Provision of Hospital Based Domestic Abuse Advocacy (HBDAA) Services

Project background:

Since 2014, City Hall has invested in embedding youth Independent Domestic Violence Advocates (IDVAs) into London’s Major Trauma Centres (MTCs).

Since 2023, this programme of work, referred to as hospital-based domestic abuse advocacy (HBDAA), has been overseen and managed by the VRU. Prior to the VRU, this programme and investment had been overseen and managed by MOPAC within City Hill, aligned to the Mayor’s Police & Crime Plan (PCP).

The HBDAA programme represents a violence reduction initiative, heavily aligned to the VRU’s own violence reduction strategies, most notably: the trusted relationship between a young person, and a trusted adult, as well as the concept of place, reaching young people where they are, and, in this case, leveraging a reachable moment in the lives of young people to break patterns of violence and harm.

Additionally, this intervention sits within a wider programme of hospital-based initiatives, specifically, operating alongside the VRU’s hospital-based youth work (HBYW) programme, which embeds highly skilled and specialised youth workers into London’s four MTCs and eight London A&E units.

Description of the service

The purpose of embedding these IDVAs is to support children and young people who have been impacted by domestic abuse and other gender based harm; IDVAs are there to offer a supportive and stabilising presence in crisis or distress, and help young people cope and recover from the trauma of physical or psychological injury due to domestic abuse, and help disrupt future patterns of violence and harm.

The service engages young people aged 11–25 who present at Major Trauma Centres (MTCs) as victims of domestic abuse, or who are identified as being at risk of future harm. IDVAs provide practical support, advocacy, and help to coordinate a broader safeguarding response for the young person, working alongside clinical and community partners to help young people access appropriate services and support. Support offered typically at the point of presentation may extend beyond that of the hospital, and into the community.

Target audience

The VRU expects the Service to proactively identify, assess, and engage, young people, aged 11-25, who present at MTCs with injuries resulting from domestic abuse, or other gender-based harms.

The following eligibility criteria will apply to the young people offered the Service.

A young person:

• will present at one of the specific MTCs within the scope of this service, AND; will be aged between 11 and 25 years of age;

Additionally, a young person:

• will have been, or will be suspected as having been, the victim of domestic abuse, OR; will have been, or will be suspected as having been, the victim of child sexual abuse, OR; will have been, or will be suspected as having been, the victim of rape, OR; will have been, or will be suspected as having been, the victim of sexual exploitation; and, or where a suspected safeguarding issue has arisen.

This list is not intended to be exhaustive, and the Provider will be expected to use their professional judgment, sometimes in collaboration with hospital staff, to identify forms of vulnerability that warrant intervention.

Scope of delivery

Services will be delivered in London’s four MTCs, namely:

• King’s College Hospital
• Royal London Hospital
• St George’s Hospital
• St Mary’s Hospital

Whilst the principles of delivery will remain the same across all hospitals, it is important that the successful bidder demonstrates a strong understanding of, and connection to, the local communities and systems in which their allocated hospitals are situated.

The specific outcomes which the VRU are seeking through this provision include, but are not limited to:

• Supporting young people to access positive opportunities and support.
• Disrupting cycles of violence and reducing violence and harm.
• Ensuring that children and young people feel and are safe.
• Reducing hospital (re)admissions/attendance.
• Reducing offending / severity of offending.

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