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Tackling domestic violence

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With domestic violence a serious public health issue and one of the biggest challenges facing the NHS, Helen Mooney reports on UNISON’s commitment to tackle the problem head-on and prioritise staff training as a key action point

Domestic violence costs the NHS a staggering £1.2bn a year.

For a number of years health and public services union UNISON has had a policy on dealing with such abuse, with a network of 12 regional officers whose job it is to raise awareness of the issue. To tackle the problem head-on it is vital that NHS staff are sensitive to the possibility that patients or colleagues may have experience of domestic violence.

Sharon Greene, UNISON national women’s officer, says the union decided some years ago that domestic violence was an issue that needed to be addressed in all settings. ‘We need to support people in the workplace if they have issues around domestic abuse, for example if a member of staff has a lot of sickness absence we will negotiate with employers about what the real issue might be and suggest that a staff member needs additional support,’ she explains.

There will also be considerations around confidentiality and allowing staff time off for court appearances and visits to their children’s school. ‘Employers should be aware that they risk losing good staff if they don’t put policies in place to help them so there is a recruitment and retention argument as well,’ Ms Greene says. However, she cautions NHS managers and other staff against becoming informal counsellors. ‘We produce support booklets and people can be directed to Women’s Aid and to UNISON Welfare,’ she explains.

UNISON would like to see emphasis on training. ‘There needs to be training for managers in awareness and in how to deal with these issues, it is important practically and psychologically,’ Ms Greene says.

Marisa Howes, national communications officer for Managers in Partnership, a trade union for NHS managers, agrees. ‘This is an important workplace issue that needs to be handled sensitively by employers. Line managers have a key role to play. Hopefully under health and well-being policies organisations would have a policy for helping staff who have been subject to domestic violence,’ she says.

Ms Howes says managers need to consider domestic violence and try and provide a supportive environment. ‘It is good management practice to be aware of any changes in behaviour in staff members - managers need to use organisational policies, they can pass on contact numbers for welfare advice services and they can use UNISON guidance on this,’ she explains.

Domestic violence: the facts


  • Women are more than twice as likely as men to be worried about violent crime
  • Nearly one in three women have experienced domestic violence
  • Nearly one in four women have experienced some form of sexual assault
  • 39% of women say fear of crime has affected their quality of life
  • 53% of all serious sexual assaults are committed by a partner or ex-partner
  • Nearly one in ten women say they have been stalked
  • Children who have witnessed domestic violence are twice as likely to have serious behavioural problems as other children
  • A survey by Sugar Magazine and the NSPCC in 2005 found that one in five teenage girls who responded said they had been hit by a boyfriend
  • 40% of survivors of serious sexual assault do not tell anybody about the attack

Amanda McDonough, domestic abuse coordinator at Wirral University Teaching Hospital Foundation Trust, works in the hospital and at a family safety unit - one of a small number of ‘Safeguarding Units’ established by some NHS trusts.
When her post was introduced in 2005 her trust produced a policy document on domestic abuse. Staff know that if they suspect that either patients or colleagues are experiencing domestic violence they should immediately refer them to the domestic abuse coordinator. ‘We advocate indirect routine questioning to find out if patients have been subjected to domestic abuse, we don’t expect them to ask direct questions and if they do suspect it is happening they should refer people to our team,’ she says.

‘Violence against women and girls is completely unacceptable and we must all see it as our duty to step in and help someone who is at risk’

Ms McDonough says this approach is different from that advocated by the Department of Health and Home Office taskforce set up earlier this year to advise health professionals, which advocates direct questioning. ‘Some years ago we carried out a survey within the trust which found that one in four of our staff had been subject to domestic violence and questioned how we could ask staff to routinely question patients when perhaps they were suffering themselves,’ she explains.

However, Ms McDonough welcomes the government’s new taskforce, which aims to spot early signs of violence, investigate the scale of the problem and ensure appropriate support across the NHS.

Launching the inquiry, former home secretary Jacqui Smith said: ‘Violence against women and girls is completely unacceptable and we must all see it as our duty to step in and help someone who is at risk. We need a wide range of workers on the frontline to be alert to the signs of violence and to be able to provide support. Violence against women and girls is a public health issue affecting the lives of thousands of NHS patients every year and we need to do all we can together to prevent violence from occurring.’ She said the taskforce would help ensure all NHS staff are trained to care for women and girls and help prevent further abuse.

UNISON director of nursing Gail Adams says that domestic violence is one of the most serious issues the health service faces and that it can affect anybody.

‘We would like the NHS to take a leading role in this in particular in training frontline staff in GP surgeries, A&E and midwifery units,’ she says. ‘Questions about domestic violence should become the norm rather than abnormal.’

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