• Led by Queen Mary, University of London.
  • Focused on domestic violence and how the NHS, particularly in primary care, can better respond to it.
  • Ran from 2007 to 2010.
  • Using a randomised control trial, tested educational support for GPs in Bristol and east London.
  • Trialled the approach with 48 general practices in Bristol and east London.

This project team focused on research identifying that primary care services had lagged behind other agencies in identifying women at risk and developing effective support for domestic violence.

Forty-eight GP practices in Bristol and Hackney took part in the project, with half receiving a specially designed programme of training and on-going support, and half acting as controls.

The training, support and resources aimed to help the GPs identify patients experiencing domestic violence, document this in patients’ records and make appropriate referrals to a named worker in a specialist DVA agency providing advocacy. The named worker provided the training and support for professionals and advocacy for patients.

IRISimp built on the success of the IRIS trial. The overall aims were to ensure that women experiencing the health impacts of current or past domestic violence had direct access to a specialist domestic violence advocate-educator through their health professional, and that primary care clinicians were trained and competent in identifying and referring patients experiencing domestic violence to an advocate-educator or specialist service.

Benefits

Results show that in the ‘intervention’ practices there was far more discussion of referrals between clinicians and patients, resulting in a six-fold increase in actual referrals for patients being received by specialist services.

Women attending ‘intervention’ practices were three times more likely than those attending control practices to have an identification of DVA in their medical record.

Bristol PCT and City & Hackney PCT went on to commission the IRIS programme, while Hull PCT agreed to trial it for a year from April 2011. The Health Foundation funded a phase two of the project to implement the programme nationally in other PCT areas.

Who was involved?

  • London South Bank University
  • Bristol University
  • The Nia project
  • Bristol NextLink
  • Bristol PCT
  • City and Hackney PCT.

Since this project was completed...

IRIS findings and implementation have been included in draft NICE guidelines, the 2012 Welsh Assembly Government White Paper, and the recommendations of Home Office Domestic Homicide Reviews. IRIS also began implementation in Scotland in 2013.

The landmark 2013 World Health Organisation publication ‘Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines’ drew heavily on IRIS research, citing the IRIS model. 

Further reading

Research report

Involving primary care clinicians in quality improvement

This is the report of an independent evaluation of our Engaging with Quality in Primary Care (EwQPC) improvement programme.

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