Discontinuity of care: Is it undermining our response to domestic violence and abuse?

Domestic violence and abuse (DVA) is common and destructive, but tragically under-detected in primary care. DVA is relevant to healthcare professionals because it corrodes the physical and mental health of those affected. The impact of DVA is trans-generational, damaging the life chances of affected children. People affected by abuse are more likely to be in contact with the health service than any other agency. A study of women attending general practices in East London found that 41% had experienced physical or sexual violence in their lifetime and 17% in the past year.1 Survivors identify doctors as individuals they would disclose to, and GPs can be a crucial source of support. Domestic homicide reviews identify fragmented care as contributing to tragic outcomes.2 Continuity of care is a multifaceted concept, with relational, …