Domestic violence and violence among young people are being tackled by two recently appointed specialists at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT).

Rebecca White is UHMBT’s new Emergency Department Navigator (EDN) working with young people aged 10 to 25 years, and Natalie Wright is the Trust’s new Independent Domestic Violence Advisor (IDVA). These roles require great sensitivity, skill, and in-depth experience of dealing with violence as well as compassion, empathy, and kindness.

The National Institute for Health and Care Excellence (NICE) identifies domestic abuse as a major public health issue, impacting survivors and their children and families’ physical and emotional health and wellbeing, and may also include homelessness, loss of income/work, isolation, poverty, and financial hardship. The Department of Health says early intervention can reduce the many consequences of domestic violence and abuse.

Domestic abuse occurs across all sections of society and men are victims as well as women, however men are far more likely to be the perpetrators and women the victims. Women are also more likely to experience repeated and severe forms of violence, including sexual violence and are also more likely to have sustained psychological or emotional impact or result in injury or death.

UHMBT is endeavouring to break the cycle of violence because children who have witnessed domestic violence can end up being perpetrators when they are older. Domestic violence is predominantly perpetrated against women; however, the Trust has been seeing more men and older people recently.

Rebecca and Natalie work alongside UHMBT’s Safeguarding Team and their roles are funded by The Police and Crime Commissioner.

Rebecca, who previously worked as an IDVA for UHMBT and as an offender manager for the police, said: “The aim of this new role is to reduce violence in younger people through early intervention and support – this is a Home Office priority and is a funded role by Lancashire Violence Reduction Network.

“I mainly work in the Emergency Department (ED) with young people who have come in with injuries, challenging behaviour, substance abuse, mental health problems and other issues.

“When I am alerted to a young person in the Trust’s care who might benefit from additional support, I approach them to see why they have come in and ask them if they would like to talk about it. We have a chat and I let them know that there are various kinds of support that we can offer such as confidential counselling, mentoring and diversionary activities making sure they have good support at home, accessing support for any substance abuse issues, making supportive plans with them, and helping them with reporting things to the police if necessary.

“Everything is done with the young person’s consent. We work together to build a bespoke plan for them with the aim of preventing further violence and other crimes. Ultimately, it is about making communities safer for everyone and improving the health and wellbeing of our young people.

“We’re part of a multi-disciplinary network of organisations including the NHS, social services, the police, charities, local councils, and schools. We’re currently managing around two to three referrals every day. The hospital at Lancaster sees significantly more cases of violence because it covers such a large area.”

Rebecca’s role also involves supporting people at risk of criminal exploitation.

She said: “Exploitation doesn’t just happen in less affluent communities – anyone can be targeted by criminals seeking to exploit them. My role is to help find people who have gone under the radar and need help.

“For many people I work with, it is their first time of disclosing. Our aim is to coordinate a safe response as we want the hospital to be a safe place for everyone. We do this by liaising with other services to make sure people are getting the right support and services for their individual needs. My last role involved offender management and I have a lot of experience in dealing with vulnerable people and people in crisis situations.”

UHMBT has a system for recording patient safety concerns via Patient Safety Incident (PSI) forms and when this is related to violence in younger people, it is referred to Rebecca.

Rebecca added: “I am excited to be doing this job because young people have so many vulnerabilities these days and I feel that I can help them a lot. I can empower them with the knowledge and options to decide for themselves what they want to do.”

Natalie is also excited to be in her new role. She has worked for the NHS for nine years starting in the Emergency Department as a Clinical Support Worker and Patient Flow Coordinator. Natalie then went on to work alongside the police as an Independent Domestic Violence Advisor (IDVA) where she would respond to emergencies with the police to support victims and families of domestic violence. Natalie has now become the IDVA for the Trust.

An IDVA is a trained specialist who provides a service to victims at high risk of harm from intimate partners, ex-partners, or family members, with the aim of securing their safety.

Natalie said: “I support victims of domestic violence and they can be patients or staff members. I can see people face-to-face or, depending on the risk factors, speak to people over the phone.

“Everything is done with the victim’s consent. We explain everything clearly and we try to provide the best possible support. We will discuss what has been going on, and I will complete a risk assessment.

“It will then go to a Multi-Agency Risk Assessment Conference (MARAC), if required, which is a meeting where information is shared on the highest risk domestic abuse cases between other IDVA services, representatives of local police, probation, health, child protection, housing practitioners, and other specialists. In this meeting the needs of the victims are discussed, and I am there to give advice and put safety measures in place.

“I can also look at the person’s plan of care, set up non-molestation orders and find a refuge for the person if they need to move out of the home or area. We will discuss safety planning to ensure that the victim feels safe and has measures in place to protect them.

“While the person is in hospital, I make sure they are safe and make sure it is safe for them to leave hospital when they are discharged. Children are now classed as victims of domestic violence, so I also make sure that they are safeguarded.

“We are trying to break the cycle of violence. Children who have witnessed domestic violence can end up being perpetrators when they are older, so we want to break that cycle. There are support programmes we can use and partner organisations we can refer people to for help. Domestic violence is predominantly perpetrated against women, but we have been seeing more men and older people recently.

“In the IDVA role, we identify patients coming through the Emergency Department or they can be referred from other departments. We also receive referrals when Patient Safety Incidents are reported on the Trust’s system. Sadly, there is a huge demand for this service.”

Rebecca added: “Both of our roles are about working with partner organisations. We should be applauding the NHS for doing this important work. We hope it will instil confidence in people that we are tackling these issues.

“Our aim is to be a ‘Trauma Informed Provider’ which means that all colleagues will consider the trauma that people are facing and treat them with compassion and empathy.”