Domestic abuse is a public health emergency, experts have claimed, after a report concluded that the NHS is failing victims by not training staff to spot and respond to the signs of domestic violence.
About one in four people (21.6%) in England and Wales aged 16 years and over have experienced domestic abuse, affecting 12.6 million people, according to the latest figures from the Office for National Statistics.
Analysis shows that the NHS has more contact with victims and perpetrators than any other public service.
But new research by the charity Standing Together Against Domestic Abuse (Stada) claims the health service is missing vital opportunities to save lives. It examined all the official reviews of domestic abuse-related homicides and suicides published in 2024 and found that about 90% cited safeguarding failings by the NHS.
Lack of domestic abuse training was the most frequent criticism identified. National Institute for Health and Care Excellence guidance advises mandatory training for frontline NHS staff in identifying and properly caring for domestic abuse victims. But Stada’s analysis found that such training was “sporadic and inconsistent”.
The report also highlights repeated failures by the NHS to record risks, share information and get victims help from other specialists such as alcohol and mental health services, and independent domestic violence advisers.
The findings follow a separate study published in the Lancet Regional Health Europe, which calculated that 26% of all women who died by suicide, and were known to secondary mental health services, had been a victim of domestic violence.
The government is due to publish its strategy this summer on how to meet its pledge to halve violence against women and girls by 2034.
But without urgent action, this ambition will not be achieved, the Stada report concludes. The NHS should fund mandatory, standardised domestic abuse training for frontline health professionals and specialist support such as mental health domestic violence advisers, the study recommends. Data recording and information sharing should also be improved.
Cherryl Henry-Leach, the chief executive of Stada, said: “We call on the government to recognise domestic abuse as a public health issue.
“Treating [domestic abuse] solely as a criminal justice issue costs lives. The NHS has more contact with victims and perpetrators than any other public service, making it uniquely positioned to address this crisis.”
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Tim Woodhouse, a suicide prevention specialist and author of the Churchill Fellowship report on suicide and domestic violence, said: “Domestic abuse is a public health emergency. The level of physical and mental pain imposed on victims (and their children) by perpetrators is immense and we know that, for many, that mental torture becomes too great and they end up taking their own life.
“I’ve calculated that 1,800 people a year could be dying in domestic abuse-related suicides every year. This is a tragically high waste of life, and a national scandal.”
Andrea Simon, the director of the End Violence Against Women Coalition, said: “Healthcare workers are often the first, and only, point of contact for victims of abuse and it is essential they are equipped to identify, signpost and safeguard victims who need support. As this report shows, the consequences of inaction can be serious harm, including death. It’s time the government took action on repeated recommendations in domestic homicide reviews and ensured all health professionals receive comprehensive training, including on the risk posed by domestic abuse-related suicides.”
Prof Kamila Hawthorne, the chair of the Royal College of GPs, said given the trusted relationships GPs have with patients, “it is concerning to hear that opportunities to help victims might be being missed”.
More training would be welcomed and valuable, she added, “as long as these are appropriately funded, take into consideration the existing training that GPs receive on safeguarding, and the workload pressures we face daily”.
An NHS spokesperson said: “All NHS staff are required to complete safeguarding training on domestic violence and abuse to give them the skills and knowledge they need to support victims and survivors, and this training is currently being updated.”
A government spokesperson said: “We remain resolute in our mission to tackle domestic abuse and put a system in place that protects victims, supports their journey to justice and holds perpetrators to account.
“Healthcare professionals are often the first lifeline for domestic abuse victims – playing a vital role in supporting them to overcome trauma and rebuild their lives – and we have prioritised funding to deliver an additional 345,000 NHS talking therapies interventions to ensure survivors get the support they need.
“Through our plan for change, we are developing a coordinated approach across government, underpinned by a new strategy to be published later this year, to prevent domestic abuse and protect victims.”