A national programme to help GPs identify patients experiencing domestic abuse or sexual violence and refer them to specialist support services is being rolled out across Torbay and Devon.

Identification and Referral to Improve Safety (IRIS) is a successful general-practice based domestic abuse and sexual violence training and referral programme developed and coordinated by the social enterprise, IRISi.

It’s the first of its kind in Torbay and Devon and will see domestic abuse and sexual violence specialists (known as IRIS Advocate Educators) work in partnership with local clinical leads to co-deliver training and support in up to 50 general practices across Devon and Torbay.

The IRIS programme is aimed at helping clinicians to identify women aged 16 years and over who are experiencing domestic violence and abuse from a current or ex- partner or adult family member and to offer them a referral to an Advocate Educator. It also helps to ensure that men who are affected by domestic violence and abuse can access support.

In Torbay and Devon the programme has been expanded to include sexual violence for the first time. This will encompass identifying women aged 18 years and over who are affected by historic childhood sexual abuse and recent or historic rape or sexual assault and will also provide information and signposting for men who are affected by sexual violence.

The programme is a partnership between an Advocate Educator, based in a local specialist domestic abuse and sexual violence service, and a local clinical lead, typically a safeguarding GP or Advanced Nurse Practitioner. Together they are responsible for co-delivering the initial training and work closely to offer ongoing peer support for colleagues across a group of practices in their local area. The Advocate Educators work within the GP practice and move around the local group so clinical staff can directly refer patients to them for expert help quickly.

This collaborative approach is already proving highly successful in over 1,000 general practices across England and Wales, not only in helping patients but also reducing NHS costs.

Recent research estimates that IRIS costs the NHS just £6 per woman and saves £14 per woman over ten years from a societal perspective and increased quality-adjusted life years.

Dr Paul Johnson, GP and Chair of NHS South Devon and Torbay Clinical Commissioning Group, said: “The NHS spends more time dealing with the impact of violence against women and children than any other agency and is often the first point of contact for those who have experienced abuse.

“GPs and their primary care colleagues have a responsibility to ensure victims of domestic abuse and sexual violence get the support they need.

“The scale of domestic abuse and sexual violence means that they will encounter patients daily who are victims or at risk.

“By training clinical staff to recognise the signs and symptoms of domestic abuse and sexual violence, ask the right questions at the right time and in the right way, we can encourage those experiencing abuse and violence to speak up and make sure that they get the help and support they need as quickly as possible.”

The two-year project is the result of a successful joint bid by Torbay Council and Devon County Council to the Home Office’s Violence Against Women and Girls (VAWG) Transformation Fund and forms part of the authorities’ work to end domestic abuse and sexual violence in Devon.

The limited funding is being used to roll out the IRIS programme in parts of Devon and Torbay, and although it isn’t enough to include all 107 GP practices in the area, 50 practices have volunteered to take part in this initial phase, with the hope that IRIS will become sustainable through universal health commissioning from 2020.

The initial training phase is already underway at 14 GP practices, reaching over 30 staff including GPs, nurse practitioners and non-clinical roles.

Cllr Julien Parrott, Executive Lead for Adult Services at Torbay Council, said: “A staggering one in four women will experience domestic abuse in their lifetime. This must change.

“We are committed to tackling domestic abuse and sexual violence in Torbay and Devon, and our plan to achieve this focuses on improving identification and intervention as well as encouraging prevention.

“General Practice staff have an essential role in responding to and helping prevent further domestic abuse and sexual violence by successfully identifying victims, intervening early and providing information, support and treatment by referring patients to specialist support services.

“The IRIS programme does exactly this by connecting vulnerable individuals to the right services and support as quickly as possible.

“Working in partnership with GPs and their colleagues is the key to its success. Local surgeries are where most people receive their care so they are often the first and only point of contact with health care professionals for thousands of our residents.

“The launch of this programme in GP practices across Torbay and Devon is an excellent example of how everyone coming together and making a joint effort can make a real difference.”

Cllr Roger Croad, Devon County Council’s Cabinet Member for Communities, said: “Our campaign against domestic abuse and sexual violence has made significant progress in recent years, and we have worked hard to develop a robust strategy to transform public services so that we can respond to increasingly complex needs.

“We know that we can improve on the current system so that opportunities to recognise domestic abuse and sexual violence are not missed, and patients can benefit from earlier intervention and support.

“Victims of domestic abuse and sexual violence often believe their doctor or nurse at their local GP practice is one of the few people they can confide in about what they are experiencing.

“However, these primary health care providers report being largely unaware of the advice or interventions available locally. They also do not feel that they have received adequate training in how to identify or enquire if someone is experiencing domestic abuse and sexual violence and respond sensitively and appropriately with enough compassion, coordination and impact.

“The IRIS programme has been proven to change this by giving clinicians the tools they need to identify victims at an early stage, which not only improves their outcomes but can also have a positive impact on families and children and can change the course of their lives.”

News of the IRIS roll-out in Devon and Torbay comes as the world shines a spotlight on domestic violence through '16 Days of Action' - the international campaign to inspire action to end violence against women and girls, which runs from ‘International Day for the Elimination of Violence against Women’ and ‘White Ribbon Day’ on 25 November to ‘International Human Rights Day’ on 10 December.

Lucy Downes, Regional Manager for IRISi, the social enterprise that developed and coordinates the IRIS programme, said: “We are delighted to see the expansion of the IRIS network into Devon and Torbay.

“Including sexual violence within the IRIS programme supports our vision of promoting and improving the healthcare response to gender-based violence.

“Sadly, 26% of women experience domestic abuse during their lifetime, whilst for women attending general practice this figure can increase to 41%.

“We know that by expanding the scope of the IRIS programme we will increase the reach of the service and the primary care response to many more patients who have experienced violence and abuse will be improved.”

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