Services Co-ordinator
c/o Gwellheans, Douglas Hocken Day Centre, Alma Place, Redruth TR15 2AT
01209 212350/ 07810 624445
Email: kwitcornwall@hotmail.com

When did work on this project start?
Date project started to operate (if different) 2003
Date project due to end (if relevant) ongoing
Funded by: Three year funding from DAAT until 2006.
Details of project: KWIT offers a friendly, lively and professional forum run by women for women, to enable women who have been involved in any way with substance misuse problems to obtain and share information and learning, meet socially, develop confidence and have fun, and ensure that their needs and views are aired and listened to.
AIMS
1. To provide peer support for women in Cornwall to help them with any problems they may have encountered with alcohol or drug misuse and to aid their recovery.
2. To ensure women service users' participation in the planning and improvement of services.
3. To aid their recovery by developing and building self esteem and confidence.
4. To provide up to date and comprehensive information on a wide range of services for women in the county and nationally, and to publicise local services to ensure that women are aware of their choices.
5. To provide a forum for women to raise and share their issues, to help each other to gain a better quality of life in their recovery and to bring fun to their lives.
We hope that women will be encouraged in their recovery by knowing that they are not alone; they can get information and support on caring for their children, on benefits and other services; they will be able to develop skills, to regain confidence, to socialise with other women, and to have fun.

Lancashire Teaching Hospitals NHS Trust

Contact: Suzanne Hargreaves
Directorate Manager, Accident and Emergency Department
Sharoe Green Lane North, Fulwood, Preston, Lancashire PR2 9HT
Tel: 01772 522402
Date project due to end: ongoing
Details of project: A domestic violence policy is in effect within A and E., Maternity and Gynaecology departments. Within the A and E department staff also collect and document evidence. Whenever domestic violence is suspected, for example because of the nature of the injuries or because they do not fit the explanation which is given, staff ask a series of questions, and record responses carefully in case the information is needed for a subsequent court case. This policy has been in effect for a few years, and Liz Yates (who developed it) won the Nursing Standard Millennium Nurse Award (Medical Category) for this domestic violence policy.Ideally they would like a Domestic Violence Co-ordinator post in order that they could research the latest information, produce a strategy and train staff throughout the hospital.

 

Contact: Dawn Harvey
c/o Unity Business Centre, 26 Roundhay Road, Leeds LS7 1AB
Tel: 0113 2349090
Fax: 0113 2345620
Email: Dawn.Harvey@leeds.gov.uk

Details of project: The Health and Social Care Project within LIAP was established to develop work in partnership with the NHS Trusts in Leeds in relation to women experiencing violence from known men. LIAP is part of Leeds Community Safety and its work is strategically placed within the Violence and Abuse Task Group of the Leeds Community Safety Partnership.
Leeds has 7 NHS Trusts made up of:
- Leeds Mental Health NHS Trust
- 5 Primary Care Trusts
- Leeds Teaching Hospitals NHS Trust

Summary of activities to date:
- Strategic Development:
The Mental Health Trust Board has agreed a Strategic Action Plan and this is being progressed by a Trust Task Group. The 5 PCTs have collectively developed a Strategic Proposal and this has been taken forward on an individual PCT basis in the form of an action plan. The Hospital Trust is considering a similar approach. The Action Plans include Policy Development, Practice Guidelines, support and supervision of staff both professionally and personally, training across all disciplines, Partnership work with other agencies in the city as part of the Leeds Citywide Strategy and monitoring and evaluation, including service user satisfaction.
- Training:
Programmes are established across all Trusts, offering three two-day courses every 6 weeks and shorter tailored programmes to fit in with professional development. These include programmes for Senior House Officers, Registrars, Trainee General Practitioners, Paediatricians, Practice Nurses, Administrative Staff and Health Care Assistants. (Within the Hospital Trust the two-day course is mandatory for Midwives and Accident and Emergency staff).
Training within Trusts is facilitated by the Project and NHS Trainers who have undertaken the LIAP Training for Trainers course.
Training is now established within the two Universities with inputs for medical and nursing students, health visitors and school nurses, and Training for Tutors is in place to support integration across pre- and post registration curricula.
- Staff Support:
In collaboration with the Cross Trusts Child Protection Team, all the Child Protection Supervisors are now being trained to be able to support staff working with women - whether they have children or not - as part of the Leeds Model of Supervision; and the course for new supervisors is being updated to include this as a component in the training programme.
Within strategic development support for staff experiencing violence in their own lives is being developed.
- NHS Guidelines:
Draft guidelines have been developed and these have been successfully piloted in the Accident and Emergency Department of the Hospital Trust (details on LIAP website), and pilots within the Mental Health Trust and PCTs are being set up for Nov-march 2005. Following the pilots and amendments, a short version and electronic version will be developed, and all Trusts asked to agree the final guidelines to ensure consistent practice and agreement through clinical Governance boards.
- Development of an Assessment Tool:
In partnership with Professor Drife (Clinical Director of the Confidential Enquiries into Maternal Death) a Project has been established in his clinic where all women will be asked at various times during their pregnancy, and post-partum, about domestic violence and appropriate support offered. Women will also be asked to fill in a simple questionnaire about how they felt being asked and if they feel all women should be asked. It is anticipated that this could serve as a model for other Departments/Services within Leeds Trusts and will contribute to the national debate about routine questioning. This project was completed in June this year and the outcome found on the LIAP website also.

 

Contact: Carole Devaney
Mansion House, 41, Guildhall Lane, Leicester
Tel: 0116 295 1514
Email: carole.devaney@lcwpct.nhs.uk

Details of project: Iniative in Leicestershire and Rutland covering the whole NHS community.
Carole Devaney is in the process of working with Leicestershire and Rutland PCTs in rolling out guidelines and protocols. These have already been signed off by the Mental Health and Learning Disabilities Trust (Leicestershire Partnership NHS Trust) and partially rolled out from the ex-Community Trust to health visitors and district nurses. A programme of training is gradually being rolled out to PCTs. This training is a standard package delivered by a pool of trainers, e.g. health visitors, learning disability manager, drug and alcohol team worker, primary mental health care worker. This training is part awareness raising and part reference to guidelines and good practice. They are also developing a mechanism for rolling out a four-hour integrated session on child protection, vulnerable adults and domestic violence for training in the University Hospitals in Leicester and Leicestershire Partnership NHS Trus and PCTs. The idea is that eventually they will have standardised training linked to guidelines/policies across the "NHS family" in Leicestershire and Rutland. The pack also includes a video which has snippets across a range of domestic violence experiences including financial abuse, vulnerable adult abuse, carer abuse, abuse of gay men, abuse in pregnancy and abuse of Asian women. Whilst getting PCTs to sign up individually they are also trying to take a more broad brush approach through the local NHS Domestic Violence group.
Carole Devaney is also looking at mechanisms for rolling out centralised data collection systems in health through Sure Start and Midwifery.
Additionally, a polaroid project is being initiated, to photograph injuries in health settings and keep these in a manner which is acceptable in court.
Finally, a leaflet is being piloted on Responding to Disclosure of Domestic Violence by Children with a group of health visitors and education welfare officers.


Mansfield District Primary Care Trust: Appointment of Nurse Consultant, Domestic Violence

Contact: Christine Mann
Nurse Consultant Domestic Violence
Health Centre, St. John Street, Mansfield, Nottinghamshire
Tel: 01623 784339
Email: christine.mann@mansfield-pct.nhs.uk

Date project started to operate: May 2001
Date project due to end (if relevant): ongoing
Funded by: Mansfield District PCT
Details of project: Mansfield District PCT is the first in the country to appoint a nurse consultant with strategic responsibility for domestic violence. Christine Mann started in May 2001. Her role is to offer professional leadership and to effect strategic change in policy and practice.She acts as a consultant within the Trust, both building on and developing external partnerships. Having recently assumed responsibility for Ashfield PCT, Christine also acts as a consultant for other PCTs. She is developing the educational process within the Trust, the community and Nottingham University,aiming to develop a sound research base. She states that "Early intervention and sensitive screening and support for victims of domestic abuse is essential but in conjunction NHS staff need to feel that their training is adequate and that their responsibilities are clearly defined."
Copies of Mansfield District PCT Domestic Violence Policy (2002-5) and Domestic Violence Strategy (2002-5) are available on request.
Publications: Mann, Christine(2001) 'No Hiding Place' Community Practitioner, October 2001, volume 74,no.10
Mann, Christine (2001) "Domestic Violence: Facing the Challenge" Primary Care Journal November 2001

 

Contact: Jill Lancaster, Health Improvement Manager for Children and Young People
Tel: 0114 271 8411
Email: jill.lancaster@sheffieldn-pct.nhs.uk
Details of project: Sheffield North PCT has recently had the joint Sheffield-wide Policy Statement on Domestic Violence accepted by the PCT board and are in the process of developing their own standards and protocols.
A number of staff have attended training sessions on domestic violence and they want to develop in-depth skills-based training to enable healthcare professionals to raise the question of domestic abuse with their clients. All PCTs in Sheffield have contributed towards the costs of the Domestic Abuse Forum Co-ordinator and Training Co-ordinator, and are contributing to running costs, training programme, and materials (£40,000 in total per annum.)
NSPCT has close links with the Parson Cross Domestic Abuse Project and with developing work in the Burngreave area of Sheffield.

 

Contact: Bridget Gardner, Marilyn Lewis
Health Visitors
West Earlham Health Centre, 46, Earlham West, Norwich NR5 8AD
Tel: 01603 504978
When did work on this project start? March 2003
Funded by: Queens Nursing Institute (QNI) and Norwich Primary Care Trust
Details of project: The aim of this project was to raise awareness with clients and staff of a Norwich health centre regarding the effects of domestic abuse on family health, by:
- offering awareness raising sessions with all staff
- developing a directory of information to assist health professionals in supporting those experiencing domestic violence
- piloting the use of reference to domestic abuse in the Personal Child Health Record ("Red Book") by the health visiting team over a 6 month period.
Evaluation: Each member of staff completed a questionnaire before and after their awareness raising session. Clients were surveyed using a questionnaire before and at the end of the 6 month period, and took part in an independently facilitated focus group.
Clients and staff gave a positive evaluation of the project. Staff identified a need for awareness raising/updating sessions to continue, with addition of case studies for discussion and additional resource material. Clients and health visitors indicated that inclusion of information about domestic violence in the Red Book should be continued.
This project won a Queen's Nursing Institute award for Innovation and Creativity, and was jointly sponsored by the QNI and the Norwich Primary Care Trust. It was cited in the Norwich PCT response to safety and Justice in June 2003.
Publications: Karen Daniels of QNI has written an article in "Community Practitioner" (journal of Health Visitors' Association), December 2003.

 

Contact: Linny Beaumont, Domestic Violence Policy Officer,
Nottinghamshire County Council Community Safety Team,
Culture and Community Department, County Hall, West Bridgford, Nottingham NG2 7QP
Tel: 0115 977 2040
Email: Linny.beaumont@nottscc.gov.uk

Details of project: The domestic violence policy officer in partnership with Nottinghamshire Drug and Alcohol Action Team and Nottingham City Council have developed a domestic violence and substance misuse action plan which is being implemented through a multi-agency steering group. Good Practice Guidelines for Working with Survivors and/or Perpetrators of Domestic Violence who Also Use Alcohol and Drugs have been produced and joint domestic violence and substance use training is currently being developed.

The aims of the action plan are:
· To increase the safe choices for women and children experiencing domestic violence where substance misuse is also an issue, by raising awareness and standards within existing service providers.
· To hold perpetrators of domestic violence, including those who misuse substances, accountable for their behaviour by raising awareness and standards within existing service providers.
· To encourage networking and information sharing between the domestic violence and substance misuse sectors with the aim of improving cross-sector training, collaboration and awareness.

The action plan addresses the issues of:
· Training for substance misuse workers on domestic violence and on substance misuse for domestic violence workers.
· The provision of specialist refuge accommodation and support for women who misuse substances. A Domestic Violence and Substance Use Development and Support Worker post has been funded by Notts DAAT.
· The development and implementation of good practice guidelines to respond to survivors of domestic violence who also misuse substances.
· The development and implementation of good practice guidelines to respond to perpetrators of domestic violence who also misuse substances.
· Monitoring numbers of women accessing substance misuse services who are experiencing/have experienced domestic violence.
· Monitoring numbers of women accessing domestic violence services who also misuse services.
· Monitoring numbers of perpetrators of domestic violence who also misuse substances.
· The development of a domestic violence and substance misuse forum.
· Provision of information about domestic violence and substance misuse.

Further contacts: Sarah-Jo Lee, Domestic Violence Policy Officer, Nottinghamshire County Council
Tel: 0115 9773864
Email: sarahjo.lee@nottscc.gov.uk
Jane Lewis, Domestic Violence Policy Officer, Nottingham City Council
Tel: 0115 9157374
Email: jane.lewis@nottinghamcity.gov.uk

 

Contact: Jane Lewis, Domestic Violence Policy Officer,
Nottingham City Council,
14, Hounds Gate, Nottingham NG1 7BA
Tel: 0115 915 7374
Email: jane.lewis@nottinghamcity.gov.uk
Can also contact: Nottingham Domestic Violence Forum, 2, First Avenue, Sherwood Rise, Nottingham NG7 6JL
Email: enquiries@ndvf.co.uk
Website: www.ndvf.co.uk

Details of project: The Domestic Violence Policy Officer in partnership with NDVF and Mental Health Social Services have developed an action plan to improve services for women and children at risk of domestic violence and with mental ill health.
The action plan includes:
-training for mental health staff on domestic violence and on mental health for domestic violence sector staff; -good practice guidelines for mental health workers on work with survivors of domestic violence;
-good practice guidelines for mental health workers on working with perpetrators with mental ill health;
-inclusion of domestic violence in mental health strategies and plans;
-monitoring of numbers of women who are mentally ill who are at risk of domestic violence;
-provision of information about domestic violence and mental ill health.
Nottingham City Council Good Practice Guidelines for mental health staff have been written in partnership with Mental Health, Social Services and the Domestic Violence Policy Officer, and sent to all Social Services offices. The work Dr Cathy Humphreys has done on the links between domestic violence and mental ill health informed the Guidelines.
Mental health staff from Nottingham Health Care Trust are being trained by the Nurse Consultant in Domestic Violence for Mansfield PCT. Nottingham City Council includes the Domestic Violence and Mental Health Action Plan in its Health Plan, and Nottinghamshire County Council have developed a working group to look at moving the Domestic Violence and Mental Health Action Plan forward.
Draft Good Practice Guidelines on work with perpetrators are being developed in partnership with the Forensic Team, the TRI project and Mental Health Social Services. (TRI is the Training Resources and Information for work with men on the domestic violence project)

Further contacts: Nottingham Domestic Violence Forum, 2 First Avenue, Sherwood Rise, Nottingham NG7 6JL
Email: enquiries@ndvf.co.uk
Website: www.ndvf.co.uk
Sarah-Jo Lee, Domestic Violence Policy Officer, Nottinghamshire County Council
County Hall, West Bridgeford, Nottingham, NG2 7QP
Tel: 0115 977 3864
Email: sarahjo.lee@nottscc.gov.uk
Linny Beaumont, Domestic Violence Policy Officer, Nottinghamshire County Council
County Hall, West Bridgeford, Nottingham, NG2 7QP
Tel: 0115 977 2040
Email: linny.beaumont@nottscc.gov.uk


Pandora Project

Contact: Irene Campbell
Director, Camden Safety Net
Tel: 0207 974 8415
Email: irene.campbell@camden.gov.uk

Funded by: funded through Neighbourhood Renewal Fund (Health) for two years from April 2004. They will be looking for mainstream funding to continue after that.
Details of project: Project Pandora will train local people with direct experience of domestic violence.
The aims of the project are:
· to train and employ two local people who have direct experience of domestic violence
· to reduce repeat victimisation to less than 10% from its current level of approximately 15%
· to improve the capacity of local health care providers to support those experiencing domestic violence by training frontline healthcare staff to routinely question, identify and make appropriate and effective referrals into Camden Safety Net Support Services, i.e. counselling and psychotherapy, confidence building, parenting programme, perpetrator programme and case working.
Although healthcare professionals see that they have a role in identifying and referring women experiencing domestic violence, they have often had little training in how to do this appropriately and effectively. Health providers often know little of the processes which fuel violence and women report that some health professionals act as if the victim is an equal partner in provoking violence. Whilst healthcare situations may be an ideal point to signpost women, the effectiveness of intervention will depend heavily on strong partnerships between health, social care, police and the voluntary sector.
By piloting both a structured training programme to frontline staff in acute and primary care, and the simultaneous development of the right partnership and support mechanisms between relevant agencies, this project will demonstrate measurable reduction in repeat victimisation.
Using the model of the Public Health Assistants' programme, recruitment will be targeted at women from socially excluded/marginalised communities who have been affected by domestic violence. The two workers will be based in Primary Care locations and work across all Neighbourhood Renewal Areas.

 

Contact: Shonagh Dillon
Project Leader
5th Floor, Civic Offices, Guildhall Square, Portsmouth, PO12AL
Tel: 023 9284 8670
Email: Shonagh.dillon@portsmouthcc.gov.uk

When did work on this project start? September 2000
Date project started to operate (if different) August 2002
Date project due to end (if relevant) Continuing as far as funding allows
Funded by: Portsmouth City Council, OPDM.
Details of project: Dedicated project workers are based in the hospital and are available to anyone who discloses abuse in Accident and Emergency, Maternity and Obstetrics, and other hospital departments. Since September 2001, hospital staff have received training in asking about abuse and handling disclosure. This is ongoing.

At present the project is available 9-5, Monday to Friday and 10-4 at weekends and bank holidays. They are hoping to increase funding to enable them to offer a 24 hour service in future.
Once domestic abuse has been disclosed, patients are asked if they would like to speak to a project worker, either immediately or at a later date. The aim is to provide the first intervention as soon as possible within the 4 hour "window of opportunity" as described in the Domestic Violence Matters Project. Project workers then work with the client and explain options that may be available to them. The work is client-led. It is not just an emergency service: the team continue to work with the client for as long as requested. This may involve advocacy work, accompaniment to appointments or ongoing support. The project is available to anyone experiencing domestic abuse, but so far (unsurprisingly) all referrals have been female. The project has access to a Bengali speaking worker and uses Language Line. They work closely with other domestic abuse services.

Evaluation: Evaluation undertaken by Linda Regan, Child and Abuse Studies Unit, London Metropolitan University. Final report showed that only 4% of clients had a return visit to A&E due to Domestic Abuse.

 

Contact: Kim Whitehead
Professional Development Co-ordinator, Health Visiting,
Sandringham House,
Castle Courts,
Windsor Street,
Salford
Tel: 0161 212 4173
Email: Kim.Whitehead@salford-pct.nhs.uk

Details of project: A two-year project was funded in 2000 for a dedicated Domestic Violence Co-ordinator, HAZ funded to develop a range of initiatives including the following:
1. Domestic Violence related policies were introduced into Salford PCT. These include a staff employment policy.
2. A Health Visitor questioning tool was introduced for all new mothers.
3. I.T. system was developed to allow the collation of reliable accurate data.
4. A Health Visitor School Health Advisor transfer of information form now contributes to assessing the needs of children.
5. The Freedom Programme: a 12 week programme to assist women to learn about domestic violence and abuse. This continues with support from Sure Start.
6. A working group improved the quality of information on the DV reports received by the PCT from the Police.
7. Funding was sought and training co-ordinated to faciliate a multi-agency pool who had completed the Training for Trainers course offered by Leeds Interagency Project. Many agencies now offer in-house and partnership training. The multi -agency Domestic Violence Implementation Group (a sub-group of the city's Domestic Violence Policy and Strategy Group) have agreed standard training along with supportive information and documentation. Monthly training continues within the PCT, and support is offered to the multi-agency pool who offer Multi-Agency DV Training to identified professionals, including health visitors and school health advisors. Multi-agency training is now co-ordinated by the city's Domestic Violence Inter-Agency Co-ordinator.
8. £12,000 was paid to Salford Women's Aid to develop partnerships with health, and this was positively evaluated.
9. Salford PCT include domestic violence in its strategies as we have a responsibility to reduce all inequalities.

City of Salford information leaflets, posters and cards were printed to support the Domestic Violence Traiing and Resource handbook, which was published as part of a Home Office Crime Reduction Programme funding.
Currently there is no provision for perpetrators in Salford other than a mandated programme.
The Inter-Agency Domestic Violence Co-ordinator continues much of the work that originates from this programme.

 

Contact: Maureen Storey,Co-ordinator
Tel: 0114 275 0101
Email: mail@daforum.fsnet.co.uk
Funded by: The NHS in Sheffield and the local Crime and Disorder Partnership
Details of project: The Forum has a Multi-agency Strategy on Domestic Abuse (2000-3) which has a set of action plans for each agency including the NHS trusts. The city-wide Health & Domestic Abuse Working Group provides a strategic overview and co-ordinates the work needed to implement the action plans. PCTs and hospital trusts are represented on this group.
Key work planned by the Health DAWG includes:
- drafting a set of local protocols for health workers
- looking into routine screening pilots and generating discussion about the issue
- developing a training strategy
- identifying resources to enable someone to specialise in strategic work with health trusts for a short time to move this work on.
There is a rolling programme of multi-agency domestic abuse training, in two stages, which is accessed by staff in PCTs.

 

Contact: Sue Thompson, Named Nurse for Child Protection
Tel: 01707 386867
Email: Sue.thompson@welhat-pct.nhs.uk

Details of project: South East Herts PCT has a written Protocol on domestic violence which has been updated recently. It is re-evaluated yearly by the Named Nurse for Child Protection, and aims to have yearly feedback from health visitors also. They collect data on domestic violence and disseminate information to health professionals and the local Domestic Violence Forum.
The PCT have assisted with devising a local intra-agency website containing information for local use.
Health visitors in East Herts routinely question all mothers with children under 5 years about domestic violence.
The Domestic Violence Forum funds therapeutic work and anger management sessions for parents and children. All this work is ongoing

 

Contact: Lisa Ryder
1st Floor, Withington Hospital, Nell Lane, West Didsbury, Manchester
Tel: 0161 6113983
Email: lisa.ryder@smpct.manchester.nwest.nhs.uk
Funded by: Neighbourhood Renewal Fund, Manchester City Council
Details of project: A recent audit of Manchester health services found that staff did not have the skills to respond to women who had experienced domestic violence and their knowledge of appropriate referrals was limited. In particular, services are not meeting the needs of South Asian, African Caribbean, Irish or Jewish women. This project aims to develop current practice and contribute directly to targets identified within the Crime and Disorder Strategy Theme Group Domestic Violence Action Plan. The aim of the Project is to develop a "beacon" primary care team in all three PCTs within the Manchester area. The objectives include:
- audit current practice in relation to domestic violence
- develop and implement a domestic violence protocol
- develop service standards
- train staff to respond appropriately to women experiencing domestic violence
- establish data collection systems
- improve communication with other health service sectors
- pilot new and innovative initiatives
- roll out project to other PCTs in Manchester area (over a two year period)
- ensure services meet the needs of black and minority ethnic women
For further information, please contact Lisa Ryder as above.

 

Contact: Jane Spencer
Tel: 07950 428178 (direct)
Email: jane@spencer77.fsnet.co.uk

Details of project: Sunflowers Women's Domestic Violence Support Group meets weekly on Wednesdays from 12 noon till 2 p.m. in Walthamstow. Either contact Jane Spencer direct (number as above) or ring Family Service Unit on 020 8509 0119 for more details. The group is open to all women dealing with domestic violence either presently or in the past.
"We define domestic violence far more widely than physical abuse; it can encompass a range of abusive and controlling behaviours within a close relationship. We provide a space for women to share experiences, receive and give support, make friends, be listened to, etc., as well as taking part in a variety of activities and workshops."

 

Contact: Pat Wallace
c/o Community Safety Department, Bucks County Council, Walton Street, Aylesbury HP20 1UA
Tel: 01296 38371
Email: pawallace@buckscc.gov.uk
When did work on this project start? Funding offered summer 2001 (orig. bid 2000)
Date project started to operate (if different) October 2001
Date project due to end (if relevant) March 31st 2003
Funded by: Home Office
Details of project: Funding was secured by the Bucks County Domestic Violence Forum from the Home Office for an 18 month project with the following aims:
- research local and national best practice
- facilitate a multi-agency approach
- data collection and sharing
-training programme for multi-agency and health staff
- support health staff in developing policies and procedures to support women living with violence (including routine questioning by some health professionals.)
The Project had two fulltime workers, one with multi-agency remit and one with health remit.
A Pilot Project was undertaken in three GP practices to identify the incidence of domestic violence from a sample of women attending surgery unaccompanied during a 1 month period; to look at potential links between domestic violence and health; to identify helpful and unhelpful responses from agencies; and to ask health professionals about their knowledge of domestic violence and thus to identify training needs. See Croston and Wallace (2003b).
Training was offered to all health staff with GPs, A and E and mental health being the key areas. 440 health staff attended training on information and awareness and 163 midwives and health visitors also attended "Ask the question" training. By the end of February 2003, all midwives and health visitors had commenced routine questioning on domestic violence. Input to two GP refresher courses achieved, but in future training within surgeries seems to be more effective. There was only a small take-up from mental health.

Project workers in conjunction with multi-agency representatives developed a Code of Practice for all agencies tn Buckinghamshire, comprising 8 protocols covering: safety, confidentiality, training and support, information, designated worker, accessibility and evaluation. 22 organisations have adopted the Code so far including most of the NHS trusts.

The Sunlight Project also produced a Directory of Services in Buckinghamshire for all frontline staff to use to enable appropriate and informed referrals. This Directory has been updated to March 2003, but this process needs to be ongoing. They also attempted collection of baseline data about domestic violence but this proved difficult for various reasons (see Croston and Wallace (2003a).
The time taken to identify, make contact with and raise interest of key people meant that it was not until the second half of the project that numbers requesting involvement and training really took off. In a time-limited project, this must be recognised.

Evaluation is being undertaken by Bucks Chiltern University College.
Publications: Croston, Janet and Wallace, Pat (2003a) The Sunlight Project: Exit Report October 2001-March 2003 (Aylesbury: Sunlight Project)
Croston, Janet and Wallace, Pat (2003b) Relationship between health and domestic violence: Women's Perceptions of their health and domestic violence: what is helpful; level of awareness of DV amongst practice staff (Aylesbury: Sunlight Project)

 

Contact: Helen Cox, Rachel Payling
Public Health Department, Castleford, Normanton and District Hospital, Lumley Street, Castleford WF10 5LT
Tel: 01977 665712 or 01977 665723
Email: helen.cox@ewpct.nhs.uk; rachel.payling@ewpct.nhs.uk

When did work on this project start?
Date project started to operate (if different) October 2000
Date project due to end (if relevant) March 2002
Funded by: Home Office Crime Reduction Programme: Violence against women initiative
Details of project: The Support and Survival Health Initiative 2000-2 was one of 24 projects funded by the Home Office Crime Reduction Programme, and one of five national projects addressing domestic violence as a healthcare issue.
During the first phase of the project, an audit was conducted across 11 group practices to establish baseline data on prevalence of domestic violence. 1207 women participated in the audit and 214 (18%) disclosed experiences of abuse. Seventy women completed questionnaires giving details of the abuse and the impact on their health. The results support national statistics that one in four women experience domestic abuse during their lifetimes.

The second phase of the project involved implementing a pilot screening programme in primary care involving GPs, practice nurses, health visitors and community nurses. Three GP practices were involved during Jan-Feb.02. Domestic Violence awareness training was provided for primary care health professionals. The aim was to establish a sustainable model for screening for domestic violence within primary care. Training and support in domestic violence awareness, effective identification and intervention was provided for health professionals who participated in this pilot. A screening pack, including a protocol and referral guidelines, has been developed using the Department of Health's Resource Manual for Healthcare Professionals.

Evaluation: Professor Ann Taket, South Bank University undertook an evaluation, commissioned by Home Office.
Publications: Domestic Abuse Screening Pilot in Primary Care July 2002
Home Office Evaluation Report available March 2003

 

Contact: Barbara Morrissey
P.O.Box 799, London SE7 8JD
Tel: 0208 3339072

When did work on this project start? 6th February 2003
Funded by: Children's Fund
Details of project: This is an ongoing project, each one lasting 6 weeks. There will be four per year. Each will be attended by approximately 6 children.
Sample timetable:
Week 1: Introductions, explanation of purpose of group, start of domestic violence folder for children
Week 2: music therapy; domestic violence folder
Week 3: craft session; mask making; domestic violence folder
Week 4: art therapy; domestic violence folder
Week 5: craft session
Week 6: outside activity; present children with folder and art work; medal; evaluation form.
Additional contact is Helen Foot of Greenwich PCT
Tel: 0208 317 9415

Evaluation: In process of evaluating the first group.

 

Contact: Julia Worms
Townhill Barn, Dorton Road, Chilton, Aylesbury Bucks HP18 9NA
Tel: 01844 202001 or 07977 100887
Email: juliaworms@hotmail.com or admin@thamesvalleypartnership.org.uk

Details of project: The Thames Valley Partnership is a charity, which seeks to reduce crime across within Thames Valley (Bucks, Berks & Oxon.). One of our many areas of interest is domestic violence and we are involved in domestic violence forum liaison, conference organising, intervention strategies, schools projects, health initiatives, fund raising for specific projects, research, network enabling, strategic planning, steering group membership etc. We have a large network of multi-agency contacts in this field and play a significant part in strategic and local planning - the work is ongoing.
Current projects include early intervention programmes, focus on work within the Health Service (PCT Audit published March 2004), perpetrator programme network and research into domestic violence data both availability and data sharing procedures etc.

 

Contact: Judy Morgan
based at Bournville Lane Police Station, Birmingham
Tel: 0121 626 4070 or mobile: 07747 825 745
Email: judy.morgan@west-midlands.police.uk
When did work on this project start? April 2003
Date project started to operate December 2003
Date project due to end (n/a)
Funded by: Neighbourhood Renewal Fund
Details of project: Aims to provide survivor-centred one-to-one support for women living with domestic violence, within Bartley Green, Weoly Castle, Northfield, Selly Oak, Longbridge and Bournville wards of Birmingham, West Midlands. Support will be provided by trained "mentors". Support - both practical and emotional - will be confidential, and led by the needs and wants of the women and her family, and will ideally start within 24 hours of initial contact.
The mentor will help survivors to:
- Gain more control of their lives through increased confidence and self-esteem
- Evaluate all their options to make well-informed decisions and plans for the future
- Find and deal with all the other services and agencies who could assist them
- Handle issues associated with moving out of the home (if that is what they decide to do)
- Feel more certain that they can manage on their own if they need to
- Go through any police, court and other legal proceedings
Other benefits hoped for include reduction in:
- The number of retractions made by survivors
- The number of repeat complaints made by survivors
- The amount of police time spent on DV incidents
- The damage to children who witness and/or are subjected to domestic violence.
Mentors will make it easier for survivors to find, contact and deal with all the other agencies who can help them and will be trained to work alongside other agencies.

 

Contact: Helen Cox, Rachel Payling
Public Health Department, Castleford and Normanton District Hospital, Lumley Street, Castleford WF10 5LT
Tel: 01977 665711 or 01977 665723
Email: helen.cox@ewpct.nhs.uk; rachel.payling@ewpct.nhs.uk

When did work on this project start? 1st April 2002
Date project started to operate (if different)
Date project due to end (if relevant) 31st March 2003
Funded by: Home Office Crime Reduction Programme Violence Against Women Initiative
Details of project: This project continued work established by the Support and Survival Health Initiative as a result of a further 12 months funding from the Home Office. The project has now ended (31st March 2003)
Publications: Full report available March 2003

 

Contact: Pat Mitchell (Sister)
Claire Timings (Staff Nurse)
Tel: 01935 873546
When did work on this project start? Early 2001
Date project started to operate (if different) March 2003
Date project due to end (if relevant) March 2004
Funded by: Home Office : Reduction in Violence Against Women Initiative
Details of project: This project has been developed as part of a multi-agency initiative with South Somerset Domestic Violence Forum.
Routine enquiries are to be made to as many women patients as possible over the age of 18 and who are in suitable physical and mental health. Enquiries will be made by trained nurses with 6 months experience in A and E. Information about the project is given to the patient, who is then asked to complete a questionnaire. Normal confidentiality applies. Child protection protocol is used to protect children. Safety is considered but we do not have a formal assessment form. Crisis management is discussed. Referrals are to various agencies: for example, the refuge, and the Domestic Violence Unit at the police station. Information on local agencies is given in a leaflet that covers services in Somerset and Dorset: Housing, CAB, Social Services, the DSS etc. There is an outreach worker at the refuge as part of the same initiative.

A Trust protocol is being considered.