The BMJ Awards, now in their 8th year, are the UK's premier medical awards programme, recognising and celebrating the inspirational work done by doctors and their teams.
The Identification and Referral to Improve Safety (IRIS) programme, is a general practice-based domestic violence and abuse (DVA) training support and referral programme that has been evaluated in a randomised controlled trial. Core areas of the programme are training and education, clinical enquiry, care pathways and an enhanced referral pathway to specialist domestic violence services. It is aimed at women who are experiencing DVA from a current partner, ex-partner or adult family member.
IRIS programme has now been commissioned by local authorities and Clinical Commissioning Groups and is running in 33 areas of England and Wales with training delivered to more than 450 practices.
“Better awareness of domestic violence among GPs doesn’t get us anywhere,” said Gene Feder, from the Centre for Academic Primary Care at the University of Bristol. “You have to really engage them, and the whole practice, by giving them the background and training them to ask the right questions, and respond appropriately. Then you provide a named person to whom they can refer patients who are being abused.”
It is this, Feder believes, that has made the IRIS system work. “Traditionally GPs would give women a card with some numbers on it, and usually nothing happened. But using this type of referral makes the difference.”
Trials have shown that practices that have been trained identify three times as many abused women, and refer seven times as many, as control practices that have not. “I was quite surprised by the size of the effect,” he says.
After a referral the advocate will ring the patient to make an appointment, often held in the general practice to provide cover, and offer advice on legal, financial, and housing issues as well as psychological support. IRIS has caught on and is now in routine use in 33 areas. “I wouldn’t really have thought it would ever get beyond a pilot, but it has,” Feder says. “I’m pleased we got out of the ivory tower.”
The winners of the BMJ Awards will be announced on Thursday 5th May.