Table 2 IDVA service case studies

Hospital type

Large metropolitan hospital

Smaller rural hospital

Number of staff

7000

3000

ED patient-load

70 k/annum

42 k/annum

Age of service

5 years old

3 years old

Service cost 2014–15

£90,000

£40,720

Funded by

NHS England, Local Clinical Commissioning Group, City Council Public Health

Primary Care Trust initially, then a charitable trust

IDVAs employed by

Hospital trust

Third sector domestic violence and abuse organisation

Institutional integration

Full - staff are Trust employees with NHS badges, access to NHS emails and hospital computer system, able to ‘flag and tag’ cases and receive real-time alerts when patients with a history of domestic violence and abuse attend the emergency department.

High – IDVAs have an honorary NHS contract, enabling them to have an NHS badge, access to NHS emails and ability to ‘flag and tag’ cases on the hospital computer system. However, second IDVA faced six month delay getting contract.

Visibility

Very high – based in a room in the emergency department, IDVAs regularly use staff room

Very high - based in a room outside the main hospital building, but IDVA visited the emergency department and maternity wards regularly and could see patients in a quiet room in both locations.

Publicity

Posters widespread in hospital – plus use of other materials (e.g. mouse mats)

Leaflets and posters (after approval by six panels).

Number of IDVAs

Two full-time, seven days a week 9 am–5 pm

One full-time equivalent (two job-sharing), Monday to Friday 9 am-5 pm

Number of HCPs trained

271 in 2014–15

200 (plus 35 General Practitioners); 120 in 2015–16 (plus 27 General Practitioners)

Number of referrals 2014–15

365

97

Referral method

Often face-to-face by calling into IDVAs’ room, by phone, or (out-of-hours) by online referral form (including risk assessment) supplemented by access to the patient’s online hospital notes.

Emergency department staff mostly used paper forms; psychiatric liaison mostly used phone during office hours; maternity mostly used phone or told IDVA face-to-face on her regular ward visits.