Adapting domestic abuse training to remote delivery during the COVID-19 pandemic: a qualitative study of views from general practice and support services

Abstract

Background: Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working which extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. Aim: We aimed to understand the adaptations and impact of remote DVA training in IRIS-trained general practices, by exploring perspectives of those delivering and receiving training. Design and setting: Qualitative interviews and observation of remote training of general practice teams in England. Method: Semi-structured interviews with 21 participants (three practice managers, three reception and administrative staff, eight general practice clinicians and seven specialist DVA staff), alongside observation of 11 remote training sessions. Analysis using a Framework approach. Results: Remote DVA training in UK general practice widened access to learners. However, it may have reduced learner engagement compared with face-to-face training. DVA training is integral to the partnership between general practice and specialist DVA services, and reduced engagement risks weakening this partnership. Conclusion: We recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.

COVID-19 adaptations to a training and support programme to improve primary care response to domestic abuse: a mixed methods rapid study

“…The majority of advocates also reported positive support outcomes for their service users, although difficulties accessing onward support (creating a need to emotionally ‘hold’ service users while they waited for other support) were highlighted. This finding could be due to the precise and unusual set of circumstances brought about by the pandemic and accompanying national lockdowns rather than remote support per se; many other usual support services became (at least partially) unavailable during the first lockdown [ 36 – 38 ].…”

“…A report by the Health Foundation highlighted that many healthcare services had to adapt as a result of the pandemic and move towards a remote mode of working and that, in general, services that managed to adapt well relied on quickness and responsiveness as enablers of change [ 39 ]. A directly comparable qualitative study, aiming to understand the adaptations and impact of remote DVA training in IRIS-trained general practices by exploring perspectives of those delivering and receiving training [ 38 ] found benefits to widening the accessibility of training to greater numbers of busy healthcare professionals. This research reported a distinct trade-off between accessibility and levels of engagement – an anxiety shared by many of our participants.…”