Executive Lead for domestic abuse and sexual violence in ICBs


Authors: Lucy Downes, Network Director, IRISi, Farah Nazeer, CEO, Women’s Aid Currently, most women who experience domestic abuse and sexual violence neither report it to the police, nor do they receive a whole-system response as survivors of these forms of violence against women and girls (VAWG). 

Much progress has been made in recent years on mental healthcare, however despite the NHS having just reached its 75th birthday, survivors still tell us they feel like the healthcare system isn’t set up for them.  Women’s Aid’s recent report Are you listening? 7 Pillars for a survivor-led approach to mental health support showed that many survivors continue to feel unheard, unsupported, or understood by healthcare professionals. We know though that healthcare professionals who are trained to identify and respond to domestic abuse cases can play a pivotal role in supporting patients to access early interventions. This is demonstrated by the 30,000+ patients referred into the IRIS Programme from GP consultations since 2010, underscoring the vital role of primary care in providing support for survivors. 

Ensuring that the healthcare system is fully prepared to support survivors must be a top priority, and there are important opportunities on the horizon. The Chief Delivery Officer, Steve Russell at NHS England sent a letter to all Integrated Care Boards (ICBs), asking them to appoint a new Domestic Abuse and Violence lead at the executive level by Wednesday 13th July. ICBs are the funding arm behind Integrated Care Systems (ICSs) which were created in the Health and Social Care Act 2022. 

The letter reiterates the need for ICBs to consider victims of abuse in their Joint Forward Plans and asks Chief Executives of ICBs and trusts to: 

  • Appoint a Domestic Abuse and Violence lead;  
  • Review policies and support to provide assistance to staff and patients experiencing abuse 

This letter represents a significant milestone in the tireless advocacy of the VAWG sector. The sector has campaigned relentlessly for years to raise awareness and prioritise domestic abuse as a public health issue. There are potentials for huge cost-savings to public services if this becomes a reality with Women’s Aid’s latest research with ResPublica calculating that domestic abuse costs the health service a staggering £2.7 billion per year. With the creation of these Executive Lead roles, we have a unique opportunity to revolutionise how our healthcare system supports survivors. 

An Executive lead possess full voting rights at ICB board meetings, enabling them to shape crucial decisions on healthcare locally. By having a seat at the table, these leads can ensure that domestic abuse and sexual violence remain central to the healthcare agenda. 

Their role is to actively engage with the local community. This must be translated into working in partnership with the specialist domestic abuse and sexual violence services in each ICB area. With their wealth of experience and knowledge of working with survivors, often over several decades, these lifesaving local services will be indispensable to understanding what survivors want and need.  In June Women’s Aid and IRISi, with the Health Foundation held a summit on ‘Improving Outcomes for Survivors in Healthcare’. The summit demonstrated the incredible willingness of regional and national VAWG and healthcare leaders to work together.  

Everyone must play their part. If you are a leader of a specialist domestic abuse or sexual violence service, or you work at a GP practice, hospital, in a mental health care setting or social care setting, reach out to your local ICB ask who their Executive Lead for domestic abuse and sexual violence is. Ask how they plan to prioritise these critical issues. You can find a list of ICBs here 

By making domestic abuse a public health priority, we can help create a whole system response that actively supports survivors of domestic abuse and sexual violence. A system where survivors are heard and involved in decisions about their care. A system that stops treating violence against women and girls as just a criminal justice issue –but a priority for every public service, including our NHS. 

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