£2.2M for clinical trial to improve general practice response to men and children affected by domestic abuse

14 March 2024

A new clinical trial of a general practice programme to improve the identification and referral of men and children affected by domestic abuse begins in May thanks to a £2.2 million National Institute for Health and Care Research (NIHR) award to University of Bristol researchers, in partnership with Oxford University and the social enterprise IRISi.

The programme, IRIS+, is an expanded version of the successful IRIS (Identification and Referral to Improve Safety) general practice training and support programme, which has been shown to increase referrals of women experiencing domestic violence and abuse (DVA) to specialist services. IRIS+ broadens the scope of the intervention to include men and children, without diminishing the response to women.

The expanded programme was shown to have promise in a feasibility study, results of which were published earlier this year.

Dr Eszter Szilassy, Senior Research Fellow at the Centre for Academic Primary Care, and Principal Investigator on the trial, said:

“Domestic violence and abuse present a significant public health challenge, affecting nine million adults in England and Wales. The IRIS programme has already proven effective in enhancing general practice responses to DVA among women. However, uncertainty persists regarding interventions for men and children. IRIS+ steps in to fill this gap, providing GP training, care pathways and specialist domestic abuse advocacy support for all family members experiencing or perpetrating DVA.

“If effective and cost-effective, IRIS+ could significantly improve the safety, wellbeing, and health of DVA survivors and their children. Future implementation of a successful intervention could create large downstream economic benefits for the NHS and society.”

Medina Johnson, CEO of IRISi, said:

“In a landscape in which public funding is increasingly limited and decision-makers prioritise evidence-based outcomes, we are excited to be involved in this new clinical trial. By acknowledging and addressing the diverse needs of all individuals impacted by DVA, we underscore our dedication to equity and equality in healthcare provision and, above all, to increasing early identification to prevent the escalation of abuse.”

The study, a cluster-randomised controlled trial, will begin in May 2024 and run until the end of 2027. It will compare outcomes in IRIS+ practices with outcomes in IRIS practices over the study period.

For more information about IRIS+, see: https://www.bristol.ac.uk/primaryhealthcare/researchthemes/reprovide/iris-plus/.

Help and support

If you have experienced domestic violence and abuse and would like support, you may find it helpful to contact one of the organisations listed below:

National Domestic Violence Helpline Freephone 0808 2000247 (24hr). Free 24hr confidential helpline for women experiencing domestic violence and abuse, and their friends, family and work colleagues.
RESPECT Men’s Advice Line Freephone 0808 801 0327 (Monday-Friday 9am-5pm). An advice and support line for men experiencing domestic violence and abuse.
RESPECT Phoneline for domestic violence perpetrators Freephone 0808 8024040 (Monday-Friday 10am-5pm).
CRUSH information and referral line 0800 014 9084. A structured programme of group support and empowerment for young people in the age range of 13 – 19 who have witnessed, experienced or are at risk of domestic abuse.
The Samaritans Freephone 116 123 (24hr). Telephone helpline for people to talk at any time, about whatever they are going through or whatever is worrying them.
Galop LGBT+ Abuse Helpline 0800 999 5428 (Monday to Thursday: 1am-8.30pm; Friday 10am-4.30pm).

Further information

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research.

It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

Follow on X: @capcbristol and on LinkedIn.

About IRISi

IRISi is a pioneering social enterprise leading the development and implementation of evidence-based programmes to improve the healthcare response to gender-based violence. IRIS, the organisation’s flagship programme, is a specialist domestic violence and abuse (DVA) training, support and referral programme for General Practices that has been positively evaluated in a randomised controlled trial.

Core areas of the programme include ongoing training, education and consultancy for the clinical team and administrative staff, care pathways for primary health care practitioners and an enhanced referral pathway to a named specialist in a local DVA service for patients affected by DVA.

In 2021, the UK implemented the Domestic Abuse Act to enshrine a comprehensive response to DA in legislation. The accompanying Domestic Abuse Statutory Guidance, issued by the Home Office in 2022, targeted both statutory and non-statutory bodies, and recommended implementing IRIS nationally.

IRISi’s second intervention, the ADViSE programme extends the success of IRIS to sexual health clinics, supporting clinicians to identify and respond to patients affected by Domestic & Sexual Violence and Abuse (D&SVA). This evidence-based programme also ensures a simple referral pathway to a named specialist in a local frontline service. Aligned with the demographic typically served by sexual health clinics, ADViSE also facilitates the identification of a more extensive and diverse range of patient groups, providing visibility and support for individuals from minority groups.

Follow IRISi on X: @irisintervent, Linkedin: @IRISi-interventions or Instagram: @irisintervent or Email: info@irisi.org

About the National Institute for Health and Care Research (NIHR)

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

Funding high quality, timely research that benefits the NHS, public health and social care;
Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
Funding applied global health research and training to meet the needs of the poorest people in low- and middle-income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK Aid from the UK government.

The NIHR is the research partner of the NHS, public health and social care.