Health Pathfinder

Transforming the health response to domestic abuse

The Health Pathfinder project was designed to transform healthcare’s response to domestic violence and abuse by ensuring a coordinated and consistent approach across the health system including acute, mental health and primary care services.

The pilot project ran from 2017 to 2020, led by Standing Together as part of a consortium of expert partners: SafeLives, Imkaan, AVA, IRISi and Standing Together. The project engaged nine clinical commissioning groups (CCGs) and 18 NHS Trusts across England to implement sustainable interventions in eight local areas.

Findings of the Pathfinder pilot informed the Whole Health Model: a coordinated and consistent approach across the health system including acute, mental health and primary care services. The Whole Health Model sees health services and local domestic abuse specialist services working together to commission integrated care pathways and help all health staff to respond safely to survivors of domestic abuse.

Why is domestic abuse a health issue?

75%
of domestic violence results in physical injury or mental health consequences to women
90%
of all female patients see 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
30%
of domestic abuse starts or escalates during pregnancy
1 in 4
women in contact with mental health services are likely to be experiencing domestic abuse

Health Pathfinder created practice briefings to support health professionals’ response to survivors in three distinct areas; acute hospital trusts, mental health trusts and GP practices.

General Practitioner (GP) profile

SafeLives’ Insights dataset found that on average, a victim will experience abuse for three years before getting effective help and will visit their GP on average 4.3 times. It is imperative that GPs are equipped to ask the right questions and support victims through disclosure and referral.

Pathfinder practice briefings

Other resources

Medical power and control wheel

A tool for healthcare professionals on responding appropriately to domestic abuse disclosures. Mel Goodway, IRISi, explains the Medical Power and Control Wheel.

Best practice responding to domestic violence and abuse in primary care

Annie Howells, Programme Director for IRIS, reflects on best practice around domestic abuse in primary care. Learn more about the IRIS model of training and support for GP practices.

Improving the health response to domestic abuse in Blackpool

A reflection on delivering specialist training and referral pathways to GP practices with the Pathfinder project. Read about the significant impact it’s made in Blackpool.

Transforming the primary health response to domestic abuse in the Royal Borough of Kensington and Chelsea

Improve the healthcare response, independent, client-led specialist domestic violence charity providing crisis intervention and on-going support to women experiencing domestic violence.

Domestic abuse and mental health: a GP’s perspective

Dr Katherine Pitt, a GP Registrar and researcher, shares her professional experiences of how domestic abuse impacts upon mental health.

I just cried. I was just so relieved that somebody, that somebody just said something. And he (the GP) gave me the box of tissues and I just sat and cried and cried and cried. And he said, 'Tell me when you're ready.' And I poured it all out and that's when he said about the specialist worker. He said, there is somebody out there to help me. I'm not on my own. And if I want help, it's there and not to be ashamed of it. Which I was, really ashamed of it. And he said, 'You're not on your own. We can get you this help.' And he did. He really did.

Victim who was supported by an Iris-trained GP surgery

Hospital profile

Domestic abuse costs the health services £2,333 million every year and every practitioner in the health system will already be treating patients who are experiencing abuse. It is vital that healthcare staff within hospitals are equipped to ask the right questions and support victims through disclosure and referral.

Pathfinder practice briefings

Domestic abuse is a public health epidemic and health must be part of the solution. We must meet victims where they are. We know four of five victims do not call the police. We have to go to them: where they feel supported, where they feel safe and free from stigma.

Diana Barran, SafeLives founder

Mental health profile

Mental health and domestic abuse are inextricably linked. SafeLives national dataset shows that people with mental health needs were more likely to have experienced abuse. The SafeLives Cry for Health report revealed higher levels of mental health needs amongst victim/survivors within hospital settings (57%), compared to those within community-based domestic abuse services (35%). This profile provides guidance around the role of mental health services.

Pathfinder practice briefings

Mental health staff shouldn’t feel intimidated or doubt their role, as they can have so much to contribute to the action planning. And most importantly, they can help ensure victims/survivors access services they may desperately need.

Alison Eley, Named Nurse for Safeguarding Children, Domestic Abuse and Marac lead, as quoted in Safe and Well, SafeLives' report on mental health and domestic abuse.

Health Pathfinder

Why is domestic abuse a health issue?

of domestic violence results in physical injury or mental health consequences to women

of all female patients see their GP over a five-year period

of all suicides and suicide attempts by women in the UK are due to domestic abuse

of women in a violent relationship seek help from health services, usually GPs, at least once

of domestic abuse starts or escalates during pregnancy

women in contact with mental health services are likely to be experiencing domestic abuse