The study, published in the British Journal of General Practice (BJGP), compared the views of 21 patients (women, men and children) with the views of 13 healthcare professionals (GPs, practice nurses and allied health professionals).

Overall, the study found that general practice played an important role in supporting patients affected by domestic abuse during the pandemic, although this was against a backdrop of concerns of rising numbers of DVA cases and falling referral of cases. Access to services was further hampered by the imposition of lockdown measures and a shift to remote care.

Key study findings were:

• Patients valued a rapid and flexible response from general practice, and they appreciated opportunities for continuity of care (seeing the same healthcare professional over a period of time).
• Patients overwhelmingly preferred a face-to-face appointment when disclosing domestic abuse, in order to visualise the response from the clinician. In one example, a telephone consultation was promptly converted to a face-to-face appointment, which enabled the patient to disclose.
• Clinicians relied on their instincts when trying to identify domestic abuse, acknowledging the loss of non-verbal communication in remote consultations.
• Clinicians also valued close collaboration and information sharing with other members of the primary care team and wider professionals who had concerns about patients.
• Clinicians relied on reminders such as a flag of historical domestic abuse in a patient’s medical record.

The study also highlighted concerns amongst healthcare professionals regarding the visibility of children affected by DVA, with remote consultations weakening opportunities to identify red flags which could indicate safeguarding concerns.

Dr Elizabeth Emsley, who trained in general practice and is a Public Health Registrar and Academic Clinical Fellow at the University of Bristol, and lead author, said: “General practice is an important place for patients experiencing or perpetrating domestic violence and abuse (DVA), and their children, to seek and receive help. Our study shows how important it is to prioritise the perspectives of patients affected by DVA and their families in general practice, including during periods of transition and change.”

Dr Eszter Szilassy, Senior Research Fellow at the Centre for Academic Primary Care, and study lead, said: “Enabling safe and easy access to primary care is vital for those affected by DVA as the remote delivery of primary care services evolves post-pandemic.”

Study participants were drawn from seven urban general practices in England and Wales taking part in IRIS+, a study testing the feasibility of a primary care DVA training and support intervention addressing the needs of women, men and children. IRIS+ is part of the National Institute for Health Research funded REPROVIDE Programme (Reaching Everyone Programme of Research on Violence in diverse Domestic Environments).

Paper: General practice as a place to receive help for domestic abuse during the COVID-19 pandemic: a qualitative interview study in England and Wales. Elizabeth Emsley, Caroline Coope, Emma Williamson, Estela Capelas Barbosa, Gene Feder, Eszter Szilassy. Published in the BJGP. October 2023.

To listen to the BJGP podcast with study authors, Elizabeth Emsley and Eszter Szilassy, go to: https://bjgplife.com/episode-137-domestic-abuse-during-the-covid-pandemic-patient-experiences-and-how-gps-can-help/

Related paper with practice guidance: General practice wide adaptations to support patients affected by DVA during the COVID-19 pandemic: a rapid qualitative study. Sharon Dixon, Anna De Simoni, Eszter Szilassy, Elizabeth Emsley, Vari Wileman, Gene Feder, Lucy Downes, Estela Capelas Barbosa, Jasmina Panovska-Griffiths, Chris Griffiths, Anna Dowrick. Published in BMC Primary Care. March 2023.