Domestic Abuse Projects – review, findings and next steps John Palmer - Cwm Taf Health Board Lisa Dunsford - Welsh Government

LSBs and Domestic Abuse Evidence base (average 11-18 presentations in A&E before action), 25% of violent crime in RCT Anecdotal community safety issue RCT LSB identified intractable Very strong mandate for change locally National priority for WAG and Home Office Funding available Incredible depth of competence amongst practitioners across public service Serendipity – good fit for Kafka Brigade

Kafka approach – 6 steps Step 1: Explorative research & case selection Step 2: Case research – people Step 3: Practitioner view Step 4: Collective performance review Step 5: Action Owners session Step 6: Follow up at 6 months Step 1 – RCT picture 86% of all reported incidents are against women; Majority aged between 20-29 years old; Majority are unemployed; 55% have children; 71% of victims children had witnessed abuse; 81% of victims were pregnant; 70.6% of incidents occur in the home; 67% of abuse is between intimate partners. Step 2 – Select representative to gather story - Emma Single mother, 30 years of age;2 children aged 5 & 6;Well spoken; Very supportive and caring mother; abuse started, living in Council housing; Abuse during pregnancy and lost baby; Abuse started 4 years ago; 2 abusive relationships. Step 3 – Agencies involved Police;Women’s Aid; A&E department; Crown Prosecution Service; Cardiff Prison; Witness Care Unit; Social Services; Council Housing; RCT Housing Advice; Health Visitors; Local GP; Probation; Midwifery service; Pontypridd Safety Unit. Step 4 - CPR Minister, Leaders, senior managers of agencies met Emma and listened; Made commitments; Action Plan prepared; Refocused CSP Domestic Abuse Forum to drive delivery of actions; Limited additional cost to implement changes – making better use of what we have. Step 5 – Action owners session Check actions are right ones and owned by agencies; Check senior leadership lined up; Reinforce delivery and follow up Step 6 – review and follow up Meeting with Emma, Minister, Leaders, and senior managers of agencies to set out what has changed; Review action plan, continue to make required changes; Majority of changes achieved by increasing professionals awareness of Domestic Abuse and how they support victims to access the services they need.

What changed? Sustained as an LSB priority 12% reduction in minor violent incidents in following quarter; Early appointment & increased number of IDVAs; Key services such as A&E/Health Visitors/Midwifery now make referrals; Examples similar to Emma’s Case now being referred and appropriate response provided; Emma now working as a Domestic Abuse volunteer with Safety Unit; Sustained improvement in MARAC approach; Sustained improvement in service model; First RBA performance management model in Wales

Kafka Brigade lessons Strength of LSB plus KB Commitment & involvement of partners, Minister, WAG, Home Office Powerful / symbolic data Resonant, representative case Unwavering citizen and delivery focus Ability to measure performance Ability to mainstream through partnerships and hold to account through LSB Centrality of the CPR

Issues identified Awareness – staff find it difficult to recognise and respond effectively to victims leading to missed opportunities for early intervention Service response – when multiple services contacted it did not trigger a rounded response, also a relatively low level of co-ordination between agencies. Also perception that perpetrator benefits more from services than victim Housing – top priority was for a safe home, but access challenging Police – victims tend to see police as the main support option (above other services), the perception that police service only effective when incident becomes serious and not before, attitudes of some police officers not seen as sympathetic Social services – lack of support, seen as threat in relation to removing children, lack of focus on the victim Criminal justice system – few cases proceed to court, prosecution relies heavily on victim’s evidence, concern over sentencing, potential for harassment from perpetrator when in prison Children – little support (counselling etc.) available for children affected by domestic abuse Data/information – very little benchmarking of performance and sharing of information

Domestic Abuse Project 10,000 Safer Lives Aims & objectives To improve the safety of and support for individuals and their families who experience domestic abuse. To ensure effective response & support from agencies to minimise risk of further abuse. Further improve service delivery through effective multi-agency working.

Scope Ensure safety of any man, women or child who experiences domestic abuse. Focus on whole family not just individual. Focus is on safety & minimising risk of further abuse. For medium/standard risk cases.

Out of scope High risk cases (have MARAC process). Preventative interventions e.g. general awareness raising/publicity campaigns. Interventions for perpetrators.

Key drivers Leadership commitment and authority to enable change. Raising awareness and enabling organisations to identify when domestic abuse is taking place and to respond effectively. Improving partnership working to ensure effective co-ordinated multi-agency response. Effective performance management to drive continuous improvement.

Approach Learning from success of Kafka Brigade and 1,000 Lives Campaign. Securing leadership commitment. Workshops throughout Wales with front-line staff to identify improvements. Testing & refining. Monitoring & measuring progress.

Progress & next steps Scope agreed by Minister. Positive feedback from stakeholders. Announced by Minister at Plenary on 12 July. Commenced work on review of data. Pilot workshop in Summer. Leadership event & multi-agency workshops Sep onwards.