Health Services Family Violence Intervention Programmes
Auckland District Health Board (ADHB)
Shine has a Family Violence Intervention Coordinator working alongside senior nurses employed by ADHB, who together make up the ADHB Family Violence Team. Together they coordinate the partner abuse part of ADHB’s Family Violence Intervention Programme (FVIP). The Ministry of Health requires all District Health Boards to introduce and maintain routine screening of all female patients for partner violence, as well as indicator-based screening of other patients for partner violence or child abuse. This national initiative is called the Family Violence Intervention Programme, commonly known within hospitals as FVIP. The idea is that by intervening early and providing timely support services to survivors and their children, the health care system can potentially avoid some of the long term health consequences, and therefore significant costs to the health care system.
Auckland District Health Board (ADHB) has been very pro-active for many years to reduce the incidence of family violence, and worked with Shine well before the Ministry of Health programme was started. ADHB is New Zealand’s largest District Health Board, with approximately 9000 staff. ADHB provides health services to the local population, and also has national responsibilities to provide specialist services at National Women’s and Starship Children’s Hospitals. Shine staff have been based within ADHB services since 2002, beginning with an Advocate at National Women’s Hospital. ADHB continues to be the only District Health Board in the country to have a FVIP collaborative contract such as this with an NGO.
Introducing a programme such as FVIP over such a huge and diverse staff is complex and time consuming. The procedures and systems which may be appropriate, for instance, in an Emergency Department, would be quite different in a post-surgical recovery ward. Staff work shifts and have many competing demands on their time and so training opportunities have to be fitted in and around this. It is also essential that once staff in each department or ward have been trained, that they continue to be supported and encouraged so that screening rates are maintained.
The team has also focused on better integration of the partner abuse and child abuse components of the programme. Core training for all new staff at ADHB now integrates child and partner abuse training into the same education session. This reinforces the co-occurrence between partner and child abuse, and the importance of health professionals asking about both partner abuse and child abuse.
We know that abused women can accurately and safely be identified in health care settings. The challenge and imperative of any FVIP is how to move beyond identifying women within health settings who have experienced partner abuse, to developing what is really required -- an integrated community response to family violence.
“Shine has played a key role in assisting ADHB to improve our response to victims of domestic violence, both by being part of our team that prepares and supports staff to screen for family violence, and by providing critical support for many of our patients who disclose family violence. We are fortunate to work with such great partners.”
Kay Hyman, GM Clinical Services ADHB
Auckland Primary Health Sector
In recent years, with support from the Auckland District Health Board, Shine has been working to establish routine family violence screening within primary healthcare services, such as GP practices, in Auckland City. Reaching into the primary healthcare sector is an opportunity to identify and support many more victims of family violence.
Research shows that women want their GP to ask the question they find too hard to raise - they trust their GP as a confidential person and believe this is a safe environment to get information (NZ College of General Practitioners).
The primary healthcare sector in Auckland City includes five Primary Healthcare Organisations (PHOs), 24 Well Child Providers, and a number of other primary healthcare providers. There are far too many of these organisations within ADHB to be targeted in a blanket approach. Hence, Shine is currently working with primary healthcare providers that have committed resources to develop a Family Violence Intervention Programme (FVIP) – primarily The Maori Health Coalition (formerly Te Hononga O Tamaki Me Hoturoa, a Maori PHO), and Auckland PHO.
Shine set up the PHO FVIP Steering Group in January 2010, beginning with three members from these two PHOs. The newly established Steering Group then identified Family Violence Champions from their member practices to join the Steering Group, and together, they are working to pilot FVIP within their practices. The Steering Group is also closely collaborating with the ADHB hospital-based Family Violence Team to develop family violence policies, protocols and systems to support PHO practices to routinely screen for family violence.
District Health Boards throughout New Zealand
For a number of years, Shine has been contracted by the Ministry of Health to support staff employed by District Health Boards around the country who deliver FVIP training to their staff. We also offer support to District Health Boards that opt to use their own internally developed training packages. Shine developed the standard Ministry of Health FVIP training package and Trainer's Manual. The Shine Health Trainer observes training being delivered, then offers support and feedback to ensure consistency of trainings at national level.
New Zealand College of Midwives
Because they often visit women in their homes and develop a very close relationship with these women, midwives are in a very good position to support women who are experiencing domestic violence. For a number of years, Shine has been delivering one-day training sessions throughout the country for the NZ College of Midwives. This training provides credit for midwives towards their Annual Practising Certificate.