Sandwell review

The DHR Recommends that the Black Country ICB (Sandwell Place) and BCWA open and maintain a regular dialogue with GP practices and PCNs to create a shared vision of how domestic abuse support is delivered in Sandwell. They should reflect on all barriers to disclosure, identifying and sharing best practice and find shared solutions to identified challenges in providing domestic abuse support using the IRIS model.

The ICB (Sandwell Place) to use current Primary Care Safeguarding Leads Meetings to reinvigorate GP engagement with IRIS

That the ICB and BCWA panel members on reviews continue to encourage DHR, SAR and CPSR Chairs to release key learning that relates to DA support by primary and secondary care, as soon as possible

That the ICB consider creating a short series of podcasts that BCWA could contribute to, which would be shared with practitioners, relating to any aspect of DA support that is identified as challenging for e.g. ‘asking the right questions’ and unconscious bias

The Black Country ICB IT team and safeguarding leads should review appropriate data collection, monitoring, and analysis in relation to all aspects of domestic abuse support to allow a strategic assessment of the effectiveness of GP responses to domestic abuse and promote improvements

Black Country ICB should seek to identify how currently used electronic patient records could be enhanced to allow both GP practices and the ICB to monitor the effectiveness of trained staff in identifying DA through direct questions, and making appropriate referrals

Black Country ICB and BCWA to identify and share with partners how referral rates of GP practices will be judged based on a ratio of trained staff to patient numbers and any other factor considered relevant to accurate data collection (i.e. disaggregated data on protected characteristics)

ICB to publish quarterly a list of top performing practices with a short commentary from safeguarding leads on how this has been achieved

Black Country ICB and BCWA to identify in relation to DA Support, poor performing GP practices and make regular direct approaches both in person and email, to senior partners and practice managers to encourage better engagement with IRIS

The Black Country ICB should engage with the CQC to request that a thematic review of domestic abuse safeguarding responses form part of their inspection regime for GP practices and provide data to the CQC to facilitate this.

The ICB should prepare a short performance summary of individual practices in relation to their identifying DA and making referrals, when they are notified of a CQC inspection.

The ICB should promote the use of the Safeguarding Self-Assessment Tool as a valuable tool that practices can share with CQC to demonstrate their compliance with safeguarding requirements

That the ICB Safeguarding team encourage 3-4 GP practices to undertake a voluntary audit of DA safeguarding practice. (This should with due warning, become a random audit)

Sandwell Adult Social Care Mental Health Team should review their performance, procedures and documentation and provide assurance to the SSP that AMHPs are carrying out routine questioning in relation to domestic abuse and that DA is adequately explored in supervisory review

Sandwell Adult Social Care Mental Health Team should review AMHP assessments to establish whether they are identifying DA and pathways to support

Sandwell Adult Social Care Mental Health Team should review current documentation used by AMHPs in their Mental Health assessments and ensure routine domestic abuse questions are embedded in their threshold grid in line with Pathfinder recommendations

Sandwell Adult Social Care Mental Health Team should ensure their revised Supervision Plan ensures clinical audit of domestic abuse risk that reflects Pathfinder guidance

Survivors of domestic abuse in Sandwell should be able to access appropriate support services that can in the first instance address wellbeing to reduce the frequency with which they are direct towards mental health services as a response to their experience of trauma

The Safer Sandwell Partnership should promote awareness of the Domestic Abuse Survivors Group (DASG) with all relevant partner agencies and domestic abuse support groups

The Safer Sandwell Partnership should identify and promote wellbeing services in Sandwell which are trauma informed and recognise that domestic abuse survivors may not wish to be directed to Mental Health services to address wellbeing