Domestic Violence Health Service Perspective

1. Domestic Violence Health ServicePerspective 28 % women ?? % men ?? % children NHS costs estimated as £1.2 billion MAJOR ISSUE FOR HEALTH SERVICES Briony Ladbury RN RM FPcert HV BA MSc 6th May 2008

2. Affects of DV • Physical Health • A and E admissions :Injury • A and E admissions : Self harm / OD • Smoking – general poor physical condition • Mental Health • Alcohol abuse • Anxiety states, depression, PTSD • Sexual Health • STD, pregnancy, exploitation • Child Health • Child abuse, neglect, emotional harm, behavioural issues – and all of the above!

3. Influencing the new NHS COMMISSIONERS PROVIDERS WIC Hospital LAS GP (commissioners too) FPC / GUM MH Services Community Public Health

4. Current Contexts Safeguarding Children Safeguarding Adults ?? DV

5. Influencing Practice • Local Serious Case Review Recommendations • Responding to domestic abuse: a handbook for health professionals • London Board: Supplementary Guidance & Risk Maitrix • Individual Trust Policies and Procedures • LSCB Policies & Procedures • DV Forums and FJC’s • Health engagement on MARACS/MAPPA’s • Public Health Campaigns • Training opportunities Some room for confusion ? Competency and Core functions

6. Use what we know

7. Use what we have

8. …….and then some • Persuading staff to get involved at all levels • Using well tried tricks • Teaching staff to manage aggressive people • Teaching staff about recording incidents • Teaching staff to manage risk to staff • Teaching staff about community resources