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Primary care has role in preventing violence

Experts say GPs can help to prevent violence

Adrian O'Dowd

Friday, 02 November 2012

A new public health approach to violence prevention that includes a role for GPs has been outlined in a new report from the Department of Health.

Protecting People, Promoting Health – A public health approach to violence prevention in England draws on the latest evidence to show that many of the key risk factors that make individuals, families and communities vulnerable to violence can be changed.

The Department commissioned the North West Public Health Observatory (NWPHO) to produce the report to provide information and evidence for policy makers and commissioners to use in developing preventative approaches with strategic partners.

In the 2010-11 British Crime Survey, more than a quarter (28%) of individuals who had suffered physical or emotional effects from intimate partner violence in the past year had sought medical treatment, most often at GP or doctors’ surgeries.

Training programmes for health care staff can raise awareness of violence, says the report, along with better recognition of the signs and symptoms of abuse, and knowledge of reporting and referral procedures.

The report cites the example of the Identification and Referral to Improve Safety programme in England, which provides practice based training sessions for primary health care staff, a prompt to ask about abuse in the medical record system and referral pathways to a domestic violence advocate.

The Department of Health had also produced a domestic abuse training manual for health care professionals and advocacy programmes providing support to victims of violence and their families such as brief support and counseling, which could be implemented in primary care as well as in community settings.

According to the report, there are 2.5 million violent incidents in England and Wales each year that result in 300,000 emergency department attendances and 35,000 emergency admissions into hospital.

Overall, violence is estimated to cost the NHS £2.9 billion every year, but the figure underestimates the total impact of violence on health because, for example, exposure to violence as a child can increase risks of substance abuse and obesity.

By adopting a public health approach, violence could be prevented, said the authors, and a range of different interventions throughout life could reduce individuals’ tendency for violence, lower the chances of those involved in violence being involved again and ensure those affected by violence got the support they required.

Planned changes to public health and other public structures should help with violence prevention, says the report, such as the establishment of Public Health England and locally accountable health and wellbeing boards as well as the movement of public health teams into local authorities and the election of police and crime commissioners to create multi-agency plans for violence prevention in all areas.

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