Norfolk review

That Home Office Multi-agency Statutory Guidance for the Conduct of Domestic Homicide Reviews S2(4) be amended to specifically include GP practices as having a duty to actively participate in DHRs including attendance at panel meetings, and have regard to any guidance issued by the Secretary of State.

It is recommended that a clause is added to the NHS GP contract to mandate their active participation in Domestic Homicide Reviews (DHRs) and Safeguarding Adult Reviews (SARs).

That Intercollegiate Guidance for adult safeguarding which informs national training should include specific focus on domestic abuse & coercive control including recognition of risk, applying the link between domestic abuse and mental health to assessments, and a process to escalate those risks and concerns. This should link with NICE Quality Standards 116 - Domestic Violence, Quality Standards 1, 2, 3 and 4 published 29 February 2016.

In recognition of Coroner’s Inquest findings NHS England should write into the contracts of all GPs that all GP practices ensure that: a) they have a stand-alone policy & referral pathway for patients experiencing physical, psychological, financial or emotional domestic abuse and/or coercive and controlling behaviours from a partner, former partner or family member. b) the referral pathway clearly advises practitioners how to refer to specialist domestic abuse services who can provide the appropriate practical advice, legal options, safety planning and emotional support. c) they identify a domestic abuse lead, who has specialist domestic abuse training, and who then leads on the practice’s response to concerns on domestic abuse for individual patients. d) they have in place clear guidance and a method of recognising and escalating when a patient's request to speak to their GP (where domestic abuse is expected/anticipated) requires an immediate response, or in their GPs absence an appropriate escalation process is activated.

The County's Domestic Abuse Change Programme and the Domestic Abuse Champions initiative to ensure that all appropriate services and advice agencies have processes in place by September 2016 to identify those experiencing domestic abuse with a particular focus on those experiencing coercive and controlling behaviours and that agencies have a clear pathway to domestic abuse support services.

All agencies to whom the Review is disseminated ensure staff are briefed on the findings, recommendations and learning, and to confirm this has been completed to the County Community Safety Partnership by July 2016.

All domestic abuse training content should be reviewed by June 2016 to ensure that: (a) Older victims of domestic abuse and the additional barriers they face form part of the training. (b) The content of training covering psychological abuse and coercive and controlling behaviour is covered in sufficient depth and takes into account the Home Office 'Controlling or Coercive Behaviour in an Intimate or Family Relationship Statutory Guidance Framework, December 2015', to enable practitioners to identify its effects and support victims appropriately. (c) Training should include reinforcing the importance of record keeping, particularly the use of a chronology to record information about all abusive and controlling behaviours experienced by a victim to identify and evidence any pattern of abuse. (d) Completion of risk assessment should include clarity of the mental well-being of the person being assessed, e.g. depressed and/or suicidal.

A review of the MASH’s current capacity and capability is recommended by end May 2016 to identify what extra resources or funding streams would be required to enable experienced staff within the MASH to assess all domestic crimes and incidents recorded by officers.

A process of continued training and message dissemination should be put in place by the end of April 2016 describing the role of the MASH, its key roles and responsibilities, and including details of the support and advice that officers can expect and the process for obtaining that advice.

The GP practice to have a stand-alone domestic abuse policy & referral pathway to guide staff seeing patients experiencing physical, psychological, financial or emotional domestic abuse and/or coercive and controlling behaviours, risk assessment, & how to refer to specialist domestic abuse services by March 2016.

Leeway to provide an aide memoire for front line officers and agency staff by April 2016 to inform agencies of the range of services Leeway provides and how to access them.

When delivering training Leeway is recommended to keep a register of attendees to show the name of the person and their role within the agency receiving the training.

It is recommended that by July 2016 Age UK Norwich put in place a stand-alone domestic abuse policy and referral pathway for their staff and volunteers separate to their safeguarding policy.

The content of Age UK Norwich domestic abuse training for staff and volunteers who are engaged in the role of advising service users should include awareness of the DASH risk assessment checklist and how to refer on to local specialist domestic abuse agencies according to identified risk. The agency to confirm the inclusion of this content by July 2016.