A Hospital-Based Independent Domestic Violence Advisor Service: Demand and Response During the COVID-19 Pandemic

Abstract

Background and aimRecent UK policy hasfocussed on improving support for victims of domestic violence and abuse (DVA), in healthcare settings. DVA victims attending hospital are often at highest risk of harm, yet DVA support in hospitals has been inadequate. A targeted service supportinghigh risk DVA victims, was implemented at a hospital Trust in North West England. The service was provided by Independent Domestic Violence Advisors (IDVAs).An evaluation exploredthe processes and outcomes associated with the service. The evaluation coincided with the COVID-19 pandemicand societal restrictions (lockdown), during which concern about DVA increased. This paper examines the hospital-based IDVA service during the COVID-19 period and addresses the research questions: What was the demand for the service? How did the service respond? What facilitated this response?MethodsA mixed-methods study was undertaken. Quantitative data on referrals to the service were examined using simple descriptive statistics and compared to other DVA services.Semi-structured interviews were undertaken with IDVAs and other hospital staff involved with the service and the data subjected to thematic analysis. ResultsThe quantitative analysis showed that referrals dropped at the start of lockdown, then increased and continued to rise; the qualitative findings reiterated this pattern. Referrals came from a range of departments across the Trust, with the majority from A&E. Pre-pandemic, the population supported by the service included higher proportions of males and people aged 40 and over than atother IDVA services; this continuedduring the pandemic. The qualitative findings indicated an effective, flexible response during the pandemic, enabled by strong working relationships and by using workarounds.ConclusionsThe hospital-based IDVA service provided a robust response to victims during the COVID-19 pandemic. Referrals increased during the firstlockdown and subsequent relaxing of restrictions. Locating the IDVAswithina team working across the organisation, and building good working relationships facilitatedan effective disclosure and referral route, which endured through social restrictions. The IDVAs supported high-risk victims who may otherwise not have been identified in traditional community-based DVA settings during the pandemic. Hospital-based IDVA services can broaden accessby supporting vulnerable, at risk populations whose needs may not be identified at other services.