In brief

Lead organisation: Queen Mary, University of London

Partners: London South Bank University, Bristol University, The Nia project, Bristol NextLink, Bristol Primary Care Trust and City and Hackney Primary Care Trust

What led to this project?

Domestic violence damages women’s physical and mental health and has long-term health and educational consequences for their children. The British Crime Survey in 2004 found that 13 per cent of women experienced domestic violence, sexual victimisation or stalking in the previous year.  

What is happening?

This project aimed to tackle the 'mismatch' between the large public health problem presented by domestic violence and the poor response from the NHS in general, and from primary care in particular. Project lead Professor Gene Feder said: ‘Women experiencing violence often want to disclose this to healthcare professionals they trust, yet primary care services have lagged behind other agencies in identifying women at risk and developing effective support.’

The team set up a randomised control trial to test an educational and support programme for GP practices, which aimed to help them identify and refer patients who are experiencing domestic violence. A key aspect was the partnership with voluntary agencies, which are provided most of the expertise for women experiencing domestic violence.

The trial name is Identification and Referral to Improve Safety (IRIS). Iris was a messenger for the Greek Gods, symbolised by the rainbow and carrying a herald’s staff. This prefigures the universal symbol of healing: a rod with two intertwined snakes.

What benefits will it bring?

The new approach was trialled in Bristol and east London, with 48 general practices.  The hope is that it will be taken up as a model in other primary care trusts. Ultimately, it could be used to commission services nationally to improve identification and to access expert domestic violence services.