1.1This protocol has been developed in response to the growing concern for the need to assess victims of domestic violence and any other dependants they have responsibility for, including children and elderly relatives.

1.2The protocol also applies to unborn children. Any violent act occurring in pregnancy should raise the level of concern for the mother, unborn child or other children in the household.

1.3Domestic violence is defined by the Home Office as “any violence between current and former partners in an intimate relationship, wherever and whenever the violence occurs. The violence may be physical, sexual, emotional and financial abuse. Domestic violence occurs across society, regardless of age, gender, race, sexuality, wealth and geography. However, it is predominantly women who suffer as a result of it” (Home Office, 2003a).


2.1This protocol has been produced in response to the growing recognition of the strong link between domestic violence and the abuse of children.

2.2In 90% of domestic violence incidents, the children are in the same room or the next room when the violence is taking place (Hughes, 1992). Therefore, they are either seeing or hearing the violence.

2.3In the USA, an association of between 45% to 70% has been found between father’s violence to the mother and his violence to the children (Stark & Flitcraft, 1996). Domestic violence is the biggest indictor of abuse to children.

2.4Domestic violence is a health issue and health care staff should be aware of the extent and seriousness of this problem. For example, women who have been abused are:

  • 15 times more likely to abuse alcohol
  • 9 times more likely to abuse drugs
  • 3 times more likely to be diagnosed as depressed or to be psychotic
  • 5 times more likely to attempt suicide (Stark & Flitcraft, 1996).

2.5Domestic violence accounts for 23% of all crimes in England and Wales (Home Office, 2000) and it has been shown that domestic violence often starts and /or escalates during pregnancy (Abbasi, 1998).

2.6This protocol should be read in conjunction with the Area Child Protection Committee’s Inter-Agency Guidance on the Assessment of Children in Need and the Child Protection Procedures (ACPC, 2001) and the Domestic Violence, Crime and Victims Bill (Home Office, 2003b).

2.7A child is defined by the Children Act 1989, as anyone under the age of 18 years. A vulnerable adult is defined by the Nottinghamshire Adult Abuse Unit as ‘ Any person aged 18 or over who is or may be in need of community care services by reason of: -

  • Mental or other disability, age or illness and
  • who is or may be unable to take care of him/herself or
  • unable to protect him/herself from significant harm or exploitation

3.1The aims of this protocol are to:

  • assist staff to assess the health needs and safety of victims of domestic violence;
  • assess the risks to anyone for whom the victim has responsibility towards, including children, unborn babies, elderly and vulnerable adults;
  • inform staff of the need to refer to other agencies to either gain information to make an assessment, or for the protection and support of the victim and their family.

4.PROTOCOL (see Appendix 1)

4.1Exclude the partner where domestic violence is suspected and assess the health needs of the victim, giving any emergency treatment as required and ensuring safety.

4.2Where the condition of the victim allows, take a history directly from the victim. With consent, photographs can be taken, using the consent and request forms for photography. Check previous attendances or other relevant admissions.

4.3Firstly enquire if there are any children in the household or if the victim is pregnant, consider any injury to the unborn child may need antenatal examination. Secondly enquire if there are any vulnerable adults in the family.

If there are children and they are not present, enquire where they are and who is caring for them. If the children are with the alleged abuser, consider referral to Social Services. Obtain basic details of the children e.g., date of birth, address, school, full name (this may be different from the mothers surname).

4.4Consider checking the child protection register. For children living in the City of Nottingham Tel:- 9159300 and in the County on Tel:-9605251. For children living outside of Nottingham contact their local Social Services Department via directory enquiries. An assessment of risk to the children will be based on:

  • information received from the victim (staff need to ask if domestic violence is occurring. (Appendix 2 outlines suggested questions). If the alleged abuser has injured the children previously
  • information received from other sources e.g. police, child protection register, family, friends etc;
  • the way that the victim may be behaving e.g. afraid, wanting to get home to the children quickly before being treated;
  • the extent of the injuries;
  • the actions that the victim may be considering to protect the children.

4.5 Enquire if there is a vulnerable adult in the household. If there is a vulnerable adult ensure that an appropriate adult is caring for them. If the vulnerable adult is with the alleged abuser, consider whether social services need to be contacted. Obtain their full name, date of birth, and any agencies involved in their care. An assessment of risk to a vulnerable adult will be based on information received from:-

  • the victim, particularly in relation to any previous abuse to the vulnerable person
  • other sources, e.g. police, other agencies, GP family, friends etc
  • the way the victim is behaving e.g. afraid, wanting to get home to the vulnerable adult quickly before being treated
  • the extent of the injuries
  • the actions that the victim may be considering to protect the adult

4.6When undertaking assessments, staff may need to consider that domestic violence may be associated with alcohol, drug misuse or other concerning adult behaviour.

4.7In all cases, offer the victim advice on support systems, refuges, help lines etc. so that they might be empowered to make informed choices (see Appendix 3 for contact numbers).

4.8If the police are not already involved, ask if the victim wishes to report the incident.

4.9Respect confidentiality and privacy and recognise the real dangers, which may be created if this is breached. The victim’s physical safety can be dependant on confidentiality being maintained. Consent should be obtained if information is to be shared with other health care staff or with other agencies in accordance with local protocols on information and confidentiality (except under the circumstances listed in 4.10).

4.10There may be situations where sharing of information without consent is required to protect individuals. Consent should only be overridden in cases of child protection, protection of vulnerable adults or in the interest of public safety when any refusal or delay in obtaining consent would endanger any individual. For example, when health care staff are aware that someone has been the target of domestic violence and is believed to be at serious risk of harm. This should be done following agreed protocols and the reasons for disclosure discussed with the victim.

4.11Record all actions, treatments and information given to the victim.


Queen’s Medical Centre is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on the basis of their ethnic origin, physical or mental abilities, gender, age, religious beliefs or sexual orientation.


Abbasi, K (1998) Obstetricians must ask about domestic violence British Medical Journal Vol. 316, January p. 7

Area Child Protection Committee (ACPC) (2001) Guidance on the Assessment of Children in Need and Child Protection Procedures Nottingham: ACPC

Home Office (2003a) Safety and Justice: the Government’s Proposals on Domestic Violence (Cm5847) London: HMSO

Home Office (2003b) Domestic Violence, Crime and Victims Bill London HMSO

Home Office (2000) The 2000 British Crime Survey for England and Wales London: HMSO

Hughes, H (1992) Impact Of Spouse Abuse On Children Of Battered Women Violence Update 1, August, pp. 9-11

Stark E and Flitcraft A (1996) Women at risk: Domestic Violence and Women's Health London: Sage


Date approved
Approving Body
Version / 1


/ Head Nurse/Matrons, Clinical Directors, Head of AHP for distribution to staff
Supporting Procedure(s) / Guidance on the Assessment of Children in Need and Child Protection Procedures
Review Date / 2008
Lead Executive / Director of Nursing
Author/Lead Manager / Karen Newham, Senior Nurse Child Protection
Further Guidance/Information / Karen Newham, Senior Nurse Child Protection




Appendix 2


These are some questions that you may choose to ask to enable you to assess the risk to the patient and others in the home. They may all be used or a selection. You may want to add others that you feel are appropriate.

Suggested Opening

“I’m sorry if somebody has already asked you but I need to ask a few questions about your injuries. It is routine now for health care staff to ask about domestic violence when people attend with these types of injuries. This is because we now know how difficult it is for people to talk about their experiences and ask for help”.

Suggested Questions

  • Is everything alright at home?
  • Do you get on well with your partner?
  • Could you tell me how you got these injuries?
  • Do you ever feel afraid of your partner or other people in the home?
  • Are you currently in a relationship where abuse is happening to you?
  • Does your partner use drugs or alcohol excessively?
  • If so, how does he/she behave?
  • Has your partner ever ,
  • Destroyed or broken things?
  • Threatened or injured the children?
  • Forced you to have sex in any form against your will with themselves or others?
  • Emotionally abused you?
  • Kept you a prisoner at home or withheld monies from you as a means of control?
  • Would you like some support?

Consider the vulnerability of the adult and consider protection of any children using the Nottinghamshire Area Child Protection Procedures for guidance.

Consider any safety issues for vulnerable adults and refer to the Nottinghamshire Adult Protection Procedures.

Appendix 3



City Social Services – Duty Social Worker – 915 2404 (Monday – Friday 8.30 – 4.30)

Out of hours and weekends – Emergency Duty Team – 915 9299

CountySocial Services – Duty Social Worker – 9175800 (Monday – Thursday 8.30 – 5.00, Fridays – 8.30 – 4.30)

Out of hours and at weekends – Emergency Duty Team – 917 5910


City Social Services - Duty Social Worker – 915 8885 (Monday – Friday 8.30 – 4.30)

Out of hours and weekends – Emergency Duty Team – 915 9299

CountySocial Services – Duty Social Worker – 915 5886 (Monday to Thursday 8.30 – 5.00, Fridays – 8.30 – 4.30)

Out of hours and weekends – Emergency Duty Team – 917 5910

For Additional Help Contact:

Karen Newham / Senior Nurse Child Protection
Named Nurse / 42921 / Bleep
80 6584 / D Floor, East Block
Stephanie Smith / Consultant Emergency Paediatrician
Named Doctor / 42320 / Bleep
80 6215 / Emergency Department
Andrew Dove / Consultant Emergency Department
Named Doctor / 41152 / Bleep
80 1024 / Emergency Department


To contact Social Services Departments out of the Nottinghamshire area, ring Directory Enquiries and ask for the Social Services Department for the area where the child or adult lives.

Ring the number and ask for the Duty Team for children or adults (depending on the situation).

When you are put through, check it is the right Social Services office by asking them if they cover the area for where the child or adult lives before going into full details of your concern.

If it is not the correct office ask them which office you should contact.


All substance misuse services should have a copy of the Nottinghamshire Domestic Violence Forum (NDVF) Service Directory. Workers should also have a supply of NDVF credit card sized information cards to give to women. To obtain a directory or leaflets contact NDVF on 0115 962 3237.

Women’s Aid Advice Centre

Freephone 24 Hour Domestic Violence Helpline0808 800 0340

Text phone0808 800 0341

City Outreach Service(Agencies)0115 947 5257

Drop-in (Mon - Fri 9am - 5pm)


Amber House Women’s Aid Refuge / Outreach0115 927 8626

Women’s Support Group0115 927 8626

Central Women’s Aid Refuge / Outreach0115 960 7943

Women’s Support Group0115 934 8487

East Women’s AidRefuge0115 948 3794

Floating Support0115 934 8445

Roshni Asian Women’s Aid Refuge0115 948 3450

(for South Asian women)

Umuada Refuge / Outreach0115 979 4141

(primarily for African Caribbean women)


Bassetlaw Women’s Aid Refuge01909 533 610

Outreach Service01909 500 522

Broxtowe Women’s Project (Agencies)0115 913 0196

Outreach project and Helpline0115 913 0521

Mansfield and Ashfield Women’s AidRefuge01623 420 652

Outreach Service01623 473 014

Midlands Women’s Aid Refuge0115 925 7647

Outreach Service0115 925 7647

Newark and Sherwood Women’s Aid Refuge01636 679 687

Roshni CountyOutreach Service0115 988 1414

(for South Asian Women)


Emergency Accommodation for Women0115 911 0289

(16-25 single)

Imaani0115 847 0335

Temporary accommodation for African Caribbean and Asian

young women – 16-25 (but can take women aged up to 30 years)

ISAS01636 610 313

Incest and sexual abuse counselling service

Lesbian and Gay Switchboard0115 934 8485

Mon – Fri: 7pm-10pm

Nottingham Domestic Violence Forum0115 962 3237

For training, information leaflets, advice

Rape Crisis0115 941 0440

Children And Young People

Childline0800 1111

NSPCC0800 800 500

Number 280115 985 8308

Support and counselling service for child

survivors of sexual abuse

Saath: Saath0115 988 1414

Roshni Children’s Outreach Service

County and City Refuges: Children’s Outreach Services

Most of the County and City refuges provide outreach support to children which can be accessed by contacting individual refuges – see previous page for contact details.


APAS0845 7626 316

(Alcohol Problems Advisory Service)

Compass Adult Drug Service0115 9114 490

Info and advice, drop In, outreach clinics

Compass Connect0115 9114 438

(for Black and Ethnic Communities)07900 814 304

Helpline (Mon 10 - 1pm, Thurs 1 - 4pm)0115 9114 489

Compass Outreach Service

Broxtowe07900 814 305

Gedling07900 980 145

Rushcliffe07900 980 146

Health Shop0115 947 5414

Services, information and support about

sexual health and substance use

Hettys01623 659 136

Confidential support for parents, carers, partners,

family and friends of drug and alcohol users

National Drugs Helpline (24 hours)0800 77 66 00

North Notts Alcohol and Drug Services01623 620121

The Maltings

Needle and syringe exchange

Nottingham Alcohol and Drug Team0115 941 8964

(John Storer Clinic)

Priory Clinic0115 969 3388

Residential and day care services

Sorted01623 633 510

Support for current and ex-drug users

Support0115 912 8011

Helpline (Mon – Fri 5pm – 10pm)07753 822 529

Support and information for carers of drug users

Women’s Drug Service01623 785 444

Text phone07887 556 149

Confidential support for women who use, have used, or are

at risk of using drugs

Children and Young People

Base 510115 952 5040

Centre for young people aged 12-25 years

Compass Young Persons Service0115 847 0445

Young people’s drug and alcohol service

Face It0800 587 7878

Support, advice and information to young people

at risk of using / already using substances

Stars Project0115 927 7992

Support for children aged 5-13 who are affected by the

substance use of someone close to them

W.A.M. (What About Me?)01623 635 326

Confidential support service for children and young people

who are affected by someone else’s substance use.



Support Group for Asian Women with Mental Health Issues


Tel: 0115 9245555

Hadhari Nari Women’s Aid

Targets Asian and African Caribbean but provides refuge accommodation for all women


Tel: 01332 270101


Temporary accommodation for Asian and African Caribbean women aged 16-25


Tel: 0155 8470335

Nai Zindagi

For Asian Women with Mental Health Issues


Tel: 0115 9483268

Roshni Asian Women’s Aid

Provides a safe house for women and their children surviving domestic violence, offering advice, support, information and counselling at their request.


Tel: 0115 9483450

Umuada Women’s Aid

Targets African Caribbean Women but provides refuge accommodation for all women


Tel: 0115 9794141


Asian Women’s Resource Centre

108 Craven Park



NQ10 8QE

Tel (general): 0208 9616549

Tel (advice line):0208 8383462

Belgrave Beheno Women’s Organisation

Provides a range of services for Asian women and girls in Belgrave and surrounding areas. Advice and information on benefits, health, housing rights, education, training and employment. Advice and support on domestic violence. Training courses, leisure and cultural activities.

14-17 Melrose Street



Tel: 0116 2667673

Black Association of Women Step Out (BAWSO)

Works with black women who have experienced or are experiencing domestic violence

195 Newport Road


CF24 1AJ

Tel: 02920 437390

Chinese Information and Advice Centre

A UK Charity offering free legal advice and support to disadvantaged Chinese people living in the UK.

152-156 Shaftesbury Avenue



Tel: 0171 6923471

Commission for Racial Equality

The CRE is a publicly funded, non-governmental body set up under the Race Relations Act, 1976 to tack racial discrimination and promote racial equality.

Head Office

St. Dunstan’s House

201-211 Borough High Street



Tel: 0207 9390000

Equal Opportunities Commission

The EOC is the leading equality agency working to eliminate sex discrimination in 21st century Britain.

Arndale House

Arndale Centre


M4 3EQ

Tel: 0161 8381733

Federation of Black Housing Organisations

The FBHO is a membership body working with the black and minority ethnic housing associations, individuals and key partners to promote and work for a diverse, innovative and dynamic housing sector.

2nd Floor

1 King Edwards Road


E9 7SF

Tel: 0208 5337053

Jewish Women’s Aid (JWA)

Aims to break the silence surrounding domestic violence through education and awareness-raising programmes, and operates a refuge and freephone helpline.

PO Box 2670


N12 9ZE

Freephone helpline: 0800 591203

Enquiries: 0208 4458060

Kiran – Asian Women’s Aid

Provides safe, temporary accommodation for Asian Women and their children escaping domestic violence

Tel: 0208 5581986

Muslim Women’s Helpline