‘Best practice’ programme that has helped GPs refer thousands of victims of domestic violence to specialist services announces ambitious plans to expand

A highly successful, evidence-based domestic violence and abuse identification and referral programme (IRIS – Identification and Referral to Improve Safety) developed by researchers at the University of Bristol has launched as a social enterprise.

  • 21st November 2017

A
highly successful, evidence-based domestic violence and abuse identification
and referral programme (IRIS – Identification and Referral to Improve Safety)
developed by researchers at the University of Bristol has launched as a social
enterprise today, with plans to scale up its activity and grow the programme
across the UK and internationally.

The IRIS programme provides training and support to GPs, practice nurses and
other primary care clinicians to help them identify and refer women with
experience of domestic violence and abuse (DVA) to specialist domestic violence
services. It also provides information and signposting for male victims and
perpetrators.

The
plans for expanding the service include growing the IRIS programme across all
clinical commissioning group (CCG) and sustainable transformation partnership
(STP) areas to encourage commissioning on an STP-wide basis in England, and
across Health Boards in Wales. There are also plans to explore opportunities in
Scotland and Northern Ireland, and further afield in Europe, and the occupied
Palestinian territories and Brazil, where work has already begun to support
delivery of an adapted IRIS model for health care services.

The
service is a collaboration between primary care and third sector organisations
specialising in DVA. An advocate educator, based in a local specialist DVA
service, is linked to general practices and works in partnership with the local
clinical lead to co-deliver the training to those practices. She also supports
patients referred from those practices.

The
programme was evaluated
in a randomised controlled trial, which demonstrated NHS and societal cost savings of £1
and £37 respectively per female patient aged 16 and over per practice per year
(all female patients, not only those affected by DVA). It became a
commissionable programme in 2010. Since then, it has directly helped over 8,000
women in 34 local areas in England and Wales access specialist support through
their GP. Over 800 general practices have engaged in IRIS training and are now
‘IRIS DV Aware Practices’, in which a further 29,000 women are estimated to
have discussed DVA with a primary care clinician.

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 £1.7
billion a year and the annual cost to the UK economy is £18 billion.

“The
need for IRIS has never been greater. While we are proud of our record of IRIS
programmes delivering results to date, there are over 8,000 general practices
in England alone, ten times the number where IRIS is currently being
implemented. At least 25 per cent of women in each of these practices will have
experience of DVA and could benefit from IRIS. The potential to make a
difference is huge and the savings to the NHS and society proven and clear.
IRIS is simply the right thing to do. This is why I am excited to be launching
IRISi today and entering this new phase in our development to promote and
improve the health care response to DVA.”

Gene Feder, a GP and 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 DVA prevalence and its devastating
impact on health and wellbeing. Operating as a social enterprise will give us
the necessary business, quality improvement, development and legal frameworks
to scale up the programme to meet future demand. We know that with more
refinements we can continue to grow as we begin to proactively market our
approach with best practice social franchising and extend beyond general
practice to other health care settings.”

John
Piesse, Head of Primary Care Commissioning at NHS Enfield, CCG said:

“Over the
last four years NHS Enfield CCG has commissioned IRIS, through Solace
Women’s Aid, to train and empower our general practice staff to identify
and support those at risk and with experience of domestic violence and
abuse. This is a much-needed response within health.

“Through
the dedication and commitment of IRIS and Solace Women’s Aid colleagues we have
been able to safeguard and support victims and their families and continuously
explore ways in which we can improve our response to this local health and
social care priority.”

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 and they consistently highly recommend it to colleagues.”

IRISi
was launched on Tuesday 21 November at the Health Foundation in London.
The team will be awarded a University of Bristol Vice Chancellor’s Impact Award at a ceremony in Bristol on Thursday, November
23.

For
information on commissioning an IRIS programme, where programmes are running
and on IRISi, contact [email protected] or
visit www.irisi.org.

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

  • National Domestic Violence 24 hr Helpline 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