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Call for national guidance to help GPs document domestic violence

31 January 2017

Guidance is urgently needed to help GPs decide what information to include on electronic records of children and families experiencing domestic violence and abuse (DVA).

This is the conclusion of a study by researchers at the Universities of Leeds, Central Lancashire and Bristol published online this week in the British Journal of General Practice.

The study investigated how and why GPs record information about DVA in families with children. It found that while most GPs recognised DVA and its impact on the safety of children, they struggled to work out the best way of documenting this on patients’ electronic records.

Dr Jessica Drinkwater, lead author of the report, said: “GPs are struggling to balance the need for patient confidentiality with the requirement to share information with health and other professionals where there is a concern about children’s safety. “

“Our study, based on interviews with 42 GPs and 12 practice nurses across six sites in England, found that in the absence of national and local guidance, clinicians are developing individual strategies to balance competing priorities. This is resulting in inconsistent and confused documenting practices.”

Co-author, Dr Eszter Szilassy said: “It highlights an urgent need for national guidance to support GPs who wish to provide the best care to their patients while also fulfilling their safeguarding duties.”

Both the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) have called for better documentation of DVA.

With at least 1.2 million women and 784,000 men experiencing domestic violence and abuse in England and Wales each year, the negative effect on families and children can be far-reaching. About one in five children in the UK are exposed to domestic violence, according to the NSPCC. Childhood exposure to domestic violence and abuse can result in long-term behavioural, mental health and education problems. 

Further information

Link to journal article: Drinkwater J, Stanley N, Szilassy E, Larkins C, Hester, M and Feder, G: Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children. Br J Gen Pract. 30 January 2017.

The British Journal of General Practice is an international journal publishing research, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide.

The Centre for Academic Primary Care (CAPC) is a leading centre for primary care research in the UK, and one of nine academic centres that form the NIHR School for Primary Care Research. Our aim is to improve primary healthcare through high quality research and teaching. We are part of the University of Bristol's School of Social and Community Medicine, an internationally recognised centre of excellence for research and teaching in population health sciences.

CAPC research on domestic violence and abuse.

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