Impacts from delivering a whole health response strategy to domestic violence and abuse: an evaluation from the UK

In this brief report, we evaluate Health Pathfinder, a ‘whole health response’ to domestic violence and abuse (DVA) in the United Kingdom. We used two national datasets: monitoring data for high-risk cases, and a service-level database used to track the performance of DVA services across the UK. Drawing on a comparative interrupted time series analysis over 2018–2019, we considered the impact of implementation in each of the eight sites on rate of referral of high risk cases standardised by the number of adult women in each area, and on composition of victim-survivors seen by services. Implementation of Health Pathfinder was associated with a 10.9 per cent step change in the rate of high-risk referrals, and growth in subsequent quarters of 10.1 per cent. At the same time, implementation of Health Pathfinder was linked with a 33.6 per cent step change increase in the proportion of victim-survivors seen by services that were judged not to be at highest risk (that is, taking up services earlier). Our findings reflect both underlying system improvements across multiple stakeholders involved in Health Pathfinder as well as improved detection of DVA across a wider spectrum of risks, and provide additional evidence that multilevel interventions to improve DVA victim-survivors’ experiences are effective.