Domestic Abuse Training for Healthcare Professionals: 5 Things the New NHS Mandatory Programme Means for Your Team

Healthcare teams are often among the first professionals to notice that something is wrong. A patient may attend with an unexplained injury, anxiety, sleep problems, repeated appointments or concerns about a partner’s behaviour. They may not use the words “domestic abuse”. They may not be ready to disclose what is happening.

That is why effective domestic abuse training for healthcare professionals matters.

In 2026, the NHS is moving towards a more consistent, whole-workforce approach to safeguarding domestic abuse. The Government’s Freedom from Violence and Abuse action plan commits to a new mandatory safeguarding learning programme for the entire NHS workforce. The programme will cover all aspects of domestic abuse and improving support for victims and survivors across the health system.

At the same time, a new domestic abuse and sexual violence referral service, Steps to Safety, is being rolled out across Integrated Care Boards (ICBs) from April 2026. Training is being offered to GP practice staff so they can identify abuse, respond safely and connect patients with specialist support.

For healthcare organisations, this is more than another online module. It is an opportunity to make sure every member of the team understands their role.

1. Domestic abuse safeguarding is becoming a responsibility for the whole NHS workforce

The new national programme is intended to apply across the NHS workforce, including clinical and non-clinical staff. This reflects the reality of healthcare settings: a patient may first disclose abuse to a receptionist, healthcare assistant, administrator, nurse, GP or pharmacist.

Not every staff member will have the same responsibility. However, everyone should know how to:

• Recognise possible signs of domestic abuse
• Respond without judgement
• Protect privacy and immediate safety
• Follow the organisation’s safeguarding procedure
• Signpost or refer to the right support
• Escalate concerns when there is serious risk

This builds on existing safeguarding expectations. NHS England states that staff should receive safeguarding training appropriate to their role, while NICE recommends different levels of domestic abuse training for different professional groups.

For example:

• Level 1 is appropriate for staff who may receive a disclosure, such as receptionists, care assistants and other frontline workers.
• Level 2 is generally appropriate for professionals who may ask about abuse, assess immediate safety and make referrals, including GPs, nurses, midwives, mental health professionals and ambulance staff.
• Level 3 is relevant to safeguarding leads, specialist practitioners and staff involved in risk assessment, safety planning and multi-agency processes.
• Level 4 is for specialist domestic abuse professionals, such as IDVAs and specialist support workers.

This role-based approach is central to good safeguarding domestic abuse training. A receptionist does not need to conduct a DASH assessment, but they do need to know how to respond if a patient says, “I don’t feel safe at home.”

2. GP practices should prepare every member of the team for Steps to Safety

Steps to Safety is designed to give general practices the tools and pathways to identify and refer victims and survivors of domestic abuse and sexual violence into local specialist services.

The service is being introduced in phases from April 2026 across ICBs. The Government’s longer-term aim is that, by 2029, anyone in England affected by domestic abuse or sexual violence will be able to access help by speaking to staff at their general practice.

The model includes specialist support workers linked to groups of GP practices. They can support practice staff, advise on cases and help connect patients with local services.

NICE guidance has recommended integrated training and referral pathways for GP practices for many years. Importantly, this recommendation includes both clinicians and administrative staff.

GP practices should therefore avoid treating training as something only for doctors and nurses. Preparation should include:

• Reception and administrative staff
• Practice managers
• GPs and advanced practitioners
• Practice nurses and healthcare assistants
• Health visitors, midwives and other visiting professionals
• Safeguarding leads
• Locums, trainees, volunteers and new starters

A short briefing for reception staff may focus on privacy, responding to disclosures and alerting the safeguarding lead. Clinical training may cover safe enquiry, risk assessment, documentation and referral. Both are important.

3. Staff need confidence to spot signs and respond safely

Domestic abuse can be physical, sexual, psychological, emotional, economic or technology-facilitated. Coercive and controlling behaviour may be present even when there are no visible injuries.

Possible indicators include:

• Frequent or unexplained injuries
• A partner who insists on staying in the room or answering questions
• A patient who appears anxious, withdrawn or unusually fearful
• Missed appointments or repeated appointments with vague symptoms
• Sleep problems, panic, depression or unexplained physical symptoms
• A partner controlling medication, finances, transport or communication
• A child showing distress, behavioural changes or developmental concerns
• A patient who seems unable to speak freely or access their own phone

No single sign proves that abuse is taking place. Staff should use professional curiosity while avoiding assumptions.

If a patient discloses abuse, the first response should be calm, respectful and clear:

• Thank them for telling you.
• Listen without pressing for unnecessary detail.
• Avoid asking, “Why don’t you leave?” or suggesting that the abuse is their fault.
• Check whether they are safe to return home.
• Ask whether the alleged perpetrator is nearby or has access to their phone or records.
• Explain what you can and cannot keep confidential.
• Follow local safeguarding and referral procedures.
• Record the disclosure factually, using the patient’s own words where appropriate.

Staff should not promise absolute confidentiality. Information may need to be shared without consent where there is a serious risk to the patient or someone else, or where a child may be at risk. Decisions should follow local policy, professional guidance and Caldicott principles.

The aim is not for every healthcare professional to investigate abuse. It is to create a safe, informed response that does not increase risk.

4. Referral pathways must be clear before a disclosure happens

Training is most effective when it is connected to a practical local pathway. Staff should not have to search for contact details while a patient is waiting for help.

Every healthcare organisation should map its referral routes and make sure staff know:

Independent Domestic Violence Advisers

An IDVA provides specialist advocacy and safety planning for people experiencing domestic abuse. IDVAs can help patients understand their options, access services and manage risk. In many areas, they also work closely with healthcare settings.

DASH risk assessment

DASH stands for Domestic Abuse, Stalking and Harassment and Honour-Based Violence. It is commonly used to support structured risk assessment. Staff should only use the version and process approved locally, and should understand when to seek advice from a safeguarding lead or specialist service.

A DASH checklist should support professional judgement, not replace it. A patient may be at high risk even when a checklist score is low.

MARAC

A Multi-Agency Risk Assessment Conference (MARAC) brings together relevant agencies to share information and agree actions for people considered to be at high risk of serious harm.

Healthcare professionals may contribute information to a MARAC through their safeguarding or domestic abuse lead. Training should explain local referral criteria, information-sharing arrangements and the healthcare team’s responsibilities after a MARAC meeting.

Sexual Assault Referral Centres

Where sexual violence is disclosed, staff should know how to access local specialist support, including a Sexual Assault Referral Centre (SARC) where appropriate. SARCs can provide medical, practical and emotional support, with forensic services available in relevant cases.

The NHS service finder provides information about rape and sexual assault referral centres.

5. Healthcare organisations should prepare now, not wait for the final deadline

The detailed operational requirements for the new NHS-wide programme may continue to develop. However, healthcare organisations can take sensible steps now.

Review your training matrix

Map each role to the appropriate level of domestic abuse learning. Include clinical and non-clinical staff, temporary workers and people who join the organisation during the year.

Check your policies

Review safeguarding, domestic abuse, information-sharing, confidentiality and record-keeping procedures. Make sure they reflect current local arrangements and the developing Steps to Safety service.

Test your referral pathway

Ask practical questions:

• Who does a GP contact for urgent advice?
• How does a receptionist alert the safeguarding lead?
• What happens if the patient does not consent to a referral?
• How are children affected by the abuse considered?
• What is the local IDVA contact?
• When should a case be considered for MARAC?
• Where is the nearest SARC?
• What support is available outside normal working hours?

Build in supervision

Domestic abuse work can be emotionally demanding. Staff need access to supervision, debriefing and support after difficult disclosures. NICE recommends ongoing training and regular supervision, rather than a single one-off session.

Keep evidence of completion

Record attendance, completion, learning outcomes and refresher dates. Evidence should show more than a tick-box exercise. Consider knowledge checks, reflective learning, scenario-based discussions and audits of referral pathways.

How Serene Futures can support your team

Serene Futures provides practical training for organisations working in the domestic abuse sector. Our approach can support healthcare businesses, GP practices, NHS trusts and healthcare providers to prepare for the changing safeguarding environment.

Our training can be adapted to different roles and may include:

• Domestic abuse awareness for the whole workforce
• Role-specific safeguarding domestic abuse training
• Safe responses to disclosures
• Coercive control and less visible forms of abuse
• Recognising signs in adults, children and young people
• DASH, IDVA and MARAC pathways
• Information sharing and professional boundaries
• Trauma-informed communication
• Scenario-based learning for healthcare teams
• Support for training matrices and compliance planning

Whether you are looking for domestic abuse awareness training corporate programmes, statutory domestic abuse training, workplace domestic abuse training or tailored domestic abuse training courses, the most important question is whether staff feel prepared to respond safely and compassionately.

The 2026 NHS changes reinforce a simple message: domestic abuse is everyone’s safeguarding responsibility. With the right training, clear roles and reliable referral pathways, healthcare teams can help patients move from being unseen and unsupported towards safety and specialist help.

For the latest policy information, see the Government’s Freedom from Violence and Abuse action plan, the NHS specialist support announcement and NICE guidance on domestic violence and abuse.

This article provides general information and does not replace your organisation’s local safeguarding policy, ICB guidance or professional advice.