Domestic abuse. Introduction. What is domestic abuse?

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1 Domestic abuse Introduction There are some issues which seem to sit outside the immediate remit of the employer but are so important that they exert an obligation on employers to get involved. One of these issues is domestic abuse. Its effects can be extremely distressing on a personal level and the costs to society as a whole are huge. Domestic abuse is a hidden epidemic and by its very nature affects the NHS and all the staff who work for it. A fifth of all violent crime occurs in the course of, or at the end of, a long-term relationship between two people. In England and Wales domestic abuse results in more than 125 deaths a year. Two women are killed by a partner or expartner each week and one man every second week. Thousands of people turn up each year in hospital casualty departments and doctors' surgeries with injuries inflicted by a current or former partner. While the physical effects are the most obvious signs of the damage being done by domestic abuse, the mental and emotional repercussions of these attacks go much deeper. The NHS is affected as both the provider of care for those subjected to domestic abuse and as the employers of thousands of staff who suffer domestic abuse or are the perpetrators of it. For this reason NHS Employers and the Department of Health were invited to join the executive committee of the UK Corporate Alliance Against Domestic Violence (CAADV) to raise awareness of domestic abuse among management and staff in the service and in doing so help reduce levels of violence and the impacting costs. These aims can only be achieved by working in partnership with senior managers in the field who are prepared to add this issue to their agenda and raise awareness among their staff. The Government is already doing much to raise public awareness of this problem, which includes introducing legislation and investing heavily in services for victims. Some government departments, including the Department of Health, have been working to raise awareness among their staff and to publicise the facilities available to help victims. NHS trade unions have also done some valuable work in this area and have produced some joint guidance and tools with NHS Employers for trusts and staff, more information on which can be found within this chapter. What is domestic abuse? The Home Office defines domestic abuse as:

2 "any violence between current and former partners in an intimate relationship, wherever and whenever the violence occurs. The violence may include physical, sexual, emotional and financial abuse" (Home Office 2003:6) A more comprehensive definition would be: "Domestic violence is a pattern of controlling behaviour against an intimate partner or ex-partner, that includes but is not limited to physical assaults, sexual assaults, emotional abuse, isolation, economic abuse, threats, stalking and intimidation. Although only some forms of domestic violence are illegal and attract criminal sanctions (physical and sexual assault, stalking, threats to kill), other forms of violence can also have very serious and lasting effects on a person's sense of self and well-being 1 ( Domestic abuse can happen to anyone, and in all kinds of relationships heterosexual, gay, lesbian, bisexual and transgender. People suffer domestic violence regardless of their social group, class, age, race, disability, gender, sexuality or lifestyle. The abuse can begin at any time in new relationships or after many years spent together. Why is domestic abuse an issue for the NHS? The issue for the NHS is twofold in that it affects it both as an employer of staff who are victims and as the provider of services that deal with the physical and mental problems resulting from domestic abuse. It is in the unique position to ensure that anyone falling victim to domestic abuse can be offered the support they need. If employers can create a safe environment that encourages people to reveal that they have been subjected to some form of domestic abuse, help them recognise that this is not acceptable and enable them to seek help and support, then they can make a real difference for thousands of people and their families. The direct and indirect costs of domestic abuse to the NHS are wide ranging, employees are subject to domestic abuse and so a cost the service in terms of increased sickness absence, work error, lost productivity, increased labour turnover when staff leave and medical and psychiatric care. By raising awareness of the issue and implementing supportive domestic abuse policies, employers in the NHS will be helping to reduce the number of domestic abuse cases and the costs to the service. The legal situation NHS employers have a duty to protect their staff from violence and the NHS has taken a strong stance against verbal or physical assaults on staff by patients or relatives (see the chapter on violence against staff). The position with domestic abuse is more complex because in most cases the domestic abuse will occur away from the work environment. 1 Statement of Principles and Minimum Standards of Practice for Domestic Violence Perpetrator Programmes and Associated Women s Services (2004), Respect

3 However, there may be occasions when the violence or harassment occurs at work, especially if the victim has left the family home and work provides a known way to contact or confront them. The NHS may have a legal duty to take steps to protect employees at such time, under Health and Safety at Work legislation. A domestic abuse incident at work may not just affect the victim. Other staff may witness an assault and may be put at risk by it, for example if they try to intervene. As such incidents may be unpredictable, especially if the employer is unaware that a staff member is the victim of domestic abuse, it may be hard to take effective action. However, there will be some cases when the employer is aware of the risk and can take action to reduce it. Employers can also seek to prevent staff carrying out violence or harassment of partners while at work. This could encompass having policies on dealing with employees who send abusive s or make abusive phone calls at work. There may be cases when one employee is harassing another with whom they have a personal relationship. This is likely to fall within the remit of an organisation s bullying and harassment policy and could lead to disciplinary action (see the chapter on bullying and harassment). However, in many cases domestic abuse is likely to take place entirely outside the work environment. While the employer is unlikely to have legal responsibility in these circumstances, good employment practice could include providing information and support, allowing the employee time off for meetings associated with the incident, and taking a sympathetic approach to problems at work which arise because of the domestic abuse. Employer responsibilities The costs of domestic abuse to employers can be huge. It contributes to sickness absence, bad time keeping and lack of productivity. The NHS is committed to becoming an employer of excellence. Within the fields of staff health and welfare this includes recognising the problems of staff suffering from domestic abuse. Domestic abuse does not just impact on home life 75 per cent of domestic abuse victims are targeted at work by telephone calls and s. People who have left an abusive partner are especially vulnerable at work as the workplace is easily identified as a place of contact by perpetrators. In addition to this: 56 per cent of abused women arrive late for work at least five times a month 28 per cent leave early at least five days a month 53 per cent miss at least three days of work a month. It is not expected that employers should perform a counselling service, as there are many professional groups who are specifically trained to deal with this. However, employers can play an important supporting role by developing policies, launching a communications exercise to raise awareness among the

4 workforce, having trained staff in the form of response teams who can provide a listening ear and help staff make the right decision on where to go next for advice and support. Employers can also offer flexible working arrangements so that staff are able to have time off work or the opportunity to work flexibly to enable them to seek protection, go to court, seek housing or arrange childcare. Domestic abuse policy A draft domestic abuse policy for trusts to adapt, which ties in with existing violence and aggression policies, is now available on the Healthy Workplaces section of the NHS Employers website ( This policy has been produced in partnership with colleagues in the field, and provides a clear statement to staff of the support they can expect from their employer if they are subjected to domestic abuse, especially if the perpetrator carries that violence into the workplace. The aim of the policy is to promote the health, safety, well-being and productivity of all employees but the success of its implementation relies heavily on the commitment of staff at all levels within the organisation particularly board level and its integration into the trust culture and management practice. Trusts should consider forming a working group locally to tailor the policy with representation from the board, staff, security, occupational health, health and safety, human resources and legal advisers. Any policy should be linked with disciplinary procedures, making clear that any acts of violence, aggressive behaviour or harassment in the workplace could potentially lead to dismissal. There are also implications around conduct outside of the workplace which could also lead to disciplinary action due to its impact on the employment relationship. It is also important to ensure that the policy covers issues for the whole workforce, including awareness training for staff who may come into contact with patients or colleagues who may be victims of domestic abuse. Co-workers often want to help a person affected by domestic abuse, but do not know the best response and end up shielding victims from unwanted calls at work or covering for the victim s absence. They may even fear for their own safety if the perpetrator visits the workplace. Training should be in place before the new policy is published and awareness raising begins. Communication designed to offer support should be delivered in ways that staff can access privately, for example in s. A good way to reach staff may be to put the telephone numbers of support groups in changing rooms or toilet facilities. It is also important that communications do not give the message that domestic abuse is seen as solely affecting women. Unison have also published a guide Raise the roof on domestic abuse 2 which provides a checklist for negotiating a workplace policy. It is also campaigning 2 Raise the roof on domestic violence, Unison

5 for training for all workers who may come into contact with domestic abuse in their place of work, for example hospital workers, housing and care workers. A domestic abuse policy checklist The following points provide a possible template for a domestic abuse policy. Set out policy aims: identify the policy's objectives. These might focus on supporting employees subjected to domestic abuse but could also include raising awareness of domestic abuse as an issue for the workplace, ensuring that all employees see it as a matter relevant to the organisation and its performance. Define domestic abuse: the Home Office has defined domestic abuse as "any violence between current and former partners in an intimate relationship, wherever and whenever the violence occurs. The violence may include physical, sexual, emotional and financial abuse." Domestic violence and the workplace: link the domestic abuse policy with disciplinary procedures, stating any acts of harassment, violence or aggression could lead to dismissal, and point out that conduct outside of work could also lead to disciplinary action because of its impact on the employment relationship. Confidentiality: stress that the employer respects an employee's right to confidentiality, but that in circumstances of child protection, or the protection of vulnerable adults from abuse, relevant protection services may need to be involved and that complete confidentiality cannot be guaranteed in these circumstances. Anti-discrimination: state that the organisation recognises that victims of domestic abuse may have absence or work performance problems, and that all aspects of a person's circumstances will be considered when addressing these work issues. Absence: set out the arrangements for helping employees experiencing domestic abuse to take time of work or work flexibly. These provisions should include temporary flexible working hours to enable them to seek protection, go to court, seek housing or arrange childcare, or the use of paid leave or informal paid leave, particularly if requests for time off are for short periods. Safety at work: state that the organisation will support employees to minimise the risk of their safety at work if they inform the employer that they are experiencing domestic abuse. Supporting employees: set out how different functions in the organisation will help those experiencing domestic abuse, for example, by being available and approachable to employees experiencing domestic abuse. Line management training: describe how managers will be trained to identify if an employee is experiencing difficulties, provide initial support, offer referral to other support agencies, but to know when to draw the line in offering advice.

6 Raising awareness: describe how the organisation will raise awareness of domestic abuse by publicising external resources for survivors and perpetrators of violence and the organisation's policy. Perpetrators While many NHS employees may be victims of domestic abuse, it is also likely that some will be the perpetrators of it. Respect (established as a registered charity in 2000) is the UK membership association for domestic abuse perpetrator programmes and associated support services. Its key focus is on increasing the safety of those experiencing domestic abuse through promoting effective interventions with perpetrators. Information and advice is available for people who are abusive towards their partners and wish to seek help. It is also available to their partners or ex partners, friends and family; and to employers or frontline workers who come into contact directly or indirectly with perpetrators of domestic abuse or people that they suspect are perpetrating domestic abuse. Further information can be found on the Respect website at or by phoning the organisation on Further guidance is being produced by NHS Employers on dealing with perpetrators in the workplace and will be available on their website at under the Healthy Workplaces section. More information The NHS Employers website has a comprehensive list of contacts and support organisations. Corporate Alliance Against Domestic Violence (CAADV) Home Office Raise the roof on domestic abuse, Unison Respect