Domestic violence is a core public health issue for GPs

GPs are often the first port of call for the 25% of women and 15% of men in the UK who suffer domestic violence at some point in their lives, according to research.

Domestic violence: affects 25% of women and 15% of men in the UK (photo:SPL)
Domestic violence: affects 25% of women and 15% of men in the UK (photo:SPL)

The RCGP has recognised domestic violence as a priority, publishing guidance this year in collaboration with charities, that outlines key principles to help GPs respond quickly and effectively to patients who disclose domestic abuse.

The college's GP curriculum says GPs should 'recognise the prevalence of domestic violence', understand how it presents and be able to direct patients to support services.

Bristol University researchers writing in the British Journal of General Practice this month found that many GPs had a good understanding of domestic violence. But overall, they found that clinicians needed more support and advice on how to deal with the issue.

A total of 272 GPs and nurses at practices in Bristol and Hackney, London, responded to a poll by the Bristol researchers. GPs scored a median of 27 out of 38 correct responses to questions to assess their understanding of domestic violence.

A total of 49% of respondents thought their practices encouraged victims to come forward.

But respondents said they had received an average of just one hour of training on domestic abuse at undergraduate and postgraduate level. Only 29% of respondents felt comfortable asking appropriate questions of suspected victims of abuse.

Clinicians were also unsure what resources were on offer in their practices or in the community. Only 24% of respondents felt prepared to make appropriate referrals for victims.

GP training

RCGP domestic violence co-champion Professor Gene Feder, a member of the Bristol research team, says there is currently no external funding available for GP training in domestic abuse. But he adds: 'Being able to care for domestic abuse patients is very much part of becoming a competent GP, part of your CPD.

'It is a common public health issue and GPs should be competent in responding to it, as they would be to diabetes, depression or stroke.'

GPC deputy chairman Dr Richard Vautrey says GPs do have this knowledge: 'GPs are very much aware of the issues in domestic violence. They recognise the signs in victims and invite patients to respond.'

But he adds: 'The key issue is for GPs to have knowledge of referral systems and support in their local area, to provide necessary support to their patients.'

RCGP guidance suggests this knowledge can come from engaging with local services to develop an effective working partnership.

It recommends assigning a local designated person to be responsible for the initial assessment of victims, either an external specialist domestic abuse service practitioner, or a trained practice nurse or other health professional.

Professor Feder pointed to the Identification and Referral to Improve Safety (IRIS) programme, which helps clinicians find direct referral routes. The charity Co-ordinated Action Against Domestic Abuse also provides health professionals with training.

Practices must ensure that when patients affected by domestic violence present, their staff are prepared.

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