The Policy Context of Domestic Violence

Amy Nichols, Head of Domestic and Sexual Violence Policy at the Department of Health, explains the policy context for addressing domestic violence in the UK.

Transcript: I have been asked to set out the policy context for “intimate partner violence.” Intimate partner violence is a form of domestic violence and abuse.

The Government has a broad definition of domestic violence which includes intimate partner violence, as well as honour-based violence, forced marriage, female genital mutilation and sexual abuse. I will set out the definition but will focus on intimate partner violence only.

So, domestic violence is: 'Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members1 regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse:

• psychological • physical • sexual • financial • emotional”

Domestic violence in England and Wales accounts for 16% of all violent crime and is the major cause of injury in women under 60 years old. More than 1 in 4 women had been affected by domestic violence since the age of 16 years. Men too experience domestic violence. The physical and mental health impact on the person at the end of the violence can be chronic. It includes trauma and injury; reproductive health and gynaecological problems; as well as mental health consequences, such as post- traumatic stress disorder, depression, substance misuse and suicide.

The effects of domestic violence don’t stop there. Children who witness domestic violence can also get caught with trauma and injury; experience developmental delays and acquire behavioural and mental health problems.

The coalition Government is absolutely committed to preventing violence against women and children in all its forms and this is a Government priority. I want to mention two important overarching pieces of legislation because intimate partner violence affects equalities and inequalities and is also affected by them. Public sector equality duties under Under the Equality Act 2010 are a key framework for ensuring that the impact of equalities is addressed in a way that provides opportunity for all. This duty requires public bodies, to demonstrate that we are taking action on equality in policymaking, service delivery as well as public sector employment. We have to take steps not just to eliminate unlawful discrimination and harassment, but also to actively promote equality. Age, Race, Sex, Sexual orientation, Religion and belief, Disability, Gender reassignment, Marriage and civil partnership, Pregnancy and maternity are important protected characteristics against which it is unlawful to discriminate and all these bear on domestic violence.
The Health and Social Care Act 2012 also requires the Secretary of State for Health to have regard to the need to reduce health inequalities. This duty covers both the NHS and public health and relates to the whole population of England.

In November 2010, the Government published a strategy on how it intends to tackle violence. The outcomes we want to achieve in Call to end violence against women and girls are: • Societal – for people to find domestic violence unacceptable and to be able to challenge it; • Reduction - for fewer people to experience domestic violence. • Identification and support - for frontline professionals such as doctors and nurses to be able to identify and deal with domestic violence • Employers – for employers to recognise and support victims of domestic violence

The main principles behind Call to end violence against women and girls are: • Preventing domestic violence • Providing services • Working in partnership • Better justice outcomes

In March 2011, the Government published the first action plan for Call to end violence against women and girls and this has been refreshed each year on International Women’s Day on 8 March. It captures what every Government Department is going to do to tackle violence, including intimate partner violence.

So where are we now in tackling intimate partner violence in England?

In wider Government: • Implemented Domestic Homicide Reviews

In the Department of health we think that preventing domestic violence is a public health matter, which requires all the relevant agencies to work together. It means taking a number of actions on a number of fronts to support commissioners as well as frontline practitioners. Our focus is on improving the evidence-base for health professionals, as providers of services to be able to identify people at risk and to help them. We also work to improve the evidence-base on interventions and to work with national organisations such as Public Health England on promotion: • So far, we have got domestic violence in its narrow sense of intimate partner violence included in the Public Health Outcomes Framework for use by commissioners of services; • With the North West Public Health Observatory at Liverpool John Moores University, we have published Protecting People, Promoting Health, A public health approach to violence prevention in England. It brings together the epidemiology of violence, information on prevention and policy for commissioners and providers of services.

• Through the Department’s Policy Research Programme, we have commissioned ‘Bridging the knowledge and practice gap between domestic violence and child safeguarding: developing policy and training for general practice.’ • Violence and its health effects is now included in Foundation Year Training for Doctors, thanks to Dr Jan Welch, Clinical Director of the London Havens.

• We have provided a number of training guidance and tools. The seminal 2006 Handbook for health professionals is being updated for publication later this financial year. We supported the e-learning tool available through the Royal College of General Practitioners Website; We have published the professional guidance on domestic violence and abuse for health visitors and school nurses and an e-learning tool is also being developed.
• The National Institute for Health and Clinical Excellence, NICE is developing joint guidance with the Social Care Institute for Excellence on Preventing and reducing domestic Violence between Intimate Partners • We have mainstreamed thinking on intimate partner violence in other policy developments such as: o The Sexual health Strategy o The Troubled Families Programme o The Mental health Strategy o The Family Nurse Partnership programme which empowers mums and dads under 19 years old to improve their child’s health and development as well as their own futures. • And we have introduced a Domestic Violence Pledge in the Public Health Responsibility Deal for employers to enable employers to commit to improving public health by putting into place the support necessary to help their staff to overcome intimate partner violence. • We, as Department of Health have also signed up to the Pledge and are tackling domestic violence as an employer, supported by the Corporate Alliance against Domestic Violence. We are encouraging other Government Departments and NHS organisations to do the same. I can also say that within the Department, we have colleagues who have volunteered as domestic violence support champions, to support colleagues who disclose by listening and empowering them to make the journey to change their lives. I am also a member of this support Champions and I know, we are already making a difference. • Work with Home Office to support effective implementation of Domestic Homicide Reviews to enable local partnerships to learn and implement lessons on prevention and improve services.

It is a long journey. Government has pledged to do what it can do as to provide national support to enable support local. Ending domestic violence in England is a both a social change and a partnership. I have set out some of the policy approaches and context. As Government departments, we hold ourselves to account through the annual refresh of the action plan on Call to end violence against women and girls.

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