London’s Violence Reduction Unit invests £1m in boosting doctors’ skills in working with victims of domestic violence

London’s Violence Reduction Unit (VRU) has today announced a new £1 million investment in training doctors and healthcare professionals to boost their abilities in identifying the signs of domestic violence and offering earlier help to victims.

Specialist training for doctors and GPs is currently available in 10 boroughs. The new funding will expand the programme across 17 boroughs, providing two dedicated domestic violence advocates per borough, with the potential to support more than two million Londoners to access support and guidance. The programme has been developed by IRISi, a social enterprise which works to improve the response to gender-based violence in the health sector, along with partner organisations.

There is strong evidence of links between domestic violence and other forms of serious violent crime, with City Hall data showing that 13 per cent of serious youth violence victims are also victims of domestic violence, while a third of female serious youth violence victims were also victims of domestic violence and abuse.

Research has demonstrated that young people who have grown up with violence in their lives are more likely to become a victim themselves in the future, or become someone who harms others. (1)

Today’s investment is a crucial part of the VRU’s work to deliver early interventions that break a cycle of violence and address the complex root causes behind violent crime.

Figures show that 80 per cent of women in a violent relationship seek help from health services and that these are often a victim’s first, or only, point of contact (2). Training for doctors and GPs will increase their skills and experience to be able to spot the signs of domestic violence earlier and help them better assess immediate risks and where to refer patients for further support. Women using GP surgeries in London where practitioners have already been trained are six times more likely to be referred to specialist support and to have had a conversation about domestic violence with their GP. Patients at these practices also report feeling safer and more about to cope, with many reporting that they visited their GP less frequently as a result (3).

The VRU was set up by the Mayor, Sadiq Khan, in 2018 and brings together specialists from health, police, local government, probation and community organisations to tackle violent crime and its underlying causes. In its first year the VRU has invested in increasing youth workers in London’s hospitals, provided investment for schools to keep London’s most vulnerable young people fully engaged with their education and safe after school, as well as funding community projects that work to reduce knife crime and give young people positive opportunities.

Its initial impact has prompted the Home Office to invest a further £7m in London’s VRU in the next financial year, while the Mayor has increased his annual budget from £1.8m to £5m.

Lib Peck, Director of London’s Violence Reduction Unit, said:

“Incidences of domestic abuse are unacceptably high, and the victims need urgent help – to keep victims safe, and also because we also know that domestic violence can manifest to wider violence. That is why we are investing in the IRIS programme, as we know that in many cases speaking to a GP can be a victim’s first or only option for seeking help, and this way we can give healthcare professionals the tools needed to spot the signs of domestic violence at the earliest possible opportunity. We are determined to challenge the view that violence is inevitable and demonstrate that it is preventable. The public-health approach we are leading in London is firmly rooted in investing in early interventions that can break the cycle of violence and give Londoners the support they need.”

Medina Johnson, Chief Executive of IRISi said:

“Over the last decade, IRIS programmes have trained teams in over 1,000 general practice and directly supported over 15,500 women. We train doctors and nurses to be professionally curious and to think about domestic violence when they are speaking with, meeting with and consulting with a patient. We train them to think about questions like ‘might the patient I am with be affected by domestic violence and abuse?’ Women tell us repeatedly that they want to be asked about what is going on for them at home and why their health is poor. They are at best, puzzled when nobody does and, at worst, left feeling alone, hopeless and unworthy of help. This investment to increase the programme across seven additional boroughs in London will mean that direct, specialist support will be accessible to many more people because many more clinicians will be better equipped to ask about DVA and refer on.”

An IRIS service user, said:

“I’m grateful that the GP referred me. She listened and was really supportive. I think it’s brilliant for anyone that needs that support as you do feel you’re isolated. To know that you’re not alone and you’re not the only one going through it, going through a dark tunnel is a massive relief and you know there’s a light at the end.”

Kirsten Shirke, GP, who has taken part in the IRIS programme and training, said:

“I’ve worked as a GP in Tower Hamlets for over 17 years, and over the years have supported many patients who have experienced domestic abuse. These have been some of the most vulnerable and traumatised patients I have worked with. Many of the women have experienced extreme levels of controlling behaviour, and are fearful and isolated, sometimes literally imprisoned in the home, and seeing a GP or other primary care worker may be the only opportunity they have to speak in confidence about their situation. For patients who do not speak English fluently, opportunities to seek help may be even more limited.

“Having the IRIS project in Tower Hamlets revolutionised the way in which we were able to support patients experiencing domestic abuse. The training GP practice teams receive from the IRIS advocate improves understanding of how to identify patients who may be experiencing abuse, how to effectively and sensitively ask questions about domestic abuse, and how to support patients if they disclose abuse. The IRIS advocate is available as a one stop referral point for all patients experiencing domestic abuse. They are already known to the practice team through the training they have provided, and contact patients rapidly following a referral. They arrange to meet the patient in the GP practice, a setting familiar to the patient which is far less likely to arouse suspicion from other family members, and spend time talking to the patient about their concerns, and offering a wide range of practical and emotional support. They then give feedback on the outcome (with patient consent), which meant we could work closely and provide the best possible support to these patients.”