Exam Pass Notes

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Recognition

• Domestic abuse covers physical, sexual, emotional and economic harm, plus threatening, controlling and coercive behaviours.
• First-contact clues include unsafe or monitored contact, restricted phone or online access, controlling relatives, visible fear, and frequent cancellations.
• Coercive control presents as patterns of monitoring, isolation, intimidation, restricted access to resources and pervasive fear.
• Domestic abuse often overlaps with child safeguarding, adult safeguarding, pregnancy-related risks, mental health problems, forced marriage, exploitation and modern slavery.

Safe Response

• Check privacy before asking sensitive questions.
• Do not promise confidentiality, confront an alleged perpetrator, or send messages that could be unsafe.
• Escalate urgently if the patient or children may be in immediate danger.
• When safe, use routine reasons to create private time for questioning.

Records and Sharing

• Record the patient's exact words, safe contact details, who was present and any actions you took.
• Restrict access to records and online systems where disclosure could increase risk.
• Do not disclose appointment details, contraception, pregnancy, mental health or safeguarding information to an unauthorised partner or caller.
• Consult safeguarding leads, clinicians and local policy when deciding what to share.

Escalation

• Use safeguarding leads, appropriate clinicians, emergency services and local domestic abuse pathways for escalation.
• Signposting alone is insufficient where there is immediate danger or clear safeguarding risk.
• Ensure concerns have a named owner and a clear plan; do not leave them as informal worries.
• If no one accepts responsibility, escalate again until the concern is addressed.