First full year impact of domestic abuse and sexual violence programme
A pilot programme at St Mary’s Hospital helped almost 100 patients affected by domestic abuse and/or sexual violence in 2024 - its first full year of operation.The programme is called ADViSE (Assessing for Domestic Violence and Abuse in Sexual Health Environments) and also trained 65 members of staff members within the hospital’s sexual health team - supporting them to identify and help patients who may be affected by domestic abuse and sexual violence.
The pilot is a partnership between Imperial College Healthcare NHS Trust, Advance, the domestic abuse charity, and IRISi, a social enterprise. It is funded for an initial two-years by London’s Violence Reduction Unit and is hosted by the hospital’s Jefferiss sexual health service.
ADViSE is run day-to-day by a full-time advocate educator who provides ongoing training and support for staff, as well as in-house specialist assessment and support for survivors – linking in with specialist services. In 2024, the first full-year of operation, the hospital’s ADViSE programme received referrals for 94 patients experiencing domestic abuse and/or sexual violence. 100 per cent of patients who provided feedback on the service in 2024 stated that they were pleased to be referred to a specialist domestic and sexual violence and abuse worker.
The team plans to further embed the programme and continue training staff on different topics in this area, including resident doctors who rotate in and out of the team every six months, so they can help as many survivors as possible.
Advance estimate that one in four women in the UK will experience domestic abuse. Domestic abuse includes physical, emotional and sexual abuse from partners or ex-partners or between family members. It can happen to anyone, regardless of age, gender, ethnicity or sexuality. Domestic abuse is often connected to sexual health and gynaecological problems. It has links to an increase in sexually transmitted infections, including HIV, and unintended pregnancy.
The ADViSE programme was first developed and piloted by IRISi. It is co-managed at St Mary’s Hospital by Imperial College Healthcare and Advance.
Dr Ali Mears, consultant in sexual health at Imperial College Healthcare NHS Trust, said: “We are thrilled to be hosting this programme and to have the opportunity to identify and support more patients affected by domestic abuse and sexual violence.
“Anyone can face domestic abuse and sexual violence, regardless of gender, age, ethnicity, socio-economic status, sexuality or background. Working with our partners, we want to provide a safe space for patients to access non-judgemental, comprehensive and expert support and advice. Whether the abuse is currently happening or happened many years ago, we want to be there to help. Being able to support and empower our patients is priceless.
“I’m grateful to all our partners for making this programme possible, including of course our domestic abuse advocate educator and wider colleagues supporting patients.”
Ramisha Patel, senior service manager - health and children social care, who manages the ADViSE programme at Advance, said: “Advance is dedicated to improving healthcare responses and outcomes to domestic abuse. Collaborating with Imperial College Healthcare NHS Trust and IRISi through the ADViSE programme marks a significant leap forward. This London pilot excites us, promising expanded survivor access to crucial services.
“Our partnership builds on our previous work together supporting survivors of domestic abuse pre and during the pandemic. It ensures survivors of domestic abuse and sexual violence get increased support in familiar settings.
“Advance’s dedicated ADViSE advocate educator provides guidance and support to both survivors and healthcare professionals at the hospital, ensuring survivors receive the care they need to be safe and professionals are equipped with the necessary tools to respond to domestic and/or sexual abuse disclosures, needs and risk.”
Melanie Goodway, director of programmes and innovation at IRISi, said: "The ADViSE programme provides clinicians with a straightforward referral pathway to specialist services, ensuring gender-based violence is recognised and addressed as a health issue. By connecting health and specialist services, ADViSE strengthens the healthcare response to domestic abuse and sexual violence while reaching diverse populations often overlooked by traditional services. IRISi, the organisation behind ADViSE, continues to demonstrate the programme’s growing impact.
“Sustained funding is critical, as maintaining the programme ensures referrals continue to grow and more survivors can access the life-saving support they need. In contrast, evidence shows that funding gaps cause referrals to drop sharply, leaving survivors without help at their most vulnerable. Public investment is essential to building a robust, integrated, and sustainable system that provides lasting support for those affected by domestic abuse and sexual violence."
Lib Peck, director of London’s Violence Reduction Unit (VRU), said: “We are committed to working in partnership with the healthcare sector and domestic abuse specialists to intervene at critical moments and provide vital support for those affected by domestic abuse.
“Our funding will help train staff to better identify and provide support for those who are not usually recognised or supported with the services they desperately need."
The ADViSE advocate educator at St Mary’s Hospital, who wishes to remain anonymous due to the sensitivity of the role, said: "My role supports patients and also professionals in identifying and responding to signs that a patient may be experiencing abuse.
“Education around healthy relationships is a key aspect of what I do, as often red flags are not obvious to someone experiencing abuse. I know this all too well, as it's not uncommon to have a patient I'm supporting say to me, 'I never even realised what I was I am going through is abuse. I thought abuse was only physical.”
The NHS website has information about domestic abuse and sexual violence, including where to get help.
