Violence against women and girls (VAWG) is a global violation of human rights that damages health and wellbeing across the life course and across generations. Spanning domestic violence and abuse (DVA), sexual violence, gang violence, female genital mutilation (FGM), and so-called honour violence, it is a major contributor to societal inequality with a large economic cost. Except in its most obvious manifestations as acute injury or distress, VAWG has been largely hidden from the awareness of health services.
At a UK national policy level, this started to change with mandatory reporting policies on FGM,1 the Royal College of General Practitioners (RCGP) safeguarding standards and toolkit,2 and the National Institute for Health and Care Excellence (NICE) domestic abuse guidelines.3 However, evidence-based guidance is not yet systematically implemented in clinical education and practice. The recognition of sexual violence within the NHS has resulted in sexual assault referral centres (SARCs), but these are not integrated with general practice. National and local VAWG prevention policies are siloed, despite the overlap of different types of VAWG, often affecting the same families, and often part of intersectional vulnerability, amplifying other sources of inequality: class, deprivation, ethnicity, gender identity, disability, and poor mental health. Although associated with inequality, VAWG is present in all communities. The current government has an ambitious commitment to reduce VAWG by half within a decade. It is developing a cross-sectoral strategy in which health care will play a part, although the Home Office is taking the lead and the Department of Health and Social Care is a junior partner.
What is the role of general practice?
The role of general practice needs to be based on the evidence for effective interventions. Despite the relatively …
