Pathfinder is a pilot project that ran from 2017 to 2020 and was led by Standing Together as part of a consortium of expert partners including made up of SafeLives, Imkaan, Against Violence and Abuse (AVA), Identification and Referral to Improve Safety (IRISi) and Standing Together Against Domestic Violence (STADV). The project engaged nine clinical commissioning groups (CCGs) and 18 NHS Trusts across England to implement sustainable interventions in eight local areas: Blackpool, Exeter & North Devon, Haringey & Enfield, Somerset, Three councils (Kensington & Chelsea, Westminster and Hammersmith & Fulham), Camden & Islington, North Staffordshire, and Southampton.
Findings of the Pathfinder pilot informed The Whole Health Model. This aims to transform healthcare’s response to domestic abuse by ensuring a coordinated and consistent approach across the health system including acute, mental health and primary care services. The model supports health services to work with the local domestic abuse specialist services to commission integrated care pathways and build the capacity of all health staff to respond safely to survivors of domestic abuse.
About the Pathfinder Toolkit
The interventions and approaches pioneered and tested across sites participating in the Pathfinder Project highlight the benefits of a Whole Health Model. The Pathfinder Toolkit brings together the key components of this model into a comprehensive and sustainable response to domestic abuse in health. The Toolkit provides detailed guidance for health leaders on how to deliver the model, including: organisational structure and strategy; policy development; the co-location of a Health Based Idva, the establishment of a Domestic Abuse Coordinator and Domestic Abuse Champions Networks; specialist guidance around how to respond to the needs of BAME, LGBT+, older and disabled survivors; staff training; data collection; patient information campaigns; and establishing referral pathways to local services.
Why is domestic abuse a health issue?
- 75% of domestic violence results in physical injury or mental health consequences to women
- Domestic abuse is the leading cause of morbidity for women aged 19-44, greater than cancer, war and road traffic accidents
- There is extensive contact between women and primary care clinicians with 90% of all female patients consulting their GP over a five-year period
- 1 in 8 of all suicides and suicide attempts by women in the UK are due to domestic abuse
- 80% of women in a violent relationship seek help from health services, usually GPs, at least once and this may be their first or only contact with professionals
- 30% of domestic abuse starts/escalates during pregnancy
- 1 in 4 women in contact with mental health services are likely to be experiencing domestic abuse when you see them
- 51,355 NHS staff are likely to have experienced abuse in the past 12 months
- Read A Cry for Health, SafeLives' report on the response to domestic abuse by health providers.
For more guidance and best practice examples on the role of health in responding to domestic abuse, see our three profiles: