SlideShare a Scribd company logo
1 of 24
Download to read offline
Disclosing Abuse: Referral Pathways in
Public Health Nursing (Health Visiting)
Centre for Crime, Policing and Justice
Conference - University of Birmingham
Dr Maria T. Clark, M.T.Clark@bham.ac.uk 02.03.2018
DVA impacts on public health
Public health nursing (health visitor’s role)
The Call to End Violence against Women and Girls (2010)
made the recommendation to;
“develop training for health visitors to support families when
they suspect violence against women or children ….so that
they can access a formal standard of training which is
directly relevant to their work”.
Why Health Visitors?
Policy Drivers
□ Effective partnership working that pulls
together the core safeguarding principles in
terms of prevention, early intervention and
formal safeguarding arrangements ( health
visiting and school nursing)
DE/DH ( 2012) Safeguarding Pathway
National Institute for Health & Care
Excellence (NICE) (2016)
NICE Quality Standard (DVA)
1. Asking about domestic violence and abuse
2. Response to domestic violence and abuse
3. Referral to specialist support services for
those experiencing DVA
4. Referral to specialist services for perpetrators
of DVA
Clark IPV2018_CCJP
Costing the service/impact
Commissioning arrangements for domestic violence and
abuse services vary across the country. Local authorities
are likely to lead on services involving public health and
social care, with clinical commissioning groups leading on
clinical healthcare services. Others, such as the police
and crime commissioners and organisations in the
voluntary sector may also commission, as well as provide,
services.
NICE (2014) Implementing the NICE guidance on domestic abuse – how
services can respond effectively (PH50)
NICE guidance for services
□ We encourage organisations to evaluate their own
practices against our recommendations and assess
the potential local costs.
□ Implementing the guidance is likely to improve the use
of resources in this area and may lead to fewer people
experiencing domestic violence and abuse.
□ It is unlikely there will be short-term savings and
benefits, however, it may lead to long term savings
and benefits to both health and social care
Success Measures (Outcomes)
The Public Health Outcomes Framework can be
used to monitor and measure effectiveness of
local efforts to improve public health:
□Child development at 2 – 2 ½ years
□Hospital admissions caused by unintentional and
deliberate injuries
DE/DH ( 2012) Safeguarding Pathway for Health Visitors and School Nurses
Ofsted's evaluation of serious case
reviews (2011).
1. Focusing on good practice;
2. Ensuring that the necessary action takes place;
3. Using all sources of information;
4. Carrying out and recording assessments effectively;
5. Implementing effective multi-agency working;
6. Valuing challenge, supervision and scrutiny and the
child being central.
DE/DH ( 2012) Safeguarding Pathway for Health Visitors and School Nurses
Serious Case Reviews
□ Under 1’s have the highest death rate from abuse
and or neglect.
□ Under 5, in particular under 1s are at highest risk
of neglect and/or abuse.
□ Adolescents subject to abuse/neglect are at
increased risk of death from suicides.
□ Teenage parents/carers are particularly vulnerable.
DE/DH ( 2012) Safeguarding Pathway
Crucial Conversations
What has
happened to you?
Nurses and domestic abuse
□ Nurses play a key role in responding to domestic
abuse. Yet nurses’ responses are sometimes
inappropriate and unhelpful, such as trivializing or
ignoring the abuse.
□ Reasons include organizational constraints, e.g. lack
of time and privacy; and interpersonal factors such
as fear of offending women and lack of confidence.
□ Nurses themselves are often victims of abuse and
may need support.
Clark IPV2018_CCJP
IRIS (Identification and Referral to
Improve Safety)
□ IRIS provides general, practice-based, domestic-
violence training, support and a referral programme.
□ Advice and support to those affected by domestic
abuse (guidance on finance and welfare benefits,
housing and homelessness, access to legal services,
parenting, emotional support).
□ A safety plan and initial risk assessment to improve
safety.
□ Signposting, referral and provision to community,
counselling and therapeutic services.
Clark IPV2018_CCJP
Key Findings ( IRIS evaluation)
□ Ten women took part. Eight had exited the
abusive relationship but two remained with the
partner who had perpetrated the abuse.
□ Women were overwhelmingly positive about
the programme and irrespective of whether
they had remained or exited the relationship
all reported perceptions of increased safety
and improved health.
Birmingham Health Visitors
In Birmingham, there are 227 number of Health Visitors
(HVs) providing support to 35,000 children and families
across the city.
HVs Do identify and respond to DVA, through their
mandated contact with children and families in the first
few years of a child’s life.
As of yet, there has been no local evaluation of health
visitors interventions to prevent DVA by providing
appropriate support to women and children at risk of
harm.
Proposed ‘joined up’ knowledge application
Community of Practice
□ Work in progress
□ UoB and BCHFT partnership
□ Group established in 2017
□ Approx 23 members
□ Early years and health visiting focus
□ Fora to share information and learning
□ Knowledge application
Key References
□ NICE ( 2014) ‘Domestic violence and abuse: how services can respond
effectively’ (NICE public health guidance 50).
□ Bradbury-Jones, C., Clark, M.T. & Taylor, J. (2017) Abused women’s
experiences of a primary care identification and referral intervention: A case
study analysis. Journal of Advanced Nursing. DOI: 10.1111/jan.13250
□ Bradbury-Jones, C. & Clark, M.T. (2016) Intimate partner violence and the
role of community nurses. Primary Health Care, 26(9), 42-48.
□ Bradbury-Jones, C. & Clark, M.T. (2016) How to address domestic violence
and abuse. Nursing Times, online issue, 12, 1-4.
□ Bradbury-Jones, C., Clark, M.T., Parry, J. & Taylor, J. (2016) Development of
a practice framework for improving nurses’ responses to Intimate Partner
Violence. Journal of Clinical Nursing. DOI: 10.1111/jocn.13276
Resources
0808 2000 2470121 685 8687

More Related Content

More from Heather Flowe

Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...
Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...
Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...Heather Flowe
 
Stark Individual Differences: Face Recognition Ability Influences the Relati...
Stark Individual Differences:  Face Recognition Ability Influences the Relati...Stark Individual Differences:  Face Recognition Ability Influences the Relati...
Stark Individual Differences: Face Recognition Ability Influences the Relati...Heather Flowe
 
Refugee Return, Geopolitics, and War Imaginaries
Refugee Return, Geopolitics, and War ImaginariesRefugee Return, Geopolitics, and War Imaginaries
Refugee Return, Geopolitics, and War ImaginariesHeather Flowe
 
Interactive lineups can improve eyewitness performance
Interactive lineups can improve eyewitness performanceInteractive lineups can improve eyewitness performance
Interactive lineups can improve eyewitness performanceHeather Flowe
 
A novel interactive face matching procedure: Performance of normal and super ...
A novel interactive face matching procedure: Performance of normal and super ...A novel interactive face matching procedure: Performance of normal and super ...
A novel interactive face matching procedure: Performance of normal and super ...Heather Flowe
 
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr Flowe
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr FloweAlcohol and Remembering Rape, St Mary's SARC Annual Conference Dr Flowe
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr FloweHeather Flowe
 
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...Heather Flowe
 
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...Heather Flowe
 
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...Heather Flowe
 
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...Heather Flowe
 
Criminal identification viewed from a different angle: Can a novel interactiv...
Criminal identification viewed from a different angle: Can a novel interactiv...Criminal identification viewed from a different angle: Can a novel interactiv...
Criminal identification viewed from a different angle: Can a novel interactiv...Heather Flowe
 
Interviewing Sexual Assault Complainants
Interviewing Sexual Assault ComplainantsInterviewing Sexual Assault Complainants
Interviewing Sexual Assault ComplainantsHeather Flowe
 
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...Heather Flowe
 
Alcohol mediates the relationship between alcohol and reporting rape to the p...
Alcohol mediates the relationship between alcohol and reporting rape to the p...Alcohol mediates the relationship between alcohol and reporting rape to the p...
Alcohol mediates the relationship between alcohol and reporting rape to the p...Heather Flowe
 
Effects of Acute Alcohol Intoxication During Encoding
Effects of Acute Alcohol Intoxication During EncodingEffects of Acute Alcohol Intoxication During Encoding
Effects of Acute Alcohol Intoxication During EncodingHeather Flowe
 

More from Heather Flowe (15)

Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...
Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...
Predicting suspect guilt from responses to multiple lineups - Ruth Horry, Zah...
 
Stark Individual Differences: Face Recognition Ability Influences the Relati...
Stark Individual Differences:  Face Recognition Ability Influences the Relati...Stark Individual Differences:  Face Recognition Ability Influences the Relati...
Stark Individual Differences: Face Recognition Ability Influences the Relati...
 
Refugee Return, Geopolitics, and War Imaginaries
Refugee Return, Geopolitics, and War ImaginariesRefugee Return, Geopolitics, and War Imaginaries
Refugee Return, Geopolitics, and War Imaginaries
 
Interactive lineups can improve eyewitness performance
Interactive lineups can improve eyewitness performanceInteractive lineups can improve eyewitness performance
Interactive lineups can improve eyewitness performance
 
A novel interactive face matching procedure: Performance of normal and super ...
A novel interactive face matching procedure: Performance of normal and super ...A novel interactive face matching procedure: Performance of normal and super ...
A novel interactive face matching procedure: Performance of normal and super ...
 
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr Flowe
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr FloweAlcohol and Remembering Rape, St Mary's SARC Annual Conference Dr Flowe
Alcohol and Remembering Rape, St Mary's SARC Annual Conference Dr Flowe
 
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...
REMEMBERING RAPE: THE EFFECTS OF ACUTE ALCOHOL INTOXICATION AND ALCOHOL EXPEC...
 
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...
Encoding Violence Under the Influence: The Impact of Alcohol and Drug Use on ...
 
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...
Show Me One or Six? A Field Study Examining How Lineup Format Affects Real-Wo...
 
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...
The Effect of Alcohol Intoxication on Misinformation Acceptance and Confidenc...
 
Criminal identification viewed from a different angle: Can a novel interactiv...
Criminal identification viewed from a different angle: Can a novel interactiv...Criminal identification viewed from a different angle: Can a novel interactiv...
Criminal identification viewed from a different angle: Can a novel interactiv...
 
Interviewing Sexual Assault Complainants
Interviewing Sexual Assault ComplainantsInterviewing Sexual Assault Complainants
Interviewing Sexual Assault Complainants
 
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...
The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy R...
 
Alcohol mediates the relationship between alcohol and reporting rape to the p...
Alcohol mediates the relationship between alcohol and reporting rape to the p...Alcohol mediates the relationship between alcohol and reporting rape to the p...
Alcohol mediates the relationship between alcohol and reporting rape to the p...
 
Effects of Acute Alcohol Intoxication During Encoding
Effects of Acute Alcohol Intoxication During EncodingEffects of Acute Alcohol Intoxication During Encoding
Effects of Acute Alcohol Intoxication During Encoding
 

Recently uploaded

Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQ-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQuiz Club NITW
 
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...Osopher
 
4.9.24 Social Capital and Social Exclusion.pptx
4.9.24 Social Capital and Social Exclusion.pptx4.9.24 Social Capital and Social Exclusion.pptx
4.9.24 Social Capital and Social Exclusion.pptxmary850239
 
ARTERIAL BLOOD GAS ANALYSIS........pptx
ARTERIAL BLOOD  GAS ANALYSIS........pptxARTERIAL BLOOD  GAS ANALYSIS........pptx
ARTERIAL BLOOD GAS ANALYSIS........pptxAneriPatwari
 
How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17Celine George
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxkarenfajardo43
 
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Association for Project Management
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...Nguyen Thanh Tu Collection
 
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...HetalPathak10
 
Mythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWMythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWQuiz Club NITW
 
Oppenheimer Film Discussion for Philosophy and Film
Oppenheimer Film Discussion for Philosophy and FilmOppenheimer Film Discussion for Philosophy and Film
Oppenheimer Film Discussion for Philosophy and FilmStan Meyer
 
Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Celine George
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdfMr Bounab Samir
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research DiscourseAnita GoswamiGiri
 
Integumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptIntegumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptshraddhaparab530
 

Recently uploaded (20)

Chi-Square Test Non Parametric Test Categorical Variable
Chi-Square Test Non Parametric Test Categorical VariableChi-Square Test Non Parametric Test Categorical Variable
Chi-Square Test Non Parametric Test Categorical Variable
 
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITWQ-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
Q-Factor HISPOL Quiz-6th April 2024, Quiz Club NITW
 
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...
Healthy Minds, Flourishing Lives: A Philosophical Approach to Mental Health a...
 
4.9.24 Social Capital and Social Exclusion.pptx
4.9.24 Social Capital and Social Exclusion.pptx4.9.24 Social Capital and Social Exclusion.pptx
4.9.24 Social Capital and Social Exclusion.pptx
 
Spearman's correlation,Formula,Advantages,
Spearman's correlation,Formula,Advantages,Spearman's correlation,Formula,Advantages,
Spearman's correlation,Formula,Advantages,
 
ARTERIAL BLOOD GAS ANALYSIS........pptx
ARTERIAL BLOOD  GAS ANALYSIS........pptxARTERIAL BLOOD  GAS ANALYSIS........pptx
ARTERIAL BLOOD GAS ANALYSIS........pptx
 
Mattingly "AI & Prompt Design: Large Language Models"
Mattingly "AI & Prompt Design: Large Language Models"Mattingly "AI & Prompt Design: Large Language Models"
Mattingly "AI & Prompt Design: Large Language Models"
 
How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
 
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 - I-LEARN SMART WORLD - CẢ NĂM - CÓ FILE NGHE (BẢN...
 
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...
Satirical Depths - A Study of Gabriel Okara's Poem - 'You Laughed and Laughed...
 
Mattingly "AI & Prompt Design" - Introduction to Machine Learning"
Mattingly "AI & Prompt Design" - Introduction to Machine Learning"Mattingly "AI & Prompt Design" - Introduction to Machine Learning"
Mattingly "AI & Prompt Design" - Introduction to Machine Learning"
 
Mythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITWMythology Quiz-4th April 2024, Quiz Club NITW
Mythology Quiz-4th April 2024, Quiz Club NITW
 
Oppenheimer Film Discussion for Philosophy and Film
Oppenheimer Film Discussion for Philosophy and FilmOppenheimer Film Discussion for Philosophy and Film
Oppenheimer Film Discussion for Philosophy and Film
 
Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdf
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research Discourse
 
Integumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.pptIntegumentary System SMP B. Pharm Sem I.ppt
Integumentary System SMP B. Pharm Sem I.ppt
 
Paradigm shift in nursing research by RS MEHTA
Paradigm shift in nursing research by RS MEHTAParadigm shift in nursing research by RS MEHTA
Paradigm shift in nursing research by RS MEHTA
 

Clark IPV2018_CCJP

  • 1. Disclosing Abuse: Referral Pathways in Public Health Nursing (Health Visiting) Centre for Crime, Policing and Justice Conference - University of Birmingham Dr Maria T. Clark, M.T.Clark@bham.ac.uk 02.03.2018
  • 2. DVA impacts on public health
  • 3. Public health nursing (health visitor’s role) The Call to End Violence against Women and Girls (2010) made the recommendation to; “develop training for health visitors to support families when they suspect violence against women or children ….so that they can access a formal standard of training which is directly relevant to their work”.
  • 5. Policy Drivers □ Effective partnership working that pulls together the core safeguarding principles in terms of prevention, early intervention and formal safeguarding arrangements ( health visiting and school nursing) DE/DH ( 2012) Safeguarding Pathway
  • 6. National Institute for Health & Care Excellence (NICE) (2016)
  • 7. NICE Quality Standard (DVA) 1. Asking about domestic violence and abuse 2. Response to domestic violence and abuse 3. Referral to specialist support services for those experiencing DVA 4. Referral to specialist services for perpetrators of DVA
  • 9. Costing the service/impact Commissioning arrangements for domestic violence and abuse services vary across the country. Local authorities are likely to lead on services involving public health and social care, with clinical commissioning groups leading on clinical healthcare services. Others, such as the police and crime commissioners and organisations in the voluntary sector may also commission, as well as provide, services. NICE (2014) Implementing the NICE guidance on domestic abuse – how services can respond effectively (PH50)
  • 10. NICE guidance for services □ We encourage organisations to evaluate their own practices against our recommendations and assess the potential local costs. □ Implementing the guidance is likely to improve the use of resources in this area and may lead to fewer people experiencing domestic violence and abuse. □ It is unlikely there will be short-term savings and benefits, however, it may lead to long term savings and benefits to both health and social care
  • 11. Success Measures (Outcomes) The Public Health Outcomes Framework can be used to monitor and measure effectiveness of local efforts to improve public health: □Child development at 2 – 2 ½ years □Hospital admissions caused by unintentional and deliberate injuries DE/DH ( 2012) Safeguarding Pathway for Health Visitors and School Nurses
  • 12. Ofsted's evaluation of serious case reviews (2011). 1. Focusing on good practice; 2. Ensuring that the necessary action takes place; 3. Using all sources of information; 4. Carrying out and recording assessments effectively; 5. Implementing effective multi-agency working; 6. Valuing challenge, supervision and scrutiny and the child being central. DE/DH ( 2012) Safeguarding Pathway for Health Visitors and School Nurses
  • 13. Serious Case Reviews □ Under 1’s have the highest death rate from abuse and or neglect. □ Under 5, in particular under 1s are at highest risk of neglect and/or abuse. □ Adolescents subject to abuse/neglect are at increased risk of death from suicides. □ Teenage parents/carers are particularly vulnerable. DE/DH ( 2012) Safeguarding Pathway
  • 15. Nurses and domestic abuse □ Nurses play a key role in responding to domestic abuse. Yet nurses’ responses are sometimes inappropriate and unhelpful, such as trivializing or ignoring the abuse. □ Reasons include organizational constraints, e.g. lack of time and privacy; and interpersonal factors such as fear of offending women and lack of confidence. □ Nurses themselves are often victims of abuse and may need support.
  • 17. IRIS (Identification and Referral to Improve Safety) □ IRIS provides general, practice-based, domestic- violence training, support and a referral programme. □ Advice and support to those affected by domestic abuse (guidance on finance and welfare benefits, housing and homelessness, access to legal services, parenting, emotional support). □ A safety plan and initial risk assessment to improve safety. □ Signposting, referral and provision to community, counselling and therapeutic services.
  • 19. Key Findings ( IRIS evaluation) □ Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. □ Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health.
  • 20. Birmingham Health Visitors In Birmingham, there are 227 number of Health Visitors (HVs) providing support to 35,000 children and families across the city. HVs Do identify and respond to DVA, through their mandated contact with children and families in the first few years of a child’s life. As of yet, there has been no local evaluation of health visitors interventions to prevent DVA by providing appropriate support to women and children at risk of harm.
  • 21. Proposed ‘joined up’ knowledge application
  • 22. Community of Practice □ Work in progress □ UoB and BCHFT partnership □ Group established in 2017 □ Approx 23 members □ Early years and health visiting focus □ Fora to share information and learning □ Knowledge application
  • 23. Key References □ NICE ( 2014) ‘Domestic violence and abuse: how services can respond effectively’ (NICE public health guidance 50). □ Bradbury-Jones, C., Clark, M.T. & Taylor, J. (2017) Abused women’s experiences of a primary care identification and referral intervention: A case study analysis. Journal of Advanced Nursing. DOI: 10.1111/jan.13250 □ Bradbury-Jones, C. & Clark, M.T. (2016) Intimate partner violence and the role of community nurses. Primary Health Care, 26(9), 42-48. □ Bradbury-Jones, C. & Clark, M.T. (2016) How to address domestic violence and abuse. Nursing Times, online issue, 12, 1-4. □ Bradbury-Jones, C., Clark, M.T., Parry, J. & Taylor, J. (2016) Development of a practice framework for improving nurses’ responses to Intimate Partner Violence. Journal of Clinical Nursing. DOI: 10.1111/jocn.13276