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Health Visiting and Integrated working: improving outcomes for victims of domestic abuse in Kent - Alison Morton and Helen Foad

Helen foadSafeguarding is a thread that runs through all levels of the health visiting and school nursing service. When families are experiencing the effects of domestic violence or abuse, the health visitor or school nurse is often one of the first to become aware of such issues within the family. Providing support to these families is important as domestic violence or abuse can have a long lasting negative impact on physical and emotional health and wellbeing.

The principles of integrated working, good communication and client centred services have been recognised as central to improving outcomes for children, young people and their families. These messages are driving innovation in Kent to improve services for victims of domestic abuse.

I was delighted to be invited to Ashford to experience the work of Helen Foad who is one of 12 Domestic Abuse Lead Health Visitors in Kent. The Lead health visitors support the wider team and have developed local networks to improve services for people experiencing domestic violence or abuse.

By embracing multi-agency partnership working, Kent has developed an effective “One Stop Shop” drop-in service where victims of domestic violence and abuse can come for support and advice from a variety of agencies, all under one roof. These are now provided weekly in most of the large towns in Kent and support is available from the Domestic Abuse Lead Health Visitor, the Independent Domestic Abuse Advisors, Early help workers, Refuge workers, Housing advice, Benefits advisors, local Police and many also have the support of a local solicitor.  Helen explains that,

 “Often the attendees may be disclosing what is happening for the first time. In some cases the person may be in considerable danger, and need immediate safeguarding. Being at the One Stop Shop is very similar to being in Accident and Emergency; you never know what you may need to help with.

The One Stop Shops have become very well used as many agencies will now sign-post their clients if there are domestic abuse disclosures.

 Ashford's One Stop Shop is one of the busiest in Kent; in the year to March 2015 there were 316 attendees, representing all ages, cultures, sexual orientation, genders and backgrounds. Within these households there were 488 children affected by violence and abuse. The Health Visitor in the One Stop Shop offers support or services to these children. Consent is gained from the attendees to let their own Health Visitor or school nurse know what is happening and ensure follow up is provided”.

Helen describes the stigma often associated with domestic abuse,

“Domestic violence and abuse is still a subject that is hidden, and shame is felt by the victims. The One Stop Shop provides an accessible service to this hard to reach group, providing early intervention by Health Visiting and other agencies to reduce harm. Most of Ashford One Stop Shop attendees report that they find it “very helpful”, and some that it "saved their life”. Safeguarding vulnerable children and adults is the highest priority of the service”

Helen concludes by reminding me that, “domestic violence and abuse costs society £15.7 billion a year, 77 women were killed in 2012/13 and it can lead to physical, behavioural and mental health problems and affects life chances in adulthood”.

 The One Stop Shop in Kent provides an excellent working example of the benefits of integrated, locally-led, public health services for families, children and young people. I am sure many 0-19 teams will be interested to learn from the Kent One Stop Shop.

Helen Foad can be contacted by email:

Alison Morton: Seconded as Professional Advisor for Health Visiting, Public Health England;

Helen Foad: Domestic Abuse Lead Health Visitor, Fellow of the Institute of health Visiting, Kent Community Health NHS Foundation Trust

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