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'Virtual' Domestic Abuse Training for London Ambulance Crews

Ambulance crews in London are being trained to spot possible domestic abuse by an immersive virtual reality (VR) programme. The London Ambulance Service (LAS) described the true-to-life scenarios — filmed using actors — as "hard-hitting". The training aims "to help clinicians understand the impact of various types of abuse and trauma on the physical and mental wellbeing of vulnerable adults and children".  

Ambulance personnel are often the first people to identify a vulnerable adult or child, and they can refer cases to an appropriate agency where there are concerns about abuse or neglect. In 2022-2023, LAS made 33,002 safeguarding referrals, up 9.2% from 30,216 the previous year, and a 39% increase on the 23,741 referrals in 2018-2019.

LAS is the first ambulance service in the country to use VR technology for safeguarding training. The VR headsets enable ambulance personnel to immerse themselves in simulated traumatic situations such as sexual abuse and domestic violence, to help them spot the signs and better prepare them for real-life situations where vulnerable people might need help. 

The simulated scenarios also include scenes of drug abuse, child grooming, modern slavery, and gang intimidation, giving users a 360 degree view. 

Paramedic Patrick Hunter said: "I thought I was unshockable, but this was really sobering to watch. I was shocked, but necessarily so. Seeing things from a child's perspective helps us to understand how integral safeguarding is to our practice."

He added that the training helped crews to understand that a child who seemed rude, or refused to engage, might in fact be very vulnerable and in need of help.

Alan Taylor, LAS's head of safeguarding, said: "The immersive experience allows ambulance staff to see things from a patient's perspective and to help understand the fear, so they truly empathise with their patient. This gives our crews a greater understanding of how vulnerable patients may display signs of trauma and means they can better protect children and adults at risk."

Domestic Abuse a 'Largely Hidden' Crime

According to charity Women's Aid, domestic abuse is "a largely hidden crime", as it occurs primarily at home. Women often don't report or disclose it to the police — even though police in England and Wales receive on average over 100 calls relating to domestic abuse every hour and describe the problem as "enormous". A report in 2015 noted that domestic abuse-related crime constituted 10% of all recorded crimes and a third of all recorded crimes involving assaults with injuries.

Whilst abuse prevalence figures are notoriously unreliable, data from the Crime Survey of England and Wales show that only 18% of women who experienced partner abuse in the previous year reported it to the police. Domestic abuse included non-sexual abuse, sexual assault, and stalking. The survey estimates that around 1.6 million women aged 16 to 74 years experience domestic abuse each year, representing 7.3% of all women.

The Government defines domestic abuse as "any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members". Abuse may be psychological, physical, sexual, financial, or emotional. Overall, nearly three quarters of victims of domestic abuse-related crimes are female in 2020, according to data from the Office for National Statistics. 

The videos and technology that LAS are using were developed by health and social care technology company Antser, which said that its programme was "designed to enhance the adults' understanding of a child's emotions, trauma and potential triggers", and was used by 45% of local authorities, as well as NHS trusts, schools, the police, and independent providers.

LAS plans to develop bespoke scenarios for emergency service call handlers, to help them identify patients at risk when taking 999 calls. 

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