Exploring primary care responses to domestic violence and abuse (DVA): operationalisation of a national initiative
| DOI | https://doi.org/10.1108/JAP-10-2018-0025 |
| Date | 28 March 2019 |
| Pages | 144-154 |
| Published date | 28 March 2019 |
| Author | Julie McGarry,Basharat Hussain,Kim Watts |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Exploring primary care responses to
domestic violence and abuse (DVA):
operationalisation of a national initiative
Julie McGarry, Basharat Hussain and Kim Watts
Abstract
Purpose –In the UK, the Identification and Referral to Improve Safety (IRIS) initiative has been developed for
use within primary care to support women survivors of domestic violence and abuse (DVA). However, while
evaluated nationally, less is known regarding impact of implementation at a local level. The purpose of this
paper is to explore the effectiveness of IRIS within one locality in the UK.
Design/methodology/approach –A qualitative study using interviews/focus groups with primary care
teams and women who had experienced DVA in one primary care setting in the UK. Interviews with 18
participants from five professional categories including: general practitioners, practice nurses, practice
managers, assistant practice managers and practice receptionists. Focus group discussion/interview with
seven women who had accessed IRIS. Data were collected between November 2016 and March 2017.
Findings –Five main themes were identified for professionals: Team role approach to training, Professional
confidence, Clear pathway for referral and support, Focussed support, Somewhere to meet that is a “safe
haven”. For women the following themes were identified: Longevity of DVA; Lifeline; Face to face talking to
someone; Support and understood where I was coming from; A place of safety.
Practical implications –IRIS played a significant role in helping primary care professionals to respond
effectively. For women IRIS was more proactive and holistic than traditional approaches.
Originality/value –This study was designed to assess the impact that a local level implementation of the
national IRIS initiative had on both providers and users of the service simultaneously. The study identifies that
a“whole team approach”in the primary care setting is critical to the effectiveness of DVA initiatives.
Keywords Domestic violence, Interventions, Women, Primary care, Health care professionals, IRIS
Paper type Research paper
Introduction and background
Intimate partner v iolence referred t o in the UK as domestic v iolence and abuse (D VA)
(United Kingdom Home Office, 2013) is now recognised as a significant global public health,
societal and human rights issue (World Health Organisation (WHO), 2017). Global estimates on
DVA indicate 35 per c ent (1 in 3) of women experience physic al and/or sexual violence in their
lifetime (WHO, 2017). In the UK, it is estimated that 1.3m women each year have experienced
DVA (Office for National Statistics, 2016). DVA exerts a detrimental impact on the lives
and health of all those who experience abuse and this includes wider family members and
especially children (Westmarland and Kelly, 2013). The impact of DVA on the physical
and psychological wellbeing of those w ho experience abuse is wide ranging . This includes the
immediate physical effects of DVA including physical injury as well as longer term chronic ill
health (Bosch et al., 2017). Acute and enduring mental ill-health, substance and
alcohol misuse, self -harm and suicide are a lso more prevalent in thi s group of individua ls
(Trevillion et al., 2012). Secondary physiological health issues such as gynaecological,
sexual health and gastro-intestinal health problems are also common (Feder et al., 2011).
Moreover, the nega tive health consequences of DVA a re not just immediate but may contin ue
in the longer term ( Lacey et al., 2013; McGarry et al., 2011).
Received 19 October 2018
Revised 20 December 2018
7 January 2019
Accepted 16 January 2019
The authors would like to thank
all the participants for taking part in
the study and for sharing their
experiences. JM and KW designed
the project and analysed the data
with input from BH. JM and KW
supervised data collection and
drafted the paper with input from
BH. BH interviewed professional
staff participants. JM facilitated
focus group interviews with
women who were using IRIS. All
authors have agreed on the final
version. The authors do not have
any conflict of interest. This
research received funding (locally
anonymised) and the funders were
not involved in the study design,
data collection, data analysis,
decision to publish or the
preparation of the manuscript.
Julie McGarry is Associate
Professor at the University of
Nottingham, Nottingham, UK.
Basharat Hussain is based at
the University of Nottingham,
Nottingham, UK.
Kim Watts is Senior Lecturer at
Kings College London,
London, UK.
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THE JOURNAL OF ADULT PROTECTION
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VOL. 21 NO. 2 2019, pp. 144-154, © Emerald Publishing Limited, ISSN 1466-8203 DOI 10.1108/JAP-10-2018-0025
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