Abstract
Hunter New England Central Coast Primary Health Network (HNECC) was funded by the Commonwealth Government to co-design an integrated systems response to DFV. Two pilot sites were established in 2020 in the New England and Central Coast regions of NSW.
One crucial action was the establishment of a DFV Local Link (DFVLL) Service to integrate a local DFV response between primary care, DFV specialist services and key systems stakeholders.
To establish the pilot sites a range of stakeholders were engaged in a co-design process:
- Consumers and carers
- Community DFV service providers
- GPs and other primary health providers
- Aboriginal Medical Services
- Local Health Districts
- Government agencies such as Police and Justice.
Most services engaging in the process had clear roles responding to DFV. However, this was not the case for many GP practices.
In 2014 the Royal Australian College of GPs estimated that GPs sawup to five women per week who had experienced some form of DVF. Yet many GP practices were challenged to respond effectively:
- How do GPs identify who is experiencing DFV?
- How do you start effective conversations?
- What is the right solution or referral to offer?
The co-design process had a number of steps:
- Stakeholder engagement to explore issues and potential responses
- Generation of insights reports
- A workshop (using human centred design principles) to generate solutions
- Further consultation and design workshops to iterate an initial service model
- Continuous improvement/reflective learning events
The following results were achieved:
- Specialist local DFV services established the DFV Local Links roles to kick start the program.
- Dedicated GPs and a DFV Outreach Practice Nurse: developed clinical resources; supported GP practice training; designed DFV roles for practice nurses; and delivered outreach services.
- Within 6 months 22 training sessions were delivered to 155 staff from 14 general practices including 70 GPs.
- Pre-existing Local Coordination Points (funded by NSW Department of Communities and Justice) developed dedicated referral pathways for their local GPs. This was critical for sustainability as the referral pathway endures regardless of funding.
The use of a co-design approach was critical to success. Key learnings included:
- The value of approaching problem definition and solution design using different consumer and service lenses
- The importance of creating environments and processes that support connection, learning and trust
- The utility of human centred design approaches to establish such learning environments
- The importance of allowing time for connection, learning and trust to grow
- The value of ongoing reflective, continuous learning approaches to support the evolution of initiatives
Next steps for the program include:
- The extension of the pilot until 30th June 2026
- HNECC has funded Local Coordination Points to deliver the dedicated DFVLL service at scale.
- The Commonwealth Department of Health has expanded the model to respond to child sexual abuse and sexual assault.
- HNECC is establishing an awareness raising campaign for GP practices, highlighting the significant health impacts of DFV.