Questions regarding assault-related injuries in Emergency Departments: FOI release

Information requested

You requested information relating to service provision for patients attending Emergency Departments who are victims of violence.

You asked the following questions:

1. In your Emergency Departments are adults and/or children attending with assault-related injuries or attending as victims of violence identified for interventions that go beyond theirimmediate health needs?
2. If yes to the above, we would be grateful to receive information detailing: The remit of this violence-specific work. Specifically, which types of patients are identified (e.g. domestic assault, sexual assault, alcohol-related assault, etc.) and whether identification is specific to a group of patients (e.g. women, children).
3. Approximately how many staff are involved with any specific violence-related initiatives.
4. Approximately when the service(s) started (year and month).
5. Whether the staff involved with the service(s) in the Emergency Department are NHS employees, employees of other organisations.
6. In the case that patients are referred to service(s) outside of the NHS, which services they are typically referred to.
7. In the case that patients are referred to service(s) inside the NHS, which services/specialities they are typically referred to.

Response

The Navigator service is run jointly with the Scottish Violence Reduction Unit (SVRU), Medics Against Violence (MAV) and a range of NHS partners. Developed by the SVRU, the Navigator service interrupts violence by supporting people involved in chaotic and violent lifestyles. Individuals who may benefit from this service are identified within an Emergency Department (ED) or Hospital Ward and approached with an offer of help. The Navigators work with individuals with a range of issues, including violence, alcohol or drug issues, mental health issues, domestic abuse, homelessness, often with a combination of these issues.

I will answer your questions as numbered above:

1. Yes, adults are identified through Navigator which is a violence intervention service currently located in 7 hospitals in Scotland. This is an initiative helping to navigate individuals attending Emergency Departments away from chaotic and violent lifestyles. Navigators are support workers who connect with patients who come into the Emergency Department and work with them in the community on discharge from hospital to connect them with services that can support them to make changes in their lives.

2. Both male and female adults are identified through Navigator with injuries relating to all forms of violence. These include interpersonal violence, domestic abuse, rape and sexual assault but also presentations related to alcohol, drugs, mental health and homelessness and often a combination of these things. Identification is not limited to a specific group of patients.

3. In total there are 15 staff involved with the Navigator service. There are 14 front line workers and 1 supervisor.

4. The Navigator service started in December 2015 in the Glasgow Royal Infirmary (Glasgow), then others added in December 2016 Royal Infirmary of Edinburgh (Edinburgh), July 2018 University Hospital Crosshouse (Ayrshire), November 2018 Queen Elizabeth University Hospital (Glasgow), October 2019 Ninewells Hospital (Dundee), December 2019 University Hospital Wishaw (Lanarkshire), and January 2020 Royal Alexandra Hospital (Paisley).

5. All Navigator staff are employees of the charity Medics Against Violence. The board of Medics Against Violence is largely made up of senior NHS staff who volunteer their time for free.

6. There are many services out with the NHS which patients are referred to. Some of the typical services are as follows:

• Alcohol and drug services including Alcohol Anonymous, Narcotics Anonymous, Cocaine Anonymous and other recovery services including residential rehabilitation
• Domestic abuse services including Women’s Aid and Rape Crisis (MARAC)
• Statutory services such as Housing and the Department of Work and Pensions (DWP)
• Legal services
• Other third sector organisations such as Venture Scotland, SAY Women, foodbanks, Simon Community and employability organisations
• There are also many local third sector organisations who patients are referred onto who do not have a national remit

7. The main services that patients are referred to within the NHS are alcohol and drug services and Psychiatric liaison. Any other NHS referrals tend to be made by the medical staff who care for the patient in the Emergency Department and not by the violence intervention team.

About FOI
The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses.