Identification and Referral to Improve Safety (IRIS) programme: Service Evaluation (NHS Mansfield and Ashfield Clinical Commissioning Group (CCG))

Executive summary: Domestic violence and abuse (DVA) is recognised as a significant global public health issue (World Health Organisation (WHO) 2013). DVA is a serious, multifaceted societal issue with profound health and mental wellbeing consequences with the potential for longer term health care needs in supporting survivors. The Home Office (2011) reports that 7% of women aged between 16 and 59 and 5% of men have experienced domestic abuse with 24% reporting repeated (three or more times) domestic abuse incidents and in 2013, 77 women in the UK were killed by partners or ex-partners as a result of domestic violence. In the summer of 2013, Mansfield and Ashfield CCG contracted the delivery of a 2-year programme for 31 General Practices in their area to receive the IRIS training programme (Identification and Referral to Improve Safety Programme). The IRIS programme comprises of a structured approach to support and manage DVA by providing training to clinical and non-clinical staff located within GP surgeries. The contracted service commenced in October 2013 and is under review in June 2015. This report forms part of the overall evaluation of the service offered within Mansfield and Ashfield CCG which is a contracted service from the national IRIS model of DVA support and management within primary healthcare. To date 100% of general practices in M&A CCG are engaged with the IRIS programme. The evaluation comprises two components: review of the pre and post IRIS training questionnaires (completed by all attending the IRIS training) and interviews with participants and practitioners. For the purposes of this evaluation data was made available for October 2013 until January 2015 and is based on the training of 151 clinicians and 124 non-clinicians within the CCG area. The findings from the pre and post questionnaires, indicates that across the eight measures of knowledge and understanding of DVA there is a statistically significant difference (within a confidence level of 95%CI) for both clinical and non-clinical staff scores. This is further supported by inclusion of IRIS participant’s written feedback, at the end of training, as to its value and application of the training to their provision of healthcare. Two thematic themes emerged from a small quantity of qualitative free text data: (1) Application to practice and (2) Knowing what to do. At this stage we are unable to provide thematic analysis from interviews that are planned for June 2015 with clinical, non-clinical staff and the IRIS team. During the introduction of the IRIS training programme in the Mansfield and Ashfield CCG (October 2013 to February 2015) there have been 64 referrals to services and 3 high risk DVA cases directed to MARACS by trained staff across the 31 CCG GP surgeries, nationally the average referral to services is 61 cases (data for 2013/2014) (Howell et al., 2014).