I was shocked to read that reports of domestic abuse have risen by a staggering 20% globally during the coronavirus pandemic – it seems to be an undeclared pandemic in its own right.

We’re all aware that domestic abuse goes on; it probably reaches almost every person in the country either directly or indirectly. If we’re not victims ourselves then it’s almost certain that we know someone who is. I remember as a child that Sunday afternoons seemed to be dedicated to this subject – thankfully not in my own home, but I had a good mate who used to come to our house to take refuge. This was also repeated during festive periods and at many other times when it seemed his father wanted a few beers.

Domestic abuse can occur in any relationship. It has been reported that 1 in 3 women are abused by an intimate male partner; while 1 in 4 women are abusive towards their male partners. DA in same-sex relationships (25-33% of couples) is a similar percentage to that in heterosexual couples.

A side effect of lockdown is that while we’re trying to save so many lives by staying at home, those people who are in vulnerable groups are now more at risk from domestic abuse. Those who live with an abuser are captive within their own home and this has led to Refuge, the UK’s largest domestic abuse charity, having a dedicated page to COVID-19! In part, this is due to a 700% increase in calls to its helpline in one single day. Another helpline for those who perpetrate domestic abuse has also received 25% more calls since the lockdown began.

Whilst thankfully the number of cases are currently in decline in the UK, and restrictions are being lifted, it could be a long time before things go back to ‘normal’. The WHO is currently reporting that globally COVID-19 is far from under control with many cities around the world experiencing a second wave of infection. UK scientists are also warning about the ongoing threat which could lead to restrictions being reimposed either locally or nationally in the coming months. This, along with the fears of increased levels of unemployment, financial worries, ongoing isolation from friends and family, and other related factors mean that we may continue to see incidences of domestic violence continue to rise.

Of course, rises in domestic abuse aren’t just COVID related. Reports show that there can be a number of triggers including major sporting events and the festive season, so sadly this is an issue that won’t go away when coronavirus finally does. We need to make sure we’re always vigilant and available to offer support.

So what can we do in primary care?

We will undoubtedly have patients who are victims of domestic abuse currently attending our practices up and down the land. Therefore, we need to keep our eyes open and look for any signs of domestic abuse among our patient groups. We also need to offer as much information and support as possible.

It is really important to bear in mind that, although you may suspect someone is a victim of domestic abuse, they may not be ready to access support, and the wrong approach at this time could be overwhelming. There are some excellent pointers here about offering support when you suspect DA is taking place, although these relate to someone you care about, the principles remain the same for patients and apply equally for both sexes. Victims can feel overwhelmed, embarrassed, and fearful of what will happen if they disclose what is happening to them.  A cautious approach is preferable, and the availability of resources that show you are non-judgemental and approachable is the best strategy.

For patients:

Display posters and helpline numbers in your practice. You can download a poster here [PLUS]

Make patients aware of the hand signal that victims can use secretly to ask for help. you can find out more here

Ensure patients know about ‘Silent Solutions’ – i.e. how to call the police for assistance when they’re in danger and unable to speak.

For staff:

Ensure your staff are aware of the relevant policies and procedures that will enable them to signpost victims to further assistance effectively.

Members of staff or their wider family may also be victims of domestic abuse, so make sure all your staff know they can ask for help, should they need it

The CQC’s Head of Primary Medical Services, Dr Rosie Benneyworth’s weekly blog asked us, on 18^th June, to be more vigilant in our approach to domestic abuse. She stated that “the current lockdown restrictions mean that vulnerable children and adults may be particularly isolated”. In her blog, she pointed us to a useful Home Office link and to a variety of posters that are available for our use.

To further assist, here at Practice Index we’ve dedicated lots of time to going through our Safeguarding Policy [PLUS] to ensure we’ve captured what’s needed to support those vulnerable adults and children in our communities. In doing so, we’ve given this policy a major overhaul and we now link support to safeguarding at a PCN level with our new PCN safeguarding policy [PCN PLUS]

We have also produced a Domestic violence policy [PLUS] and created our own Domestic Abuse poster [PLUS] which can be placed in waiting rooms and on TV screens to raise further awareness.

Our Domestic violence awareness eLearning course is available as part of our Essential eLearning package in the HUB. You can sign up for three months’ free access for you and your staff here.

Next steps…

Reminding staff to be ‘DV aware’ is incredibly important and this must be the take-home message here. But can I suggest that as the CQC has this on its radar, they’ll be asking what you have done to support sufferers of domestic violence in your practice. Therefore, I’d strongly suggest that, along with other Emergency Support Framework (ESF) questions, you include this hot topic.

Another must-do, if you haven’t already done so, is to sign up to Rosie’s Weekly Blog. This is an invaluable source of information and a good insight into the next big thing that will be asked of you come inspection day… whenever that may be!

Good luck, stay safe and be vigilant!

Mat