Simple Yet Brilliant

Somewhere in England, earlier this week, I was playing the role of a victim of domestic violence, so that some nurses who worked in Accident and Emergency could practise broaching the subject with real victims of domestic violence.

"Did you have make-up?" I was asked by an actor the next day, but no, I didn't need it - the woman whom I was playing had suspicious bruises on her upper arms and abdomen which had come to light when she'd come to A and E because her abdomen hurt. So the roleplay started after the bruises had been found, and I didn't need "real" bruises.

The nurses found it very difficult but - as very often with nurses - dealt with it very well. At the end of it the nurse in charge of the day gave me, and the other person playing the same role, a thank-you card each, because they said they had all found it really useful. I was very touched - I've been doing medical roleplay since 1985, and though I've almost always been thanked, nobody has ever given me a card before.

The course was designed to draw their attention to a new scheme, which was pioneered elsewhere in the country and has now been implemented in the area where I was working.

Victims of domestic violence are always reluctant to go to the police: on average, it takes 35 assaults before they do.

Under this new scheme, once they have been found to have suffered violence, they are asked to fill in a form whilst still in A and E.

And then all the different agencies are alerted, from the police to the school nurse to the local hospitals to Social Services.

So if - say - a parent turns up at A and E with bruises, and then one of the children is found by the school nurse to have strange bruises, the two events will marry up. Simple, yet brilliant.

"It gives the perpetrator the message that we're on to them," said the nurse in charge.

In the area of the country where the scheme was pioneered, the number of people reoffending has dropped from 65% to 15%. In the area where I was working, the scheme has been running for a year and has so far highlighted 200 cases.

You may have assumed that the victims are women - well, most of them are, though, of the 200, five were men, so it's not always so.

A bit Big Brotherish? Well, maybe - - but then, let me repeat the statistic that the number of people reoffending has dropped from 65% to 15% in the first area, and highlighted 200 cases in the second area.

Where children are held to be at risk of violence - and they always are at risk if one of their parents is being hit - then a healthcare professional has no alternative now but to inform Social Services.

And that's where it gets tricky. The whole thing is now reliant on the sensitive handling by Social Services. If, for example, they were to write to the victim of abuse, and the letter were to be found by the perpetrator, then the victim would become in tremendous danger, in many cases.

And if the victim does decide to leave, then that, all statistics show, is the most dangerous time for them, because that infuriates the perpetrator more than anything.

I'm sorry to have to keep using the words "victim" and "perpetrator" but I don't want it to turn into a gender thing, because, as I said above, although most of the victims are women, some are men.

It's always going to be very difficult to help in such situations, without charging in and making things worse. Domestic violence didn't used to be taken seriously - the phrase "just a domestic", often used by police, covered a multitude of tragedies. I think that this scheme is a very good step forward, and I hope it is implemented nationally, with the resources to back it up.