Quality statement 2: Response to domestic violence and abuse

Quality statement

People experiencing domestic violence and abuse receive a response from level 1 or 2 trained staff.

Rationale

People experiencing domestic violence or abuse should expect staff to respond consistently and appropriately. Training staff to respond to disclosure (level 1) and how to ask about domestic violence and abuse (level 2) is essential for safe enquiry about experiences of domestic violence and abuse and a consistent and appropriate response. People experiencing domestic violence or abuse should be questioned sensitively and responded to with empathy and understanding. Private discussion with trained staff should allow assessment of the person's immediate safety in order to prevent further incidents.

Quality measures

Structure

Evidence of local arrangements to ensure that staff are trained to level 1 or 2 to respond to domestic violence and abuse.

Data source: Local data collection.

Process

Proportion of people experiencing domestic violence or abuse who receive a response from level 1 or 2 trained staff.

Numerator – the number in the denominator who receive a response from level 1 or 2 trained staff.

Denominator – the number of people who disclose or are asked if they are experiencing domestic violence or abuse.

Data source: Local data collection.

Outcome

Safety of people experiencing domestic violence and abuse.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers (primary, community including third sector, secondary and tertiary care providers of health and social care services, including prison health services) ensure that frontline staff are trained to provide a level 1 or 2 response appropriate to their role. They should work in partnership with voluntary and community agencies to develop training. Training should be provided by qualified trainers, use accredited materials where possible and include face‑to‑face contact, as well as online content.

Health and social care practitioners are trained to provide a level 1 or 2 response to disclosures of domestic violence or abuse. They should ask about domestic violence in a way that facilitates disclosures, in a private discussion, in a sensitive manner and in an environment in which the person feels safe. They should respond sensitively to disclosures in a way that ensures the person's safety; they should offer referral to specialist services. They should document discussions, agreed actions and outcomes.

Commissioners (NHS England local area teams, clinical commissioning groups and local authorities) ensure that they commission services in which frontline staff are trained to provide a level 1 or 2 response at a level appropriate to their role and document discussions. Services should raise awareness and address misconceptions about domestic violence and abuse. They should ensure that frontline staff have the skills and training to provide effective support.

What the quality statement means for service users

People who experience domestic violence or abuse are helped to talk about their experiences by trained staff. They know that they are not alone, that they can get help and support, that their experiences are not that unusual and that they will be believed.

Source guidance

Definitions of terms used in this quality statement

Response

Frontline staff should be trained and able to respond to disclosures of domestic violence and abuse to a level appropriate to their role.

Level 1 staff should be trained to respond to a disclosure of domestic violence or abuse sensitively and in a way that ensures people's safety. They should also be able to direct people to specialist services. This level of training is for physiotherapists, speech therapists, dentists, youth workers, care assistants, receptionists, interpreters and non‑specialist voluntary and community sector workers.

Level 2 staff should be trained to ask about domestic violence and abuse in a way that makes it easier for people to disclose it. This involves an understanding of the epidemiology of domestic violence and abuse, how it affects people's lives and the role of professionals in intervening safely. Staff should also be able to respond with empathy and understanding, assess someone's immediate safety and offer referral to specialist services. Typically this level of training is for nurses, accident and emergency doctors, adult social care staff, ambulance staff, children's centre staff, children and family social care practitioners, GPs, mental health professionals, midwives, health visitors, paediatricians, health and social care professionals in education (including school nurses), prison staff and alcohol and drug misuse workers. In some cases, this level of training will also be relevant for youth workers.

[Adapted from Domestic violence and abuse (NICE guideline PH50)]

Equality and diversity considerations

Health and social care practitioners need to understand equality and diversity issues and ensure that assumptions about people's beliefs, values, gender identity or sexuality do not stop them from recognising and responding to domestic violence and abuse.

When interpreters are needed for discussions, these should be professional interpreters who are impartial and have a duty to maintain confidentiality. Family members or friends should not act as interpreters for enquiries or discussions.