PCD 1392 IRIS

PCD 1392 IRIS

In February 2023, the Mayor announced an £8.5m package of funding to tackle violence and support victims in London, and to further strengthen the work of the London Violence Reduction Unit. This announcement included £1.5m for an expansion of the IRIS programme to new London boroughs, meaning all London boroughs would have the opportunity to deliver the IRiS programme within their primary healthcare systems in recent years. 

IRISi are a social enterprise established to improve the healthcare response to gender-based violence. Their flagship programme- ‘Identification and Referral to Improve Safety’ -provides primary care practitioners with training on the dynamics of domestic abuse, and co-location of domestic abuse ‘advocate educators’ within primary healthcare settings. This unique model means that survivors who are identified as requiring support by their GP, are provided with a direct referral route into specialist third sector support co-located within primary health settings.  

This additional investment will further expand the IRIS programme, enabling a further 6 boroughs to adopt the model over a 26-month period; 

• Sutton- in partnership with Sutton’s Women’s Centre 

• Havering- in partnership with Aanchal  

• Merton - in partnership with Refuge 

• Wandsworth- in partnership with Refuge  

• Harrow - in partnership with Advance and Asian Women’s Resource Centre 

• Hillingdon- in partnership with Advance and Asian Women’s Resource Centre 

The Deputy Mayor for Policing and Crime is recommended to:  

Approve a variation to the grant held between the VRU and IRiSi, costing £1,500,000. This variation will cover financial years 23/24, 24/25 and 25/26.   

3. To note funding will be provided through one off funding approved as part of the 2023/24 budget. 

4. To approve the carry forward of funds totalling £1,029,705 to align funding with expenditure. 

This decision is seeking approval to vary the VRU grant agreement held with IRiSi to enable a further expansion of the programme. The cost of this variation is £1,500,000. 

PART I - NON-CONFIDENTIAL FACTS AND ADVICE TO THE DMPC 

1. Introduction and background  

1. IRiS is a programme providing training and support to improve the response to domestic abuse within general practice. IRiSi provide training for general practice teams, training materials on health and domestic abuse, and ongoing support to practice teams and clinical leads. Critically, IRiSi identify a local community-based domestic abuse service to provide ongoing advocacy support to women identified by GPs through a dedicated ‘Advocate Educator’ who co-locate within GP practices- ensuring general practice have an ongoing referral pathway into specialist domestic abuse provision.   

2. The programme is based on the principle that primary care has an important role to play in identifying women affected by domestic abuse and facilitating their access to support. Recent research by the National Domestic Abuse Commissioner shows that victims and survivors are most likely to tell a health professional about abuse before any other professionals, and proactive outreach by healthcare services is critical for victims and survivors to understand their rights, and signpost to support.  

3. City Hall are committed to cultivating partnerships to prevent and tackle VAWG. Following the commitment within the Mayor’s VAWG Strategy for London 2022-2025, City Hall are convening a summit with NHS leaders to move towards a pan-London approach to VAWG for the health sector, and to influence the successful implementation of the statutory duty on integrated care boards to create strategies to address domestic and sexual violence.  

4. The VRU are instrumental to the delivery of this summit and believe that the healthcare system has an integral role in prevention and early intervention of violence against women and girls. The IRiS programme is instrumental in changing perceptions of healthcare staff responsibilities in ensuring survivors access the support they need and deserve, and we will use the opportunity of the summit to advocate for sustainable investment by the health system in training for healthcare professionals around domestic abuse- and other strands of VAWG. 

2. Issues for consideration 

1. The VRU have been funding IRISi flagship programme ‘Identification and Referral to improve Safety’ (IRIS) since 2019; 

• ‘7b:’ Tower Hamlets, Croydon, Barking and Dagenham, Brent, Ealing, Hammersmith and Fulham and Westminster (2019-2022)  

• ‘4b:’ Newham, Redbridge, Richmond and Kingston (2022-2025) 

• ‘IRiS ADViSE’: an adaption of the IRiS programme for 2 sexual health clinics (2023-2025) 

2. In May 2022, an independent evaluation of ‘7b’ found robust evidence demonstrating that IRiS is effective in improving the primary care response and increasing women’s access to support. This not only contributes to the improvement of women’s health and well-being (thereby reducing their use of primary care) but can also impact positively on the resilience and protectiveness of families. 

3. In order to identify boroughs to benefit from this new funding, the VRU and IRiSi undertook a mapping exercise. As of April 2023, we found IRiS operating in 16 London Boroughs. 8 boroughs were identified as never having an IRiS intervention before and these boroughs were invited to apply as delivery boroughs. 2 boroughs opted not to apply. 

4. 4 boroughs were identified as previously delivering IRiS but discontinuing the intervention. The VRU contacted these boroughs and found that sustainability of funding- especially by the health sector- was the key factor. Learning from this, and from the sustainability of IRiS 7b, the VRU are supporting IRiS to make contact with local health commissioners from the offset and using our networks to advocate for longer term investment in health by ICBs as part of their responsibilities under the Serious Violence Duty.  

5. Through this programme, the VRU are confident that all London boroughs have had the opportunity to deliver the IRiS programme within their healthcare systems within recent years- and this provides us with a strong position to advocate for commitment and investment from the health system post City Hall investment. 

3. Financial Comments  

1. This report is seeking approval to vary a grant held between the VRU and IRiSi by £1,500,000. The programme will be funded from one-off Mayoral funding approved as part of the 2023/24 budget.  

2. Approval is also being sought to carry forward funds totalling £1,029,705 to align the expenditure across the three financial years of the programme. The full £1,500,000 was allocated to VRU budget in FY 23/24 and through carrying forward funds the programme can be delivered over 3 financial years.  

3. The total value of IRiSi grant, including this variation, over the period will be £2,783,333. 

4. Legal Comments  

1. Under MOPAC’s Scheme of Delegation, the award of individual contracts of £500,000 and above is reserved to the Deputy Mayor for Policing and Crime. This includes the responsibility for signing the contractual agreements. 

2. Officers must ensure that the arrangements comply with the Financial Regulations and Contract Regulations.  

3. Legal advice was sought on any potential Subsidy considerations as a result of the grant award. The grant will be used for non-economic activities only, this has been confirmed by the service provider and will be included in the terms of the grant agreement. As a result of the assessment, it was determined that that the grant award is not a Subsidy.   

4. Officers can confirm that the DMPC has the legal authority to agree this decision.  

5. Commercial Issues  

1. This decision is seeking to award IRISi a grant of £1,500,000 to expand the provision of training and support to improve the response to domestic abuse within general practice. It was determined that the best approach to expand the service was to award money to the provider that has the networks and is already delivering the service. This will ensure that there is a consistent service across all boroughs, efficient monitoring and minimal mobilisation costs. 

2. Officers confirm that IRISi will be providing value for money as the cost's breakdown includes salary costs that are reflective of the current market and the costs submitted in 2019.           

3. As this is a grant and not a contract the Public Contract Regulations 2015 does not apply.  

6. Public Health  

6.1 This programme is part of the London Violence Reduction Unit’s women and girl's portfolio. The programme acknowledges that violence against women and girls is preventable, and the healthcare system- in partnership with specialist domestic abuse organisations- have a unique role to play in intervening early and ensuring that survivors get the support they need. 

7. GDPR and Data Privacy  

1. As this is an extension to an existing programme, there are no changes to GDPR implications 

8. Equality Comments  

1. The VRU have prioritised tackling violence against women and girls (VAWG), recognising that women and girls are disproportionately affected by intersecting domestic abuse, sexual violence and exploitation. The investment in IRiS reflects this prioritisation and supports the Mayor’s Violence Against Women and Girls Strategy. 

9. Background/supporting papers 

1. An independent evaluation of the IRiS programme is available here; 300522-IRIS-in-7B-Evaluation-report-by-DMSS-V4.pdf (irisi.org)