Following on from the Commissioner’s visit to Yorkshire Ambulance Service, their Specialist Domestic Abuse Practitioner Lindsey English wrote a blog describing their pioneering approach to domestic abuse.
Domestic abuse affects our communities, patients and workforce. Ambulance services have a unique opportunity to identify and respond to abuse: we enter people’s homes, hear disclosures during moments of crisis, observe family dynamics and reach people who may have little contact with other services.
Yorkshire Ambulance Service NHS Trust (YAS) recognised that staff confidence in identifying and responding to domestic abuse needed strengthening, and that learning from Domestic Abuse Related Death Reviews (DARDRs) was not consistently translating into practice. In response, YAS became the first ambulance service in the country to appoint a dedicated Specialist Domestic Abuse Practitioner (SDAP).
By recruiting an experienced IDVA into the SDAP role, we have brought specialist domestic abuse expertise into the heart of the organisation. This has helped staff better identify and respond to domestic abuse, strengthened our safeguarding approach, and ensured victim-survivors can be more easily connected to the support they need.
We are particularly proud that YAS became the first ambulance service in the country to introduce dedicated clinical guidance on non-fatal strangulation which addresses an importance gap in practice. This guidance has strengthened our clinicians’ understanding of the risks associated with strangulation and their ability to recognise the signs quickly. We have also played a key role in developing and authoring the National Domestic Abuse guidelines for all ambulance clinicians by working in partnership with the Joint Royal Colleges Ambulance Liaison Committee (JRCALC).
Patients experiencing repeated mental health crises, self-harm or suicidal thoughts may also be living with domestic abuse. This is a key lesson from DARDRs, which highlight the close relationship between abuse, trauma and mental ill health. To address this, we partnered with Specialist Paramedics in Mental Health to equip our frontline staff with the knowledge and confidence to recognise these connections and provide more trauma-responsive care.
But our work extends beyond frontline emergency ambulance services. Domestic abuse training has been embedded within NHS 111 induction, helping practitioners recognise the signs, ask safe questions and know how to respond when speaking with a victim-survivor of domestic abuse. This approach will also be replicated within our 999 Emergency Operations Centre.
Non-emergency Patient Transport Service colleagues also have an important role to play. Because of their repeated contact with the same patients, they are well placed to notice changes in behaviour, relationships or living circumstances. Many of these patients have complex health and care needs that increase vulnerability and create additional barriers to disclosure. That’s why we have used targeted awareness campaigns to support our non-emergency Patient Transport Service staff to recognise and respond to domestic abuse earlier.
YAS has also strengthened its response as an employer, recognising that work may be the safest part of a colleague’s day. We have enhanced policies, manager guidance and support resources, working with our wellbeing team, HR and staff networks to create a culture where colleagues feel safe to seek help. Staff feedback indicates this has helped colleagues affected by domestic abuse access the support they need, while enabling them to remain safely in work where that is right for them.
While the benefits of embedded domestic abuse expertise are clear, delivering a consistent response across Yorkshire remains challenging. YAS works across three Integrated Care Board areas, multiple local authorities, police forces and domestic abuse services, each with their own referral pathways and partnerships.
Our SDAP helps bridge these differences, providing a single point of expertise, strengthening partnership working and helping ensure a more consistent response for victim-survivors across the region.
Ambulance and NHS 111 services have a vital, often overlooked role in the response to domestic abuse. Every interaction is an opportunity to recognise abuse and offer a route to safety. As an IDVA with almost 20 years’ experience, I will continue to advocate for that role because every contact counts, every conversation matters, and one interaction could change someone’s future.