2. Southern Domestic Abuse Service is a local charity providing services to women, children, young people and men who have experienced or who are experiencing domestic abuse. The organisation was originally set up in 1977 as Havant Women’s Aid. Southern Domestic Abuse Service was established in 2012.

3. Services Include: Refuge accommodation Outreach and Resettlement Services Young People and Children’s Services Independent Domestic Violence Advocate Service Group work for young people and children Women only group work Group work for families Holiday activities Specially provided workshops FGM Community Development Domestic abuse preventative work/awareness raising/training

4. We provided services to 2,309 victims and survivors between 1 April and 30 September 2015 A further 6,705 children and young people living in Havant, Fareham, Test Valley, Rushmoor and Gosport Boroughs, Portsmouth City and East Hampshire District attended sessions raising awareness about domestic abuse in the last twelve months. Demand for services outstrips service capabilities. In the first six months of this year we were unable to accommodate 224 women and 244 children in refuge accommodation.

5. Our model builds on strengths and enables clients to identify their needs and plan to address them in the short/medium/and longer-term. Key Features: 1.available to all, children aged 0-16 and adults 16+ 2.offers named key-workers for each client providing  consistent case management, support planning, specialist advice and Advocacy 3.outcome focused

6. 4.ensures access that suits the Client - weekends/evenings, at home or a community venue 5.contacts referrals within 24hrs/urgent access planned into staffing model 6.prioritises and targets support by completing a DASH risk assessment with adults (including 16/17 year olds) within 48 hours of referral 7. allows referrals from individuals/friends/relatives and professionals via telephone/email/fax etc.

8. Hampshire County Council Adult Services led the procurement process on behalf :  Hampshire County Council Adult Services  Hampshire County Council Public Health  Hampshire County Council Children’s Services  Hampshire Supporting Troubled Families programme  Office of the Police and Crime Commissioner for Hampshire and the Isle of Wight The tender for the Integrated Domestic Abuse Services for Hampshire was offered in three geographic lots. From 1 st April 2015 we started delivering the HCC IDASH Service in Fareham, Gosport, Havant and East Hampshire.

10. Domestic abuse is a major public health problem with devastating health consequences and enormous costs to the NHS. The NHS spends more time dealing with the impact of violence against women and children than almost any other agency and is often the first point of contact for women who have experienced violence. 1 The health service can play an essential role in responding to and helping prevent further domestic abuse by  intervening early,  providing treatment and information and  referring patients to specialist services. 1Department of Health. http://www.dh.gov.uk/en/MediaCentre/Pressreleasesarchive/DH_113837 [cited June 2011]

11.  The cost of DVA to the health service is £1.7 billion per year with the major costs being to GPs and hospitals. This does not include mental health costs, estimated at an additional £176 million.2 2 Walby S. The cost of domestic violence: Update 2009. Lancaster: Lancaster University; 2009

12. Survivors who are subject to forms of wounding that involve sustaining serious or slight injuries make an average of three visits more to a GP than an average person. 3  On average, survivors of abuse experience: o more operative surgery, o more visits by and to doctors o more hospital stays, o more visits to pharmacies and o more mental health consultations over their lifetime than non-victims. 3 Walby S, Allen J. Home Office Research Study 276. Domestic violence, sexual assault and stalking: findings from the British Crime Survey. London, Home Office, Research, development and statistics directorate; 2004

13. There is extensive contact between women and primary care clinicians with 90% of all female patients consulting their GP over a five year period. 4 This contrasts starkly with its virtual invisibility within general practice, where in fact the majority of women experiencing domestic abuse and its associated effects are not identified. Specialist providers like SDAS rarely receive referrals from primary care and historically general practice has been absent from community domestic violence partnerships. Currently only 0.48% of our referrals come from GPs 4 Wisner CL et al. Intimate partner violence against women: do victims cost health plan’s more? Journal of family practice. 1999; 48(6): 439 - 443

14. A GPs’ response to women and children who can be isolated and fearful as a result of their experiences is critical to their future wellbeing. The initial reaction of the person they tell and the follow-up within and beyond the NHS can have a profound effect on their ability to re-establish their life, health and wellbeing. 5 Eighty percent of women in a violent relationship seek help from health services, 6 usually general practice, at least once, and this may be their first or only contact with professionals. 5 Feder G, Long C et al. Report from the Domestic Violence Subgroup: Responding to Violence Against Women and Children –The role of the NHS. London. Department of Health; 2010 6 Department of Health, Conference Report: Domestic violence: A health response: working in a wider partnership. London: Department of Health; 2000

16. We asked our clients: How they would like to receive information/help from a GP/ GP practice?  Numbers for agencies to contact for support  Extra time if needed  GP to ask if domestic abuse is happening  GP's should get more training on affects of domestic abuse so have more understanding and recognise the signs  Posters, leaflets to make the world know that GP'S are there to help and it's not a scary place

17. What could be improved?  Listen, more time and give us time to explain what is happening  More information  Confidential drop-in service at GP Practice for victims  Counselling  Information on domestic abuse service: outreach, refuge, Freedom Programme etc.  More visual information, posters, leaflet etc

18. Priorities for how health can deal better with domestic abuse victims  Understanding/awareness/empathy  Not assume that you’re depressed and offer anti-depressants  Signposting to domestic abuse services and other support i.e. counselling  They could ask if we need more support to either stay or leave  They could be more aware and maybe more suspicious of random bruising or illness that come about of they believe something is going on  Understand my situation, give me time to talk  Understand on how it affects the person  By listening and going through my options

19. Priority 1 Short to Medium Term To ensure all health professionals delivering services are appropriately equipped to: 1.recognise domestic abuse 2.provide support to victims and survivors of domestic abuse 3.access/signpost to appropriate agencies Health care professionals need to be aware of appropriate interventions and have effective training. Creating an environment in which patients are more likely to feel safe enough to discuss domestic abuse will make a real difference for women, children and men. SDAS have developed an information sheet “Getting it right first time: A quick guide for professionals who don’t work in domestic violence services” with locally appropriate contact details.

20. Priority 2 Medium to longer-term To commission IRIS - Identification and Referral to Improve Safety IRIS is a general practice-based domestic violence and abuse training support and referral programme for primary care staff and provides care pathways for all adult patients living with abuse and their children. Core areas of the programme are:  training and education,  clinical enquiry,  care pathways and  an enhanced referral pathway to specialist domestic violence services. It is aimed at victims/survivors who are experiencing domestic abuse from a current partner, ex-partner or adult family member.

21. IRIS also provides information and signposting for male victims and for perpetrators. IRIS is a collaboration between primary care and third sector organisations to deliver essential services and close the historical gap between the two sectors. An advocate educator is linked to general practices and based in the local specialist domestic abuse service ensuring a direct link with services. The advocate educator works in partnership with a local clinical lead to co-deliver the training to practices. Ultimately IRIS improves the quality of care for patients experiencing domestic abuse and fulfils the moral, legal and economic case for addressing domestic abuse in general practice.

22. 023 9248 0246 info@southerndas.org www.southerndas.org