"At present there is a silo mentality towards delivering services for domestic violence victims, whereas most people need the support of a number of different agencies"
In this section we consider the ways in which agencies and Government departments need to work together to provide adequate protection to victims and manage perpetrators.
Multi-agency responses are needed to respond effectively to domestic violence
341. Domestic violence is an issue which does not fit neatly within the responsibilities of one agency or Government department, but which requires a co-ordinated response. One of a series of briefing notes on effective approaches to domestic violence, commissioned by the Home Office in 2000, concluded that "local policy and practice has been transformed in some areas by multi-agency domestic violence work".
342. One domestic violence professional described the genesis of multi-agency approaches:
Multi-agency approaches to domestic violence developed out of frontline, especially voluntary sector, service providers' awareness that the survivors they worked with needed to contact a range of agencies when they had experienced domestic violence, and were not well served when such agencies did not communicate or work well together.
343. The same professional noted that agencies have different approaches to domestic violence, and these agencies need to work with one another in order to get the full picture. For example, the police and CJS have an incident-based approach, whereas domestic violence tends to be part of a wider pattern of behaviour which can be overlooked in an incident-based response.
Appropriate data sharing is essential for agencies to work together
344. One barrier to effective inter-agency working was identified as information sharing between agencies. The police, in particular, stated that information sharing is inadequate since there is no legal compulsion to share. Chief Constable Brian Moore told us that:
There is inadequate information sharing between agencies. Each agency may have part of the picture but if it is operating only on that it will never properly understand the risks someone faces and prevent further harm. It is only when all the pieces of information from the police, education, social services and local housing authorities are put together that you have the clearest picture of those most at risk.
Chief Constable Moore called for a change in the law to make information sharing mandatory: "I say that the law in this regard is inadequate. The law on information sharing is passive".
345. Several witnesses particularly cited health professionals as being reluctant to share information. For instance, ACPO stated "some agencies, notably Health, are reluctant to share information even in forums (such as MARACs) designed to facilitate such exchange. Concerned professionals frequently cite their obligation to patient confidentiality as the basis for their reluctance". The British Medical Association supported this, citing concern about disclosing patient information as one of the major barriers to engagement.
346. The Parliamentary Under-Secretary of State at the Home Office Vernon Coaker MP noted some confusion amongst professionals about what information can be shared, particularly in relation to the Data Protection Act, and to patient confidentiality. He told us:
We have been to see the Information Commissioner about this and information which is shared on the basis of public protection is information that can be shared providing it is done properly. I think sometimes with data protection and all of these other things people are frightened of it...We need to change people's mindset that you cannot share information as you will be doing something illegal.
The Home Office has published guidance for practitioners on sharing personal and sensitive data in domestic violence contexts. This guidance is listed as having been last updated in April 2004.
347. Safe sharing of appropriate information between agencies is vital in supporting and protecting victims. Witnesses reported confusion amongst some agencies and professionals about what data the law currently allows to be shared. We have not seen evidence of a need to change the law to mandate information-sharing, as suggested by the police. However, there is a need for better understanding of what the law allows amongst front-line professionals. We therefore recommend that the Government, in consultation with the Information Commissioner, updates its guidance for practitioners on sharing personal and sensitive data in a domestic violence context, and writes to practitioners to highlight this guidance.
348. The Department of Health expert group on information-sharing should draw up ground rules as to how patient data can be safely and ethically shared with other partners to prevent domestic violence. However, data must only be shared and retained in a secure way, according to agreed protocols of access and use. The consequences of a breach in security, leading to the unwanted disclosure of the personal information of a domestic violence survivor, are potentially very serious.
349. 'One-stop shops' have been hailed by both users and professionals as an effective form of multi-agency working. In a 'one-stop shop', relevant agencies are co-located in the same offices, allowing them to share data and meet together on a daily bases, rather than holding occasional meetings. The most developed model in the UK is the Family Justice Centre (FJC) in Croydon, based on a model in San Diego, USA. We visited the Croydon centre to find out from staff and users about the impact it has had on domestic violence. The centre, which opened in 2006, has co-located between 50 and 90 existing staff from 36 agencies, including the police, social services, housing, Women's Aid and domestic violence advocates. In the first few years of operation the FJC's outgoings were only rental costs, and it did not require any new staff nor changes in policy.
350. The centre costs £276,000 a year to run. It has served 7,761 families in two years (out of a population of 340,000), which works out as £71 per family. Staff told us that the centre is cost-effective in that it reduces domestic violence homicides (none have occurred since the centre opened, as compared to five in the previous year). The FJC told us that it estimates that the amount saved by preventing one homicide 'pays' for five years of the centre's operating costs. We met mothers whose daughters had been murdered by their partners or ex-partners. In their opinion, had their daughters been able to access a family justice centre, they might still be alive today, because they would have found approaching the centre less daunting than going to a police station, and would have had immediate access to all the right support.
351. The Croydon Family Justice Centre has not yet been formally evaluated, although it has applied for EU funding to carry out a study of what has been most effective, in order to target resources effectively. Several other local authorities intend to set up family justice centres, and Croydon FJC is providing consultative advice. The Metropolitan Police Service supports the model, arguing that centres "will involve significant resources to establish but the benefits resulting from early interventions would outweigh the initial costs".
352. Another one-stop shop, the Northampton Sunflower Centre, has been formally evaluated and was found to provide the most effective model for reducing repeat victimisation. The evaluation found that conviction rates for the Northampton project users was nearly twice that of a comparison group of all cases heard at the Magistrates' Court. One survivor writing on our eConsultation praised the Northampton centre:
"I believe that a one stop shop (similar to tha of the sunflower centre) is a great resource for victims of domestic violence. Although we do not have one in our area, It is my understanding it is an umbrella for all supporting agencies under one roof. I have found that for many victims there is a sense of being pushed from pillar to post in relation to various agency intervention at the point upon which they are seeking advice to leave or are at a point of leaving. This style of multi agency working will allow a more co-ordinated response" - Natasha7
353. Early evaluation and feedback on the 'one-stop shop' model, in which multiple agencies co-locate in the same place, shows a positive improvement in outcomes for victims. The Government should work with local authorities to carry out further evaluation of the 'one-stop shop' model, including assessment of the specific costs and benefits involved. If such an evaluation confirms the benefits, we urge the Government to consider the establishment of a 'one-stop shop', such as a family justice centre, in each local authority area.
Multi-agency risk assessment conferences (MARACs) and Independent Domestic Violence Advisers (IDVAs)
354. Multi-agency risk assessment conferences (MARACs) are meetings held between a range of statutory and voluntary agencies, such as the police, probation, social services, housing, health and counselling services, to identify and intervene in the case of high-risk victims of domestic violence and their children. The agencies develop a safety plan tailored to the needs of the individual case and ensure that the agencies are communicating regularly about the case. This is facilitated by information-sharing and use of risk assessment tools. The first MARACs were held in Cardiff in 2003. In 2006-07 the Home Office announced that MARACs would be introduced initially in all the areas with Specialist Domestic Violence Courts (SDVCs) and then established in other areas. By late 2007 there were 70 accredited MARACs operating around the country, with plans to increase this number to over 100 in the next year.
Multi-Agency Risk Assessment Conference case study
Tessa had been in an extremely violent and abusive relationship for a period of 8 years. Tessa separated from the perpetrator; however he continued to harass her for two years. On one particular incident Tessa called the police again. In line with the recent updates to the domestic violence policy the attending officer completed a risk assessment, referred the case to the police domestic violence unit and to the local refuge. The police domestic violence unit put a 'treat as urgent' marker on Tessa's address, referred her to the MARAC and to the local IDVA. The refuge was unable to house Tessa and her children because her son was aged 15.
Refuge staff referred her case to the local IDVA service. The IDVA contacted Tessa, completed a risk assessment and put a safety plan into place. The IDVA asked Tessa what she needed to stay safe so that they could bring this information to the MARAC. At the MARAC, agencies discussed the case and created an action plan based on the risk to Tessa and her own assessment of what she needed to feel safe. The local housing department agreed that as a matter of urgency they would put security measures into the property Tessa and her children were in and would offer her another property with security measures in a different area. Tessa was also concerned about her financial situation so the MARAC referred the case to the CABit turned out that Tessa was not receiving the correct amount of child benefit. The IDVA offered to support Tessa through the court system when reporting the harassment and giving evidence at court.
Eight months after the MARAC Tessa began to receive harassing letters from the perpetrator who was in prison. The IDVA service liaised with the security forces in the prison to stop these letters and referred Tessa to a solicitor who was successful in getting a non-molestation order.
355. Alongside MARACs the Government has introduced Independent Domestic Violence Advisors (IDVAs). These are independent advocates whose role is to support survivors and work with other agencies to ensure their safety. This may mean support for a criminal prosecution, obtaining civil injunctions to protect the individuals affected, improving home security, support with mental health problems or alerting schools to the risks that the children face. IDVAs advise, explain and ensure that comprehensive safety plans for each individual are implemented, working closely with, but independently from, the statutory authorities. Most referrals to IDVAs are through agencies, rather than self-referrals.
356. MARACs and IDVAs, along with SDVCs, form a key part of the Government's response to domestic violence. The Government invested £1.85m to set up MARACs in both the 64 SDVCs and in non-SDVC areas bringing the total funded in 2007 to over 100. During 2006/07 the Ministry of Justice provided £3 million for the development of IDVA services in the 64 SDVC areas, and has committed the same sum for 2007/08. Each IDVA can support around 75 high-risk victims a year.
357. Co-ordinated Action Against Domestic Abuse (CAADA) estimated the cost of implementing MARACs and IDVAs across the UK:
CAADA has estimated that we would need 1200 IDVAs to cover the country adequately and 300 MARACs. The cost of funding this in salary terms alone would be in the region of £36 million for the IDVAs, and £9m for the MARAC co-ordinators annually. In addition CAADA would need to grow considerably...we estimate that our running costs for this would be £5 million per annum.
CAADA stated that MARACs can save public money, as well as improving victim safety:
[A network of 1,200 IDVAs and 300 MARACs] would support over 100,000 victims annually and save the public purse in excess of £250 million in direct costs alone.
Reducing repeat victimisation
358. Evaluation of the first MARAC in Cardiff has shown a reduction in repeat victimisation, which has been below 10% for over two years in Cardiff, compared with typical levels of 30-35% nationally. Early evidence from the new MARAC areas shows a halving in repeat victimisation for the highest risk families. The Haven refuge in Wolverhampton told us: "It is our opinion that MARACs greatly increase the survivors safety. There were a reported 23 repeats which is 12%, whereas the current DV repeat rate for Wolverhampton as a whole is 30%". However, as yet there has been no national independent evaluation of the model.
359. A recent evaluation of the ASSIST IDVA service in Glasgow showed that the local co-ordinated response between police, courts and the IDVAs resulted in approximately 70% of victims suffering neither physical nor emotional abuse at the end of support from the IDVA.
Criticism for focusing on high risk, disempowering victims and not being mandatory
360. MARACs have been broadly welcomed by the domestic violence sector. Most respondents to the Women's Aid special survey agreed that MARACs increased survivor safety to some extent (34%), or to a great deal (16%). However, some practitioners felt that MARACs increase the focus on high risk cases to the exclusion of other cases; others that they take control away from the victim when they should be empowering them; and others that, since MARACs are voluntary, co-operation is not being maximised.
361. Nicola Harwin, Chief Executive of Women's Aid, criticised MARACs for only focusing on high-risk cases: "the focus is on developing responses to women who are higher risk when other women are not getting the help and support which might prevent them getting to the point of high risk". Director of Refuge, Sandra Horley, said that focussing only on high risk cases is dangerous, since "risk is so fluid, it can escalate very quickly. What might seem low risk today tomorrow is very high. I had a case of a man brandishing a knife in his wife's face which was considered low risk. In my view that is attempted murder".
362. Diana Barran, Chief Executive of CAADA, defended the decision to focus on high-risk cases:
About 1.5 million people a year suffer domestic abuse. The MARAC is targeted at about the top 150,000, so we are talking about the top 10%...in terms of how we prioritise our resources, I think it is only defensible to look at those who are most at risk of being killed or seriously injured.
363. Nicola Harwin was also concerned that the MARAC disempowers victims:
Multi-agency risk assessment conferences in most areas are not survivor-led. The victim is informed that a referral is happening. In a sense they are in direct conflict with the principle of empowerment which has always been the way we support abused women to get out of abusive situations.
364. MARACs are not statutorylocal authorities are only obliged to 'have regard' to MARACs, meaning that each area can choose whether or not to set up a MARAC. A number of organisations argued that MARACs should be placed on a statutory footing in order to ensure that a) there is national coverage, and b) all agencies are forced to participate fully in them. For example, ACPO stated that:
We do not consider it acceptable that effective public protection systems should be left to the whims of local agencies to decide upon... there is a clear requirement that all areas shall have in place MARAC capability by a date to be determined. This is likely to require legislation.
CAADA supported putting the MARACs on a statutory footing:
We would also recommend that there is greater clarity on the commitment required from statutory agencies at MARAC. This could obviously be achieved by putting MARACs on a statutory footing. The key is that all agencies should understand that this is a priority which addresses the safety of victims, of their agency staff and will cut costs for all concerned.
365. Practitioners told us that a key obstacle to effective working is that they are expected to attend MARACs in addition to their normal duties, and they are not allocated any additional resources for administrating the MARAC process. One domestic violence co-ordinator told us:
Too often knowledgeable workers are effectively excluded from strategic and multi-agency domestic violence work because they are presented with too-tight deadlines, overwhelming documentation or have to give higher priority to short-term and urgent frontline work.
366. Similarly to MARACs, Independent Domestic Violence Advocates (IDVAs) have been mostly welcomed for the support they offer victims. The Haven Wolverhampton told us that "IDVAs are hugely effective in supporting survivors and improving their safety". Diana Barran told us that IDVAs carry out "up to 80% of the work from the MARAC". However, we were told that IDVAs are a very overstretched resource. A recent analysis of barriers facing effective operation of IDVAs, carried out by CAADA, concluded that:
The average number of referrals per practitioner per year is over 300. This flood of referrals is resulting in an unsustainably high average caseload of over 150 cases per IDVA which we fear must impact on the quality of service that can be offered.
IDVAs have also attracted criticism for drawing resources away from previous outreach services. We discuss this further in paragraphs 372 to 376.
367. Evaluation of the first multi-agency risk assessment conference (MARAC) in Cardiff showed a 40% reduction in repeat violence after one year. We heard from practitioners that the MARAC process has been positive in terms of improving inter-agency working. However, there has not yet been a national independent review of the effectiveness of the model. We consider that such a review would prove useful in determining the current effectiveness and future direction of MARACs.
368. We recognise that some practitioners consider multi-agency risk assessment conferences to focus disproportionately on high risk victims. However, in our view MARACs provide a necessary forum for considering those at greatest risk of violence.
369. The key complaint about multi-agency risk assessment conferences (MARACs) from participating agencies was that they lacked time and resources to attend regular, often lengthy, meetings. The principal criticism from organisations representing victims' interests was that the process disempowers victims when an independent domestic violence advocate (IDVA) is not available to represent the victim's views. However, IDVAs are a hugely overstretched resource, with each advocate, on average, managing 150 cases. We conclude that IDVAs fulfil a crucial function in supporting and empowering victims and recommend that the Government increases the rate of its funding for IDVA services to meet the target of 1,200 IDVAs nationally, set by Co-ordinated Action for Domestic Abuse.
370. Although the police argued that multi-agency risk assessment conferences (MARACs) should be placed on a statutory footing, it was not clear to us to what extent the voluntary status of MARACs presented difficulties. It seems possible that ensuring agencies are equipped with adequate resources to enable them to participate in MARACs might prove more effective than forcing them to do so. We therefore support the Government's decision not to legislate for MARACs at the current time, but we recommend that it monitors closely their effectiveness, with a view to placing them on a statutory footing should it prove necessary.
371. Co-ordinated Action Against Domestic Abuse (CAADA) estimates that a full national network of multi-agency risk assessment conferences could save in excess of £250 million in costs to statutory agencies. If this calculation is accurate, multi-agency risk assessment conferences have the potential to release huge savings within those services. We recommend that these savings be specifically re-deployed to fund some of the recommendations made elsewhere in this report.
346 Reducing Domestic Violence...what works? Multi-agency fora, Home Office (January 2000), p 3 Back
347 Ev 125 Back
348 Ev 127 Back
349 Q 8 Back
350 Ibid. Back
351 Ev 180 Back
352 Ev 97 Back
353 Q 448 Back
354 www.crimereduction.homeoffice.gov.uk/ispol.htm Back
355 This figure covers employment of 8 independent domestic violence advocates, and rent. Back
356 Ev 237 Back
357 Home Office Research Study, HORS 290 Back
358 Case study provided by CAADA Back
359 Ev 248 Back
360 Ev 120 (CAADA) Back
361 Ev 121 (CAADA) Back
362 Ev 119. Chief Executive of CAADA, Diana Barran, told us that the figure of £250 million in savings comes from the research carried out in 2004 by Sylvia Walby on the direct costs of domestic violence, coupled with the number of times a victim might contact the police, their GP and other agencies. Based on these calculations, CAADA estimated the total cost of each case to society before it reached the MARAC at £10,000. This figure has been multiplied by the number of victims who would get support from the MARAC. CAADA estimated the proportion of victims who will access safety as a result of the MARAC at 30% (half of the figure being seen at MARACs currently). These calculations produced a minimum saving of £250 million in direct costs alone. Back
363 CAADA, Achieving Safety: Evidence and Action, (2007), p 5 Back
364 Ibid., p.5 Back
365 Ev 141 Back
366 CAADA, Achieving Safety: Evidence and Action, (2007), p 5 Back
367 Ev 221 Back
368 Q 197 Back
369 Q 198 Back
370 Q 326 Back
371 Q 196 Back
372 Ev 180 Back
373 Ev 121 Back
374 Ev 128 Back
375 Ev 141 Back
376 Q 331 Back
377 CAADA, Achieving Safety: Evidence and Action, (2007), p 7 Back