GP-led domestic violence scheme saves lives and cuts NHS costs

A training programme developed by GPs to help practices identify and refer victims of domestic violence is being rolled out UK-wide after being found not only to help patients but also to reduce NHS costs.

Around one in 10 GP practices in England have had training under the Identification and Referral to Improve Safety (IRIS) programme, and have used their knowledge to support tens of thousands of victims of domestic violence.

Research into the scheme has found that it can save the NHS £1 for every female patient aged 16 or over registered on a practice list - not only those directly affected by domestic violence - and that wider societal savings can reach £37 for every woman.

The scale of domestic violence in the UK, with one in four women and one in six men affected during their lifetime, means that GPs will encounter patients daily who are victims or at risk. Research published earlier this year by the University of Bristol, however, found that domestic violence training for GP trainees was inadequate.

GP Dr Gene Feder, professor of primary care at the University of Bristol’s Centre for Academic Primary Care and architect of the IRIS programme, said: 'IRIS is a crucial response to the high domestic violence and abuse (DVA) prevalence and its devastating impact on health and wellbeing.'

GP training

The IRIS scheme is a collaboration between primary care and third sector organisations that specialise in DVA. It links an expert from a local specialist DVA service to GP practices, with the expert working with the local clinical lead to train practices and managing patients referred through the scheme.

It is now being launched as a social enterprise that aims to offer the service to commissioners in each of England's 207 CCG and 44 sustainability and transformation partnership (STP) areas.

Medina Johnson, chief executive of the new social enterprise, called IRISi, and a founding member of the IRIS programme said: "Domestic violence is a major public health and societal problem. DVA is a gendered crime and, while it affects one in four women and one in six men during their lifetime, DVA against women is more frequent and more severe with long-lasting effects that have an impact on children, other family members and friends too. It costs the NHS £1.7bn a year and the annual cost to the UK economy is £18bn.'

Dr Clare Ronalds, IRIS Manchester's GP clinical lead, said: 'IRIS changes lives. It makes it possible for GPs and nurses to do something that before was "too hard". It teaches us to recognise the huge impacts of domestic abuse, how to ask about it safely, how to respond, and most importantly, how to refer to the IRIS advocate educators. The feedback I have received from GPs who have taken part in the training and who are implementing IRIS has been overwhelmingly positive.'

For help and support on domestic violence, these services provide free helplines:

  • National Domestic Violence 24 hr Helpline run by Refuge and Women's Aid for women experiencing abuse: 0808 2000 247
  • Men’s Advice Line for men experiencing abuse: Monday-Friday 9am-5pm: 0808 801 0327
  • National LGBT Domestic Abuse Helpline: 0800 999 5428
  • RESPECT Phoneline: Confidential helpline offering advice, information and support to anyone concerned about their own or someone else’s violent or abusive behaviour. Monday-Friday 9am-5pm: 0808 802 4040

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