The innovative program helping general practices support patients affected by family violence

  • Nurse talking to woman

Primary Care Pathways to Safety trains health care professionals to respond appropriately when patients disclose that they are impacted by family violence.

Sustained high levels of family violence in Australia have prompted several approaches across government and industry to try to better support victim-survivors and stop this national trend.

Many of these strategies involve police and the courts, while others focus on providing crisis accommodation and financial assistance.

An innovative program designed by North Western Melbourne Primary Health Network (NWMPHN), in collaboration with the University of Melbourne’s Safer Families Centre of Research Excellence, is finding success in an altogether different area – general practice.

It is well established that many people impacted by family violence first disclose this to a GP, nurse or receptionist at their local clinic.

NWMPHN’s program, called Primary Care Pathways to Safety, aims to empower practice staff to recognise such disclosures, and then to provide appropriate responses and referrals.

The program operates on two levels. First, it trains staff to provide appropriate support to patients impacted by family violence. This ranges from information on local services right through to alerting emergency and crisis organisations to provide immediate refuge and protection. Second, and just as important, it builds staff confidence to do so.

“As the Australian and Victorian governments have acknowledged, gendered violence has reached crisis proportions in this country, with family violence accounting for a large proportion of incidents,” said Bianca Bell, NWMPHN’s Executive Director, Health Systems Integration, who oversees the project.

“Often victim-survivors first tell what they are going through to people in primary care. General practices are safe spaces run by compassionate people, and Primary Care Pathways to Safety is a valuable pipeline to help ensure GPs, nurses and other staff can respond confidently and appropriately.”

The program began in 2019 as a pilot with funding from the Australian Government provided to 30 practices across Melbourne’s north and west for training and resources. It then went through two rigorous evaluations, by Safer Families Centre and the Sax Institute. The approach was found to be valuable and effective.

In 2022 it was renewed and expanded. NWMPHN is in the process of recruiting another 30 practices to undertake the training. This is done in tranches of 10, via expression of interest, and the response has been strong. Thus far, participating practices commissioned by NWMPHN have been largely located in Melbourne’s western and northern suburbs, which account for two-thirds of its region. At May 2024, only one of the 41 that have done the training is located in a rural area (in this case, the shire of Macedon Ranges). This reflects the sparser distribution of primary care services in non-urban areas.

Geographic location, however, is less important in the case of the latest expansion of the Pathways to Safety suite of resources. NWMPHN has designed, developed and commissioned a new secondary consult service, to commence in July that will be of immediate and free use to all practices across its 3200 square-kilometre catchment.

“The secondary consult service allows a GP to reach out to family violence specialist services,” explained NWMPHN’s Pathways to Safety program officer, Precious Farounbi.

“This can be for general advice, or for specific advice regarding a victim-survivor with whom they have an appointment.”

Ms Farounbi said the new service – delivered by two well-established community organisations – will increase capability, and build greater cohesion and coordination between general practices and other social care and family violence services.

“It’s also of direct benefit to patients,” she said. “They can be connected to family violence specialist services through warm referrals, which can lead them to the support they need, including legal advice and access to housing.”

Participation in Pathways to Safety has likely bolstered my confidence in recognising and responding to the impacts of family violence in the community,” said Dr Atef Asham, principal GP at Deer Park Medical Clinic (DPMC), who took part in the program in 2023.

“Through education and skill-building exercises, I have gained a deeper understanding of the signs of family violence and feel more prepared to intervene and offer support."

DPMC practice manager, Namarata Malhotra, agreed, adding that the benefits spread across the entire clinic. “The Pathways to Safety program has positively impacted the ability of the practice team to care for and support patients impacted by family violence,” she said.

“By equipping the clinical team with the necessary knowledge and skills, the program has enabled them to provide more comprehensive and compassionate consultation to patients experiencing family violence. This may include offering referrals to support services, safety planning, and ongoing follow-up to ensure the patient's wellbeing.

“Overall, it has enhanced the practice's capacity to address the complex needs of the patients affected by family violence.”

General practices have long been regarded as places of safety, support and confidentiality. With this program providing direct approaches to tackling the crisis of gendered violence impacting Australia, that reputation is set to be further enhanced and reinforced.

For more information about any aspect of the Primary Care Pathways to Safety program, please see this NWMPHN webpage.

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