Archive for June, 2012

June 10, 2012

Themis – Locating IDVAs in hospitals

We had our first meeting on Friday with the six organisations who are going to be the research sites for our hospital based IDVA evaluation.  They are the IDVA team in Addenbrookes (Cambridge), Advance, the IDVA team in Bristol Royal Infirmary (who sadly couldn’t attend), North Devon WA, Victim Support in Newcastle and Worth Services.  As is always the case with these meetings, it is just so refreshing to hear from the different IDVAs, their managers and clinical champions about their work.  And, as is always the case, I learnt a lot.

The things that struck me most were:

1. The incredible determination and commitment of those involved.  It is only a slight exaggeration to say that some IDVAs are close to camping on a chair in the corridor of A&E, waiting for their opportunity to integrate with the process.

2. What a difference it makes to have a clinical champion and someone to advocate for the approach with the management of the hospital so that it is quickly embedded and integrated.

3. How much training is needed for clinical staff – it sounded endless in order to cope with high levels of staff turnover and low levels of DV awareness. Also the inconsistencies between one trust where DV training is mandatory and its neighbour in the room where it is not.

4. How in every single case, just the presence of the IDVAs in the hospital makes such a difference in terms of numbers of disclosures, and how many of these victims are unknown to any other agency.  I haven’t doubted that this is a wise approach – but it is really reassuring to hear again how true it is and how complementary to existing services.

5. Finally, the need to make the case for this work to public health commissioners in particular is acute.  More work to do…..

June 5, 2012

Updated MAPPA Guidance – the links with MARAC – clarity or confusion?

Version 4 of the MAPPA Guidance 2012 has recently been published, so I thought it was worth highlighting the areas that touch on MARACs given the continuing discussion about how the two processes fit together.  This guidance will replace the earlier version 3 published in 2009.  For the super conscientious, you can find the whole document at The pages relevant to MARAC are on 108-9.  Sadly, it seems that despite some consultation some of the points are still unclear.

The updated guidance is much shorter than the previous one.  It also uses ‘standards’ (what we at CAADA might describe as principles) for each element.  The standard in relation to MARACs is:

“MAPPA and MARAC work together to manage the risk of serious harm posed by offenders convicted of domestic abuse.”

We think clarification is needed on two points:

  1. The two processes should work together to manage the risk of serious harm posed by offenders convicted of any offence to victims of domestic abuse.  In our experience the majority of MARAC perpetrators are not subject to MAPPA.  For those who are subject to MAPPA, it is normally as a result of other offending, not domestic abuse.  If the domestic abuse is visible at MAPPA, i.e. is the index offence, then we would expect MAPPA to deal with it appropriately, with input from the IDVA and other agencies as set out in the guidance.  The concern relates to MAPPA offenders where the DV is ‘invisible’ and where the input of the MARAC is essential.
  2. The guidance says that the MAPPA should take precedence over the MARAC.  Of course it is a statutory set of arrangements – but in practice, a MARAC might be the better place to manage risk to the victim, and children, because of the wider range of agencies present.  Our expectation is that often a MARAC would be called before a MAPP meeting.

Finally, the referral form specifically asks whether a MARAC referral has already taken place and what actions arose from the MARAC meeting.

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June 1, 2012

Belated Congratulations to WRSAC for GlaxoSmithKline IMPACT award

I am probably the last to have heard, but just in case I felt it was worth celebrating the success of WRSAC (Women’s Rape and Sexual Abuse Centre in Cornwall) in beating over 350 other contestants to win the GlaxoSmithKline IMPACT award for their pioneering work supporting women experiencing domestic and sexual abuse in hospitals.  Readers of this blog will know that we are really focusing on building support for victims of domestic abuse in a hospital setting so it is fantastic to see the recognition of WRSAC’s work in such a prestigious way. WRSAC has a hospital based IDVA service and has helped to introduce routine enquiry so that many more victims of domestic abuse are identified.  We are really proud to say that WRSAC is a Leading Lights accredited service.

Let’s hope that this prize brings more focus by health commissioners on the value of such services so that one day we will see them all across the country.  Congratulations to the pioneers in Cornwall!