Your practice should have established integrated care pathways for identifying, referring, and providing interventions to support patients identified as victims of domestic violence NICE. These pathways should also address those who perpetrate abuse NICE.
Key referral pathways and supporting mechanisms available include:
- Specialist Domestic Violence and Abuse Agencies: A clear referral pathway to specialist domestic violence and abuse agencies should be established NICE. These services provide tailored advice, advocacy, and support based on the individual's risk level and specific needs, including support in different languages NICE.
- Independent Domestic Violence Advisors (IDVAs): Referral to an IDVA service is a key pathway, particularly for victims at high risk of harm NICE CKS. IDVAs help assess risk, discuss options, create safety plans, and work with other agencies to increase safety for victims, including children NICE CKS.
- Multi-Agency Risk Assessment Conference (MARAC): For adult and child victims at high risk of serious harm or homicide, cases can be referred to a MARAC NICE CKS. This process brings together various statutory and voluntary agencies to jointly support victims and address perpetrator behaviour NICE CKS.
- IRIS (Identification and Referral to Improve Safety) Programme: Practices may utilise the IRIS programme, which provides specific domestic abuse in-house training, support to practice teams, referral, and recording, often by embedding a domestic abuse specialist within the practice NICE CKS.
- Other Health and Social Care Services: Referrals can be made to a range of services depending on the patient's needs, including:
- Maternity services NICE CKS
- Sexual health services NICE CKS
- Sexual Assault Referral Centres (SARCs) for reported sexual abuse NICE CKS
- Mental health services NICE CKS
- Substance misuse services NICE CKS
- Housing support NICE CKS
- Financial advice NICE CKS
- Counselling NICE CKS
- Advocacy services NICE CKS
- Police and Criminal Justice System: For medical and legal investigations, especially in cases of reported sexual abuse, referral to the police may be appropriate NICE CKS.
- Children and Young People's Services: Children and young people affected by domestic abuse should be offered referral to age-appropriate specialist domestic abuse services, which may include psychoeducational support, counselling, or specialist children's victim support workers NICE CKS.
- National and Local Helplines/Organisations: Information about support, including contact details for relevant local and national helplines, should be clearly displayed NICE. Specific helplines and organisations include:
- Men's Advice Line (for male victims) NICE CKS
- Respect (for male victims and their networks) NICE CKS
- Survivors UK (for men and non-binary people affected by sexual abuse) NICE CKS
- Women's Aid (provides web information and support for children and young people) NICE CKS
- ChildLine (a free 24-hour service for anyone under 19) NICE CKS
- Galop (national LGBT domestic abuse helpline) NICE CKS
- National Centre for Domestic Violence (provides a fast, free emergency injunction service) NICE CKS
Referral pathways should include age-appropriate options and options for groups who may find it more difficult to disclose or access services NICE. All services should have formal referral pathways in place for those subjected to abuse, perpetrators, and affected children NICE. Information sharing between agencies should follow clear protocols, adhering to confidentiality principles and the Data Protection Act, with consent sought unless there is serious risk NICE. Documentation of domestic abuse should be hidden from accessible online records NICE CKS. For pregnant women, consider offering referral to a domestic abuse support worker NICE CG110.