Communities and Culture Committee

Scrutiny Inquiry : Domestic Abuse

Response from Conwy & Denbighshire NHS Trust

May 2008

The Conwy & Denbighshire NHS Trust is committed to recognising the effects of Domestic abuse to both staff and clients, thus work has been on going to ensure support is available for both staff and client who are victims of abuse. The following paragraphs highlight the work that has been undertaken during the last year, the continued areas of work and the challenges for the year ahead.

The document 'Tackling Domestic Abuse: The All Wales National Strategy (2005) recommends 'individual agencies/organisations/employers adhere to the minimum standards’.

Key Achievements during the Last Year within the Trust

The All Wales Pathway for Antenatal Routine Enquiry implemented. Midwives ask pregnant women, when the opportunity arises, direct questions with regard to domestic abuse.
92% of Midwives within the Conwy & Denbighshire Trust have completed training with regards to the All Wales Pathway.
72% of Health Visitors within the Conwy and Denbighshire Trust have completed training with regards to the All Wales Pathway.
General information/ awareness pathway sessions for obstetric medical staff, SCBU

Letters to all General Practitioners sent in Conwy and Denbighshire area and letters to social services. All midwifery community areas have a Domestic Abuse resource box, containing relevant support information and guidance.

Compliant with Welsh Risk Pool Standard 15 'The management and local support strategies for women who disclose domestic violence’.
Since commencing the pathway fourteen clients have disclosed domestic abuse. Support provided for these clients and child protection processes initiated.
Domestic Abuse Policy Group reformed, to develop a Trust Domestic Abuse Policy for Employee’s. The group meets bi-monthly. Policy has now been ratified.
Awareness sessions held to highlight the need for Trust Employee Domestic Abuse Policy. Positive feedback received from the sessions.
Trust Level Three Child Protection training sessions focused on domestic abuse and its impact on Child Protection issues.
Achieving compliance with NICE Antenatal Guidelines, The Confidential Enquiry into Maternal and Child Health (CEMACH) and the Royal College of Obstetricians and Gynaecologists (RCOG) Guidance, with regards to antenatal direct questioning.
Domestic abuse module to be included in the North East Wales Institute (NEWI) timetable for Trust staff to access to commence March 2008. Module developed between Trust and NEWI staff.

Continued Ongoing Areas of Work

The All Wales Group formed to produce an All Wales Domestic Abuse pathway for women’s health services, to include gynaecology and other integrated sexual health services is being implemented within the Trust. Two members of the gynaecology team are members of the All Wales Group.
The All Wales Domestic Abuse Pathway for clients who attend A&E is ready to be implemented; training will start within the next month. Two members of the Trust’s A&E department are on the All Wales Group.
Trust Attendance at Multi Agency Risk Assessment Meeting (MARAC). Minutes received from Conwy & Denbighshire meetings (child protection perspective).
Professional links formed with both Conwy and Denbighshire Domestic Abuse coordinators, who have had valuable input in training days, provided leaflets, posters and information with regards to external study sessions for the Trust.
Continued direct domestic abuse questioning for all antenatal clients. Disclosures dealt with appropriately and referred to MARAC and Child Protection professionals, thus increasing safety and reducing risk.
Ongoing meetings with Executive Nurse and provide relevant updates as required.
Bid written and submitted applying for a Trust Domestic Abuse Coordinator from Trust.

Challenges for the Year Ahead

Employ a Domestic Abuse Coordinator for the Trust to ensure the Trust is working in line with the Welsh Assembly Document 'Tackling Domestic Abuse: The All Wales National Strategy’ (March 2005).
Implement Domestic Abuse Policy for all Trust employees.
Domestic abuse to be included as part of the Trust induction day for new staff.
Continue to raise awareness with regards to domestic abuse throughout the Trust.
Training available for ward/department managers to ensure they have adequate knowledge to support them in managing staff who experience domestic abuse.
Develop and implement a Trust Training Strategy for Domestic Abuse.
Domestic abuse to be highlighted and awareness raised throughout the Trust.
All clients admitted to the Trust to be asked direct questions with regards to domestic abuse on admission.

Summary

This report highlights the considerable amount of work that has been undertaken and that is required to be undertaken in the coming year. Domestic Abuse is a hidden crime that needs the commitment of all agencies and employers to the national strategy.

Implementation of the above will have the potential to provide staff with support, to reduce sickness levels, increase disclosures from clients and thus provide support as appropriate, and increase the safety of children in Conwy and Denbighshire by ensuring referrals to the Safeguarding Children Team.

Gill Murnane
Senior Midwife - Risk Manager
Domestic Abuse Trust Link.