Violence against women and girls funding review: analysis of responses

Question 4.4

What role should the NHS play in the provision of services for women, children and young people experiencing violence against women and girls?

229 responses were analysed for this question, consisting of 158 individual responses and 71 organisation responses. The organisations that answered this question included 8 local authorities/governments, 4 NHS organisations, 40 third sector organisations, and 19 classified as "other" or did not specify. There were six themes emerging from the qualitative analysis of the free-text responses to this question,

Theme 1: Single-sex spaces

The most frequently mentioned theme in this question was the need for single-sex spaces. Respondents believed that the NHS should have a major role in providing services for females by female nurses as victims of VAWG would feel safer in single-sex spaces. Some respondents suggested that services for other individuals identifying as women should be offered separately.

"There should be specialised training for NHS staff who may be dealing with traumatised victims as there is a lot of misunderstanding about the effects of trauma and how they present in different people. This support should always be single sex wherever required so recruitment drives in this sector should be aimed at attracting more females specifically for this role." (Individual)

Theme 2: Mental health support

Respondents frequently mentioned the need for provision of mental health support. The majority of respondents highlighted that NHS Scotland should have a pivotal role in offering mental health services to victims of VAWG. Respondents described mental health support as counselling, encouragement and empowerment sessions. A few responses mentioned a holistic approach, consisting of physical health, and forensic examination offerings.

"Women told us that they felt there had to be better provisions for counselling and for waiting lists to be reduced for mental health support for both them and their children." (Third sector organisation)

"The NHS should provide the expertise for counselling and medical support. Ensuring that any counselling accessed is of high quality and professionally competent." (Individual)

Theme 3: Interagency collaboration and signposting

Responses frequently asked for close interagency collaboration such as the complementarity of provision by third sector organisations, local governments and the police. Respondents explained that each service has a different set of experiences and expertise, thus by working together victims of VAWG would benefit the most. Some responses highlighted the role of the NHS in signposting. For example, when the NHS practitioner does not have the capacity or expertise to treat a case, they should direct the individual to the appropriate service, and proactively engage with the police and other statutory bodies.

"NHS should continue to play a pivotal role in supporting and referring women, children and young people experiencing, having experienced or at risk of experiencing GBV. Expectation of true partnership working with specialist organisations should be standard across all areas in Scotland ensuring women, children and young people get access to all requisite services at any and all points of need. Partnership working should be embedded into daily practice between NHS and the local GBV specialist service providers. NHS should be represented at all GBV partnership meetings, requisite forums and steering groups" (Third sector organisation)

Theme 4: Additional training

The need for further training was frequently mentioned as one of the key roles the NHS should play in the provision these services. Respondents said that NHS staff should be adequately trained to treat the most severe cases of VAWG and be aware of practices for identifying early signs of abuse. Some respondents also mentioned the need for trauma-informed care. Lastly, a few responses suggested that the NHS should also have a role in training non-specialists and volunteers in the VAWG space.

"The NHS, while it is a fantastic service and so, nurses need to be trained, if they wish, to be a point of contact for someone who may be needing help. They need to be trained in order to see and listen in case they or another person things that women or child needs help. A lot of the nhs staff would love to assist but unfortunately do not have the training in order to approach the person concerned. All nhs staff, from porters to reception need to have at least one person who has the training to approach the person they think needs help." (Individual)

Theme 5: Additional specialist teams

The next most common theme was the need for additional specialist teams within the NHS. Respondents explained that this would reduce the need for signposting to other organisations and would also ensure faster and better treatment.

"Appropriate care and clear pathways for support within both universal and specialist services are core business for NHS Scotland. The role of Mental Health and Psychological Trauma Services are crucial in supporting all survivors of GBV to recover to the fullest. Further specialist services which NHS Scotland are ideally placed to provide and/or maintain include Sexual Assault Referral Services and also FGM revision surgery." (Local Authority)

Theme 6: Routine enquires

Lastly, some respondents suggested that the NHS should have a key role in conducting routine enquires about VAWG. This theme was commonly associated with the importance of prevention and early intervention, as the NHS could improve victims' outcomes, as well as save money, through timely identification and treatment of cases. Some respondents recognised that the NHS is already conducting routine enquires to an extent but felt that this needs to be further escalated.

"Despite routine enquiry being recommended in many health settings, the National Survivor Survey in Scotland shows than in reality, the right questions are not being consistently asked. Survivors believe this is in part due to health staff not having sufficient information about domestic abuse, including an understanding of coercive control and power dynamics, and therefore lack confidence in making enquiries. This may also indicate the need for a more ingrained and wide-scale cultural-shift to create an enabling environment for routine enquiry to be as effective as possible across all the many forms of health services." (Multi-agency partnership)