Presentation 3: Reflections and learning from implementing Routine Enquiry on Gender Based Violence Katie Cosgrove (Organisational Lead Gender-based Violence, NHS Health Scotland) – Background NHS Health Scotland policy on gender-based violence is to adopt a systems approach to ensure that the NHS recognised and met its responsibilities on gender-based violence as a service provider, employer and partner agency. It introduced routine enquiry on gender based violence as it was not being done - if you don’t know people’s life experiences then likelihood that the intervention will be partial at best. Previously the onus was on individuals to disclose even though that is very difficult for them and they don’t always make the connections. There is a debate about the traditional public health screening model which is about a population health intervention. Routine enquiry is not about screening, it’s about understanding and working with people to discuss what will help them. Implementation The intention wasn’t that should be assessed when they come in contact with every service, rather that routine enquiry should be done by key services that are more likely come into contact with women who have experienced abuse. Before implementing training, the team worked with Health Boards to encourage them to consider how to introduce routine enquiry effectively. Some services were in a better position to implement it than others, and those that are aligned to a medical model can find it harder to shift. Routine enquiry training was mandatory. Change is difficult. Some of the issues that were raised included lack of time, lack of expertise, opening can of worms, what we going to do, child protection concerns. Staff resistance is understandable as services are under pressure. Staff can be fearful of talking about abuse. Many NHS employees will have experienced abuse themselves in every training – session at least one member of staff disclosed abuse, reinforcing the need to take care of our staff. Leadership is incredibly important, both nationally from the Scottish Government and at a local level. There wasn’t a script for workers to follow; instead they were trained and supported on how to have the conversation. It’s not about asking you experiencing domestic ‘are abuse?’, rather you living in fear? are you being harmed?’ etc. ‘are Not all people recognise their experiences as abuse. They may need help to piece it all together and recognise it as abuse, and information to help them make informed decisions their narrative is important as they’re the expert on their lives not – services/workers. Not everyone will need counselling.
Presentation 3: Reflections and learning from implementing Routine Enquiry on Gender Based Violence Katie Cosgrove (Organisational Lead – Gender-based Violence, NHS Health Scotland) Background NHS Health Scotland policy on gender-based violence is to adopt a systems approach to ensure that the NHS recognised and met its responsibilities on gender-based violence as a service provider, employer and partner agency. It introduced routine enquiry on gender based violence as it was not being done - if you don’t know people’s life experiences then likelihood that the intervention will be partial at best. Previously the onus was on individuals to disclose even though that is very difficult for them and they don’t always make the connections. There is a debate about the traditional public health screening model which is about a population health intervention. Routine enquiry is not about screening, it’s about understanding and working with people to discuss what will help them. Implementation The intention wasn’t that should be assessed when they come in contact with every service, rather that routine enquiry should be done by key services that are more likely come into contact with women who have experienced abuse. Before implementing training, the team worked with Health Boards to encourage them to consider how to introduce routine enquiry effectively. Some services were in a better position to implement it than others, and those that are aligned to a medical model can find it harder to shift. Routine enquiry training was mandatory. Change is difficult. Some of the issues that were raised included lack of time, lack of expertise, opening can of worms, what we going to do, child protection concerns. Staff resistance is understandable as services are under pressure. Staff can be fearful of talking about abuse. Many NHS employees will have experienced abuse themselves – in every training session at least one member of staff disclosed abuse, reinforcing the need to take care of our staff. Leadership is incredibly important, both nationally from the Scottish Government and at a local level. There wasn’t a script for workers to follow; instead they were trained and supported on how to have the conversation. It’s not about asking ‘are you experiencing domestic abuse?’, rather ‘are you living in fear? are you being harmed?’ etc. Not all people recognise their experiences as abuse. They may need help to piece it all together and recognise it as abuse, and information to help them make informed decisions – their narrative is important as they’re the expert on their lives not services/workers. Not everyone will need counselling.
routine-enquiry_-november-2017-workshop-report-version-4-april-2018.docx