General Note
NHS Fife acknowledges and agrees with the importance of regular and timely review of policy/procedure statements and aims to review policies within the timescales set out.
New policies/procedures will be subject to a review date of no more than 1 year from the date of first issue.
Reviewed policies/procedures will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.
If a policy/procedure is past its review date then the content will remain extant until such time as the policy/procedure review is complete and the new version published, or there are national policy or legislative changes.
1. FUNCTION
NHS Fife is a member of the multi-agency Fife Domestic and Sexual Abuse Partnership. Working together, the partnership has developed the joint document “Shared Understanding – for addressing domestic and sexual abuse in Fife”.
As part of the responsibility for the health, safety and welfare of its employees, NHS Fife employs a Domestic Abuse Co-ordinator to promote the domestic and sexual abuse agenda throughout NHS Fife, to work closely with partner agencies and to offer support, information and clinical expertise. Support for employees experiencing domestic abuse is a very important element of NHS Fife’s commitment to tackling domestic abuse and in promoting an effective, confidential and empathetic response to employees who have experience of domestic or sexual abuse.
NHS Fife, both as a health service provider and major employer of Fife’s workforce, will endeavour to take all steps possible to help combat the reality of domestic and sexual abuse through the principles of Provision, Protection and Prevention (Scottish Exec 2000).
This means that employees who are affected by domestic or sexual abuse will be offered support by NHS Fife in an attempt to combat this serious issue within society.
2. LOCATION
This policy applies to all employees appointed directly or seconded by NHS Fife.
The policy will clarify the support available to employees experiencing domestic or sexual abuse, and reinforce the responsibilities of managers, employees and trade union/professional organisations when dealing with employees with experience of domestic and or sexual abuse.
The policy promotes the Community Plan Milestone principles of improving Provision, Prevention and Protection in relation to domestic abuse.
3. RESPONSIBILITY
Guidance for Managers
Managers have an overall responsibility for the health and safety of NHS Fife employees at work, particularly those they manage. Managers should be fully aware of the impact domestic abuse may have on employees – on their health, personality and behaviour. It may be that for an employee experiencing abuse there will be a negative impact on an employee’s attendance at work, capability, conduct or general well-being. Therefore, as part of good practice for managers - and as with any work related issue - the employee should be given full opportunity to discuss or reveal any difficulties that they may be having in their personal lives before any formal process is considered. Whether the work issue is conduct, absence, capability or alcohol/drug related, managers should fully explore potential reasons for such behaviour and take into consideration the personal circumstances of each case and the impact the abuse is having on the employee before deciding the most appropriate course of action. As with all policies, guidance should be sought from Human Resources if a manager is unsure of any aspect of implementing this policy.
A manager may be approached at any time by an employee who is experiencing domestic and or sexual abuse. It is imperative to be as supportive as possible. Research has shown that often the biggest step for an individual is revealing to another person the extent of abuse and a manager may be the first person the employee has approached – believing the employee and telling them that you believe them is often a key trigger for an individual empowering themselves to confront the abuse. Managers should also not underestimate the danger or the threat posed to the employee and should be mindful of the responsibility for their health and safety at work.
NHS Fife recognises that employees and managers are obliged to keep some information confidential. This requirement is especially salient around the issue of domestic abuse as NHS Fife wishes employees to feel that they can seek help if they are experiencing abuse without fear of any repercussions on their own or their family’s safety.
It is therefore imperative that managers consider the following points to ensure the safety of all employees:
- Home address and telephone numbers of colleagues should never be revealed unless an individual has given express consent for it to be available. If an employee has moved location or home, or work location, an abusive partner may try to track them down by speaking to colleagues – this may put a colleague in danger.
- If an employee discloses sexual and or domestic abuse, and where children might be considered to be at risk, managers and employees should be aware that they are bound by Fife Child Protection Committee interagency guidelines regarding information sharing.
- If an employee has been temporarily redeployed or working in another location, managers should take all reasonable steps to ensure that the working environment is safe for them. This may involve a risk assessment of the new working environment.
4. OPERATIONAL SYSTEM
4.1 What is Domestic Abuse?
Domestic abuse can be perpetrated by partners or ex-partners and can include:-
- physical abuse (assault and physical attack involving a range of behaviour)
- sexual abuse (acts which degrade and humiliate and are perpetrated against their will, including rape)
- mental and emotional abuse (such as threats, verbal abuse, racial abuse, withholding money and other types of controlling behaviour such as isolation from family or friends)
It must also be recognised that:-
- Children are witnesses to and subject to much of this abuse and there is some correlation between domestic abuse and the mental, physical and sexual abuse of children.
- Other family members connected through marriage/partnership may be involved in or may participate in the abuse. This has been identified particularly within black and minority ethnic communities but can happen within any community.
- Domestic abuse occurs in all social groups and is not caused by stress, unemployment, poverty, alcohol or mental illness, or by people who experience the abuse.
- Domestic abuse can result in physical injury, poor health and a range of psychological difficulties for adults and children.
(All above points referenced from Scottish Executive 2004 document “Domestic Abuse - A National Training Strategy)
4.2 What is Sexual Abuse?
Sexual abuse includes sexual acts which are degrading and humiliating and are perpetrated through the use of force, threat or intimidation, including rape. Statistics vary widely depending on definitions used, whether or not the assaults were reported to the police and whether the researchers had won sufficient trust to enable the disclosure of very personal and distressing information, however;
4.3 Prevalence of Domestic Abuse and Sexual Abuse
- At least one in five women experience domestic abuse at some time in their lives (Scottish Executive, 2000).
- Domestic abuse is the primary cause of violence against women in Scotland. In the 2000 Scottish Crime Survey 66% of all violent incidents experienced by women were described as “domestic”.
- The British Crime Survey (2000) reported that 10% of women have experienced sexual victimisation - including rape.
- Overall, 45% of women and 26% of men aged 16-59yrs have been subject to domestic violence (abuse, threats or force), sexual victimisation or stalking at least once in their lifetimes (British Crime Survey, 2004)
- One in four women and one in ten men will have experienced childhood sexual abuse.
- 90% of women who are raped are raped by men they know.
Anyone can be the victim of abuse regardless of their age, background or lifestyle.
4.4 Impact of Abuse
All NHS Fife managers and employees should be aware of the impact domestic and or sexual abuse can have on our colleagues, and the wide-ranging effects on employee behaviour. It must be recognised that a victim of abuse may be vulnerable and that abuse can impact significantly on the working lives of NHS Fife employees. Scottish Women’s Aid (2005) provides indicators of potential signs of domestic and sexual abuse:
Behavioural:
- Inability to concentrate at work
- Frequent use of minor tranquilisers or pain medications
- Sleeping problems
- Coping mechanisms – substance abuse, smoking.
- Refusal to talk about personal life
- Avoidance when questioned about bruising
Physical
- Poor health/physical injuries
- Untreated injuries (a sign of not seeking medical help for fear of exposure)
- Abdominal or similar complaints
- Chronic headaches
Psychological
- Depression or stress or anxiety
- Anger or frustration
- Withdrawal
- Impatience
- Nervousness
- Fear
- Panic attacks
- Low self esteem, loss of confidence
- Unable to make decisions, take responsibility
- Changes in normal behaviour
However, although NHS Fife fully recognises that there are many wide-ranging reasons for some of the indicators above, it is also imperative to ensure that managers and employees are aware of the possible signs that a fellow employee may be subject to abuse.
4.5 Support for Employees
If you are an employee experiencing domestic and or sexual abuse you may wish to speak to one or more of the following people:
- Line Manager
- Domestic Abuse Coordinator
- Work colleague
- Occupational Health and Safety Advisory Service
- Trade Union representative
- Human Resources Officer
Alternatively you may wish to access direct support services available throughout Fife listed in Appendix A.
If you are a colleague of a fellow employee who is experiencing domestic or sexual abuse your support may be very important to them. There are relevant “Sources of Information and Support” in Appendix A of this policy.
NHS Fife may be able to provide services to employees experiencing domestic abuse such as:-
- an advance of pay
- time off, where needed
- possible redeployment to another work location or flexible working hours
- support from the Occupational Health Service, line manager, or Human Resources, when required
In recognition of the support of employees experiencing domestic and/or sexual abuse may need, NHS Fife will endeavour to explore any feasible avenue to help any employee at risk from abuse. The following list of available options is not exhaustive, nor should any option be explored without full consideration being given to the health, safety and welfare of the employee.
- Redeployment or transfer to another work location, change to working hours or another suitable alternative arrangement that would allow the employee to feel safe from an abuser. Any permanent or temporary redeployment within NHS Fife would be co-ordinated through Human Resources and the Redeployment Co-ordinator under the principles of the Redeployment policy. The Redeployment Co-ordinator would assess individual’s circumstances when giving consideration to any variance to theredeployment policy requirements.
- Potential redeployment to another NHS Board, where cooperation is obtained from another individual NHS employer, may be possible.
- Time off work (paid or unpaid, utilisation of flexi-time, ability to breach core work hours) to ensure that the employee can access support services such as solicitors, court, banks, schools, doctors, police, Women’s Aid, Family Protection Unit or any of the support services listed in Appendix A.
- Paid leave of absence up to a maximum of 5 days through NHS Fife’s Compassionate/Bereavement Leave or Carer Leave policies. Extended special leave may be granted for employees with an acute need and advice should be sought from the Human Resources Department. Unpaid leave may be utilised for extended periods of absence for situations in which the employee needs considerable time away from work, and in these situations managers should look to utilise annual leave or other paid leave in the first instance, and should seek Human Resources advice in such circumstances.
- NHS Fife also recognises that managing finances for an employee in an abusive relationship may make escaping abuse difficult to organise, and often lack of money is a deterrent to leaving. It may be possible to arrange for an advance of pay when an employee needs to flee an abuser.
- Access to the Occupational Health and Safety Advisory Service – either for counselling services or as part of a self-referral. If a manager is aware of an abusive situation for an employee, a management referral should be made to offer support – access to OHSAS will be available through Human Resources.
Employees who feel they may need other types of support not listed above can speak to their line manager or senior manager, who will be able to listen to them and consult with Human Resources if it is appropriate to do so. The important aspect of support for the employee is that NHS Fife will be committed to helping empower the individual to make changes to combat the abuse – therefore employees should not consider the above list exhaustive.
5. RISK MANAGEMENT
5.1 Prevention
NHS Fife is committed to the prevention of domestic and sexual abuse by making all employees, including any who may be abusers, aware of the standards of behaviour expected of them. As an exemplar and major employer of Fife’s workforce, NHS Fife takes very seriously the role of prevention of domestic and sexual abuse.
NHS Fife employees should be aware that if they are found to be engaging in domestic or sexual abuse that this may have an impact on their employment position.
5.2 Commitment
NHS Fife will widely publicise their position on domestic abuse and produce user-friendly information for employees.
NHS Fife will also:
- Offer training to managers on implementation of the policy and on supporting employees experiencing domestic or sexual abuse.
- Monitor the operation of the policy and ensure that reports of all incidents of domestic abuse against employees in their workplace are recorded appropriately, having due regard for issues of confidentiality.
6. RELATED DOCUMENTS
Equality and Diversity Impact Assessment
7. REFERENCES
- Scottish Executive (2000) National Strategy to Address Domestic Abuse in Scotland
- Scottish Executive (2003) Preventing Domestic Abuse National Strategy
- Scottish Executive (2004) Domestic Abuse - A National Training Strategy
- Scottish Executive (2003) Responding to Domestic Abuse Guidelines for Healthcare Workers in NHSScotland
- Fife Domestic and Sexual Abuse Partnership (2006) Shared Understanding and Action Plan 2006-8
