A safe, just and equal world for women

Whole Health Approach

1.7 million women experience domestic abuse every year in England and Wales.

The cost of domestic abuse to society is estimated to be upward of £66 billion, with costs to the health service, barring mental health, averaging about £2.3 billion per year with the major costs being to GPs and hospitals.

It is estimated that nearly half a million victims and survivors of domestic abuse seek assistance from medical professionals every year , and often health professionals such as GPs, nurses and midwives are the first point of contact to those who are suffering abuse, especially groups who face additional barriers to getting support such a black and minoritised, disabled, older and LGBTQI+ communities.

Pregnant women are particularly vulnerable because 30% of domestic abuse begins at this time, and about 40–60% of women experiencing domestic abuse are abused during pregnancy.

Women living with disabilities are twice as likely to experience abuse and often their abuse continues for much longer, on average about 3.3 years. They are also more likely to live with their perpetrator who might be acting as a carer and exploiting a position of power, and more likely to experience abuse from multiple perpetrators.

Health professionals such as GPs, nurses, midwives, and hospital doctors are in a unique and pivotal position to spot, help reduce and signpost survivors to specialist domestic abuse support services.

ADViSE programme

Domestic abuse is often connected to sexual health and gynaecological problems. It has links to an increase in sexually transmitted infections, including HIV, and unintended pregnancy.
Advance delivers the ADViSE (Assessing for Domestic Violence and Abuse in Sexual Health Environments) programme in St Mary’s Hospital Paddington in the City of Westminster. 

Advance ADViSE Advocate Educator supports sexual health clinicians to identify and respond to patients affected by domestic abuse and provides them with a simple referral pathway to specialist services.

The programmes core components include ongoing training, education and consultancy for the sexual health team and administrative staff, care pathways for sexual health care practitioners and enhances referral pathways to Advance and Advance’s partners services.

If you are attending the Sexual Health Clinic at St. Mary’s Hospital and would like to discuss support for domestic and/or sexual abuse, please approach a doctor or nurse who can provide guidance and arrange an appointment with a specialist caseworker at the clinic.

IRIS programme

GPs are often the only professionals who engage with both the perpetrator and the victim. This puts them in a unique position to see and hear invaluable information to prevent domestic abuse and related homicides. Advance recognises the need to improve access to specialist support for women in health settings, such as GP surgeries, experiencing domestic abuse.

The IRIS model is a domestic abuse training, support and referral programme for GP practices previously delivered by Advance in partnership with Asian Women’s Resource Centre within the London.

It aimed to equip health professionals with improved understanding of domestic abuse and its relevance to health, and a better knowledge of how to respond. It trains them to ask about domestic abuse, how to contact and refer to a domestic abuse specialist and the importance of safeguarding. It offered women a safe place in which to disclose and be listened to, resulting in improved access to support and intervention, and improved safety for women.

For more information on current IRiS programmes, visit IRISi Interventions.