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NSW Health Violence, Abuse and Neglect Health Redesign Program

Responsible government

  • New South Wales

Fourth Action Plan actions

  • Respect, listen and respond to the diverse lived experience and knowledge of women and their children affected by violence
    • 11 Deliver policies and services to address the disproportionate impact of violence on particular groups.
  • Respond to sexual violence and sexual harassment
    • 14 Deliver client-centred, trauma-informed, specialised and consistent support to victims and survivors of sexual violence.
  • Improve support and service system responses
    • 16 Enable workforces to provide trauma-informed support with a focus on safety and recovery to victims and survivors of domestic, family and sexual violence.

What are we doing?

The NSW Government’s Violence, Abuse and Neglect Redesign Program will enhance the capacity of the NSW public health system to provide 24-hour trauma-informed and trauma-specific integrated psychosocial, medical and forensic responses to:

  • Sexual assault (adult and children)
  • Domestic and family violence
  • Child physical abuse and neglect
  • Children and young people with problematic or harmful sexual behaviour.

It will also improve service responses to children and young people displaying problematic or harmful sexual behaviour.

The VAN Redesign Program will help to minimise the impact of trauma, support patient recovery from trauma, promote long-term health and wellbeing, and assist interagency partners to promote safety and justice outcomes for victims and the community. It will also enhance the skills, capabilities and confidence of the NSW Health workforce to respond to and meet demand from clients who experience violence, abuse or neglect.

What have we achieved so far?

In 2017–18, the NSW Government allocated $10 million in recurrent annual funding for the VAN Redesign Program. This funding is in addition to budget allocations already provided for NSW Health VAN services and has been distributed through local health district and speciality health network service agreements.

The Integrated Prevention and Response to Violence, Abuse and Neglect (IPARVAN) Framework is a key component of the VAN Redesign Program. The IPARVAN Framework is an overarching strategic platform for all of NSW Health to respond to violence, abuse and neglect. It outlines guiding principles and key priorities to strengthen NSW Health services responding to these issues alongside detailed guidance for NSW Health’s specialist VAN services.

Implementation of the IPARVAN Framework is being undertaken in two overlapping phases:

  • Phase One will focus on the specific efforts required for NSW Health VAN services to strengthen integrated responses. It was the focus of state-wide efforts during January 2019 to June 2020 however implementation will continue into Phase Two;
  • Phase Two will focus on broadening the integrated response for violence, abuse and neglect across the whole NSW Health system and with partner agencies. Phase Two will be the focus of state-wide efforts during July 2020 to June 2025.

Key activities include:

  • The development of the IPARVAN Framework
  • The release of The Case for Change, which gives a summary of key findings from the research and literature.
  • The Integrated Violence, Abuse and Neglect Statistics and Research Project, which has infographics and fact sheets to help workers understand and communicate relevant violence, abuse and neglect statistics and research accurately and succinctly and to dispel myths, mistakes and misinformation about them.
  • NSW Health engaged the Agency for Clinical Innovation to facilitate 12 local health districts and specialty health networks (LHDs/SHNs) with their VAN Local implementation Support Projects.
  • The establishment of Agency for Clinical Innovation VAN Clinical Network
  • The establishment of the Prevention and Response to Violence, Abuse and Neglect Aboriginal Advisory Group
  • Completion of various key policy documents including: VAN Service standards; New Street Policy and Procedures; Child Protection Counselling Services Policy and Procedures; Responding to Sexual Assault (adult and child) Policy and Procedures; Domestic and Family Violence Strategy; Domestic Violence Routine Screening Protocol

Key activities currently underway (as of May 2021):

  • Development of Phase 2 Implementation Plan.
  • Various communications, engagement and co-design Phase 2 activities between VAN services and identified priority services.
  • Development of key policy documents including: Safe Wayz program Policy and Procedures, which is a program that responds to children under the age of criminal responsibility with problematic and harmful sexual behaviours, and their families; Aboriginal Family Wellbeing and Violence Prevention Strategy; Domestic Violence – Identifying and Responding; Joint Child Protection Response Program NSW Health Policy and Procedures.
  • Development of an integrated 24-hour psychosocial, medical and forensic domestic and family violence crisis response, which will be made available in every district across NSW.
  • Domestic Violence Routine Screening in Emergency Departments Pilot
  • Completion of an Evaluation Framework and commencement of an evaluation of Phase 1 by Nous Group, which includes proposed indicators, measures and potential data sources.
  • Local implementation of the IPARVAN Framework with various activities across NSW Health districts and networks.
  • Establishment of the Prevention and Response to Violence, Abuse and Neglect (PARVAN) Serious Incident Review Subcommittee through the Clinical Excellence Commission in order to analyse relevant incidents that have undergone a serious adverse event review or have been referred by the NSW Ombudsman’s Office. The Subcommittee will support the continual improvement of the quality and safety of NSW Health responses to violence, abuse and neglect. The Subcommittee has convened its inaugural meeting and will meet on a quarterly basis.

COVID-19 response has had an impact on the progress of both state-wide initiatives and local implementation of VAN Redesign as many NSW Health staff have been either deployed to the COVID-19 response and/or those in VAN Services have needed to adapt service delivery in response to the pandemic. This has had a small impact on Phase 1 implementation (which had already commenced prior to the pandemic) however has had a larger impact on Phase 2 particularly given the focus on integration across the broader health system and with partner agencies.

What is next?

The implementation of Phase One continues and will work to integrate NSW Health VAN services within districts and networks. Phase One will feed into Phase Two (June 2020 to June 2025), which has commenced. Phase Two aims to increase NSW Health system’s focus on safety and improved health outcomes for people experiencing violence, particularly women and children, and those who present with complex, overlapping health and social issues by providing:

  • a client-centred, integrated and trauma-informed service response;
  • better support for the healthcare staff who provide it; and,
  • linkages with broader health and social systems.

Phase two will see NSW Health integrate NSW Health’s Violence, Abuse and Neglect services with the broader health system and with interagency partners, particularly priority health areas such as mental health, drug and alcohol, maternity, child and family health, youth health and paediatrics. It will continue work with interagency partners to update or develop policies, procedures, guidelines and protocols for joint or multi-agency responses across the spectrum of violence, abuse and neglect.

NSW Health is also undertaking an Evaluation of the IPARVAN Framework. The evaluation has commenced and will be done over a five to six-year period, in the following stages:

  • Stage one will focus on the implementation process of the framework and short-term outcomes at 18 to 24 months post implementation.
  • Stage two will focus on the medium and longer-term outcomes associated with the framework, taking into account a range of concurrent initiatives and reforms at four to five years.
  • Stage three will focus on the economic benefit of the framework at five to six years.

NSW Health will use the analysis to help decision makers determine best value for future investment.

What difference will we make?

The VAN Redesign Program will enhance NSW Health services’ capacity to prevent and respond to violence, abuse and neglect.

The key objectives are to:

  • strengthen leadership, governance and accountability;
  • enhance the skills, capabilities and confidence of the NSW Health workforce;
  • expand violence, abuse and neglect services to ensure they are coordinated, integrated and comprehensive; and
  • extend the foundations for integration across the whole NSW Health system.

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