Agenda item

The Board was provided with a report and accompanying presentation on the IRIS Project in Bromley.

The Board was briefed on the report by Bob Parker--Interim Safeguarding Adults Project Lead: BCCG. The Board was taken through the PowerPoint presentation by Josephine Feeney – IRIS Advocate Educator (Victim Support). Also present was Ann Thorne – Senior IDVA (Victim Support). (IDVA is an abbreviation for Independent Domestic Violence and Abuse Advocate).

The Board heard that since November 2015, GP practices in Bromley had benefitted from the IRIS Project (Identification and Referral to Improve Safety) which had been commissioned in response to a Domestic Homicide Review-- following the death of a Bromley resident in November 2013.

Bromley Clinical Commissioning Group had been in partnership with Victim Support since November 2015 to provide training and support to GP practices in Bromley around domestic violence/abuse. This was a local project supported by the National IRIS Team, and funded by the Mayor’s Office for Policing and Crime (MOPAC), with additional financial support from BCCG for the GP Clinical Lead.

IRIS developed responses to improve early detection and to develop support pathways for domestic violence within General Practice. The service delivered a training and support programme targeted at primary care clinicians and administrative staff leading to improved numbers and quality of referrals to specialist domestic abuse services, and improved recording and identification of women experiencing domestic abuse.

The IRIS model provided GP practices with:-

• Local named Independent Domestic Violence and Abuse Advocate-Educators (IDVA-E) who received all referrals from clinicians and provide feedback to those clinicians. They were hosted by the Domestic Violence and Abuse (DVA) specialist third sector organisation (Victim Support).

• Direct care pathways to access specialist local DVA services by integrating third sector organisations with Primary Care.

• Free on-site customised health-focused DVA training delivered by a local GP (who was trained to be a clinical specialist in DVA) and the IDVA-E.

Ms Feeney explained that without crisis intervention work, several cases of DV could have led to a homicide in Bromley. All appropriate agencies within the borough were now aware of the cases, and were working together to safeguard them.

Ninety two referrals had been received since December 2016; seven of these cases were very high risk, and could have resulted in homicides. 

An example of how intervention really helped patients was outlined:

One of the seven cases was a woman in her late 20s, a frequent attender who came in with depression and anxiety. Before her doctor enquired about DV, the client had not disclosed what she was experiencing. She only told the GP part of the story, but it was enough for her to be referred. It came to light that her partner was controlling, threatened her with knives and raping her-- sometimes in front of their son. Thanks to the intervention from IRIS, she now resided in a confidential address with her son, and was going through the criminal justice system to get justice.

Although the ninety two referrals evidenced that the training had massively increased GPs enquiring about domestic abuse, the materials advertising ‘this practice is DV aware’ provided by IRIS in practices had encouraged patients to disclose.

The Board heard that it was crucial for funding to be provided so that an adequate level of service could be maintained.

It was envisaged that effective use of the IRIS programme would result in reduced GP appointments and reduced A&E admissions. Ms Feeney hoped that ‘DV Hubs’ could be set up in GP practices as focal points to ease pressure on GPs.

Councillor Carr advised Mr Parker to seek Pan London funding that was currently available from London Councils.

It was hoped that by March 2018, IRIS would have trained over 85% of the Practices in Bromley--equipping them in identifying, enquiring and responding to domestic abuse.

Dr Paranjape stated that she had been through the training and that in her opinion the training was good quality and had upskilled GP’s in consultations. The CQC were viewing this type of training as being of similar importance to safeguarding training.

Harvey Guntrip felt that the service was invaluable and that guaranteed funding should be made available. Dr Bhan suggested that the funding referred to by Councillor Carr should be explored.

RESOLVED that the report and presentation be noted.