What referral pathways are available for patients identified as victims of domestic violence in my practice?

Your practice should have established integrated care pathways for identifying, referring, and providing interventions to support patients identified as victims of domestic violence ¹. These pathways should also address those who perpetrate abuse ¹.

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 ¹. These services provide tailored advice, advocacy, and support based on the individual's risk level and specific needs, including support in different languages ¹.
• Independent Domestic Violence Advisors (IDVAs): Referral to an IDVA service is a key pathway, particularly for victims at high risk of harm ². IDVAs help assess risk, discuss options, create safety plans, and work with other agencies to increase safety for victims, including children ².
• 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 ². This process brings together various statutory and voluntary agencies to jointly support victims and address perpetrator behaviour ².
• 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 ².
• Other Health and Social Care Services: Referrals can be made to a range of services depending on the patient's needs, including:
  • Maternity services ²
  • Sexual health services ²
  • Sexual Assault Referral Centres (SARCs) for reported sexual abuse ²
  • Mental health services ²
  • Substance misuse services ²
  • Housing support ²
  • Financial advice ²
  • Counselling ²
  • Advocacy services ²
• Police and Criminal Justice System: For medical and legal investigations, especially in cases of reported sexual abuse, referral to the police may be appropriate ².
• 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 ².
• National and Local Helplines/Organisations: Information about support, including contact details for relevant local and national helplines, should be clearly displayed ¹. Specific helplines and organisations include:
  • Men's Advice Line (for male victims) ²
  • Respect (for male victims and their networks) ²
  • Survivors UK (for men and non-binary people affected by sexual abuse) ²
  • Women's Aid (provides web information and support for children and young people) ²
  • ChildLine (a free 24-hour service for anyone under 19) ²
  • Galop (national LGBT domestic abuse helpline) ²
  • National Centre for Domestic Violence (provides a fast, free emergency injunction service) ²

Referral pathways should include age-appropriate options and options for groups who may find it more difficult to disclose or access services ¹. All services should have formal referral pathways in place for those subjected to abuse, perpetrators, and affected children ¹. 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 ¹. Documentation of domestic abuse should be hidden from accessible online records ². For pregnant women, consider offering referral to a domestic abuse support worker ³.