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NHS GRAMPIAN Gender Based Violence (Support for Staff) Policy

This document is also available in large print and other formats and languages, upon request.

NHS Grampian will pay for “Language Line” telephone interpretation or “face to face” interpretation for staff whose first language is not English, should this be required

Similarly, NHS Grampian will pay for British Sign Language interpretation or the production of material in different formats for staff with a communication disability.

Please call NHS Grampian Corporate Communications on (01224) 551116 or (01224) 552245.

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NHS GRAMPIAN Gender Based Violence (Support for Staff) Policy

Index Page

1 Scope 4

2 Definition 4

3 Policy Statement 4

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5

6

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8

9

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12

13

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17

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Principles and Values

Confidential Contacts

Training for Key Staff 6.1 Content of the Training 6.2 Resources

Responding to Gender Based Violence 7.1 Impact on the workplace 7.2 Impact on work colleagues

How Gender Based Violence may affect staff 8.1 Current/ongoing abuse 8.2 Past Abuse

Barriers to seeking support

Supporting staff with experience of abuse 10.1 What managers can do

Responding to a disclosure of abuse

Vicarious Harm

Possible work related adjustments

Responding to staff who may be perpetrators

Allegations of abuse within the workplace

Allegations of abuse outside the workplace 16.1 What managers can do

Allegations of abuse – Criminal proceedings pending 17.1 Notification of perpetrators, post conviction

Links to adult protection

Appendices

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6 6 6

6 6 6

7 7 8

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NHS GRAMPIAN Gender Based Violence (Support for Staff) Policy

1.0 Scope

Gender Based Violence (GBV) is a major public health issue which cuts across the whole of society. It is also a fundamental violation of human rights. Given its prevalence within the wider population, and the size of the workforce in NHS Grampian, it is inevitable that a significant number of NHS Grampian employees will have experience of some form of abuse, past or current.

Whether it takes place within or outside of the workplace, the employment implications for employees who experience abuse are significant. It can have a detrimental impact on health and well­being, which may affect attendance, performance or productivity.

Allegations of abuse made against employees could have potential implications for their employment role and could breach organisational and professional codes of conduct.

• NHS Grampian is committed to supporting patients through disclosures of domestic abuse. For NHS Grampian’s GBV policy and guidelines to support staff when dealing with such disclosures please see:

• Asking about Domestic Abuse

• Adult Survivors of Childhood Sexual Abuse – Link to GBV Policy: Domestic Abuse

2.0 Definition

Gender Based Violence is an umbrella term that encompasses a spectrum of abuse experienced mostly by women and perpetrated mainly by men including: domestic abuse, rape and sexual assault, childhood sexual abuse, sexual harassment, stalking, commercial sexual exploitation and harmful traditional practices such as female genital mutilation (FGM) which is illegal in the United Kingdom, forced marriage and so­called ‘honour’ crimes.

3.0 Policy Statement

The creation of a specific policy on Gender Based Violence demonstrates the commitment of NHS Grampian to improving the safety and welfare of all staff affected by abuse. Having an explicit policy enables organisations to:

• Raise awareness of GBV as a serious health and social issue, highlighting its hidden nature and the impact on those affected by it

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• Send a positive message to employees with experience of abuse that they will be listened to and supported

• Project a clear signal that the actions of employees who perpetrate abuse, within or outside the workplace is unacceptable

• Strengthen their commitment to addressing the issue? by formally recognising and responding to Gender Based Violence as a serious workplace issue

4.0 Principles and Values

The principles and values of this policy reflect those within other NHS Grampian policies i.e. valuing all employees and acknowledging that they have a right to work in an environment that is safe, promotes equality, dignity at work and encourages individuals to treat each other with respect.

NHS Grampian is committed to ensuring that all employees have equitable access to the provisions of this policy. Given this, the policy takes account of the barriers and differential needs of staff who may require additional support due to the impact of various forms of inequality i.e. gender, race, disability, sexual orientation, age, socio­economic status, religion and belief.

All disclosures of abuse experienced by employees should be treated confidentially, the key exception being situations where there is reason to believe that there may be a risk to others, including harm to children. In these circumstances, local child/adult protection procedures should be followed.

NHS Grampian is committed to creating an environment in which employees are safe to disclose their experience of abuse in order to access support and increase safety for themselves and others. The right of staff not to disclose must be respected and no­one should feel pressured into sharing this information if they do not wish to do so.

As is the case with other criminal convictions, employees (and prospective employees) are required to disclose any unspent convictions related to abuse. Furthermore, depending on the nature of the role, prospective employees may also be required to disclose spent convictions as part of the application process.

5.0 Confidential Contacts

Given the sensitive nature of this issue and the challenges it may present for managers, NHS Grampian has identified a network of Confidential Contacts for Gender Based Violence.

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6.0 Training for key staff

Although managers may recognise GBV as a serious social issue, they may not necessarily feel equipped to respond appropriately to disclosures of abuse from staff. Consequently it is important that they have access to guidance and support.

To ensure this is available, it will be necessary for key staff with such a role to receive training on understanding the provisions of this policy and its implementation i.e. Line Managers, HR, Occupational Health, Learning and Development Staff and GBV Confidential Contacts. Key staff are encouraged to complete the GBV AT learning course.

6.1 Content of the training should cover:

• The nature of Gender Based Violence and its impact on the workplace;

• Awareness of the legal context

• Why Gender Based Violence is a management responsibility

• How to risk assess and safety plan

• How to respond effectively to allegations of abuse

• Who to go to for support and advice

6.2 Resources

Training will be provided through AT Learning – Gender Based Violence course

7.0 Responding to gender based violence

7.1 Impact on the workplace

• Negative impact on an employee’s ability to attend or function effectively at work e.g. s/he may have mood swings, be constantly tired or preoccupied, have difficulty concentrating, be withdrawn and have a strained relationship with colleagues

• Absenteeism due to long­term physical injuries and/or psychological symptoms such as anxiety/depression and using drugs/alcohol as a coping strategy – these may be linked to former abuse in childhood or adulthood

• Lateness as a result of the abuser attempting to prevent an employee from going to work

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• Harassment/abuse at the workplace; such behaviour can include numerous telephone calls, faxes or emails or the abuser turning up. Employees may be stalked, or subjected to verbal or physical abuse at the workplace or whilst travelling to and from work

7.2 Impact on work colleagues

Gender Based Violence can also affect other staff members who may:

• Have to fill in for absent or less productive colleagues

• Try to protect a colleague experiencing abuse from unwanted phone calls or visits

• Feel helpless and unsure about how to intervene

• Be distracted from their own work

• Fear for their own safety

8.0 How gender based violence may affect staff

It is important to recognise that some staff may have experience of more than one form of Gender Based Violence.

All forms of abuse can have an adverse impact on both physical and mental health. Although the actions required to support staff may vary depending on the nature and timing of the abuse, the core principle of offering a supportive and flexible response remains consistent. For example:

8.1 Current/ongoing abuse

This may be in the context of domestic abuse from a partner or ex­partner; it may involve ongoing physical and psychological abuse, threats, and/or stalking and harassment. In such instances, there may be an urgent need for a workplace risk assessment and safety planning to assess the potential risks to the staff member, children, colleagues and others.

Flexibility around working arrangements may also be needed and information made available on what support can be provided by the NHS and other national/local agencies such as the Domestic Abuse Helpline, Men’s Advice Helpline, Women’s Aid, Rape Crisis, Scottish Women’s Rights Centre which offers free and confidential legal information (08088 010 789) and advice and trade unions/professional organisations etc.

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8.2 Past Abuse

Employees may have experienced abuse in the past e.g. sexual abuse in adulthood or childhood, which is currently interfering with their ability to cope, and they may need support to deal with this. Their current reaction might have been triggered by working with patients on these issues, requiring some flexibility and sensitivity around their case management. It may also be that they are involved in legal proceedings around the abuse and need to have both practical and supportive line management during this period.

9.0 Barriers to seeking support

Although widespread, Gender Based Violence is often hidden, generally occurring in a private or domestic setting, away from the workplace. The vast majority of cases of abuse are not disclosed to public agencies (including the police) and of those which are, relatively few result in criminal convictions. The covert nature of abuse and the impact it has on individuals can act as barriers to disclosure. For example:

People who have experienced abuse are often silenced by the perceived shame and stigma that surround it. They may feel they will be judged or blamed for the abuse and may therefore be reluctant to seek help within the workplace.

Issues around trust and concerns about confidentiality, especially if children are involved or if the perpetrator is also an NHS employee, can make it difficult for individuals affected to come forward.

Staff may fear that seeking help could impact on how they will be treated by managers or colleagues, e.g. that they may be perceived as less competent or ineffective in their post and/or that it may prejudice career advancement.

It is equally important to be mindful of diversity within the workforce, and that staff may have other experiences of discrimination or inequality which could affect the impact of abuse. For example:

People in lesbian, gay or bisexual relationships who have not disclosed their sexual orientation may be reluctant to discuss domestic abuse, thereby ‘outing’ themselves in an environment which they may fear to be unsupportive or homophobic.

Whilst Gender Based Violence is predominantly experienced by women; it does impact on some men. Disclosing abuse can be difficult for men who may fear being seen as ‘weak’ or ‘unmanly’. Male survivors of rape or childhood sexual abuse may also fear being regarded as potential abusers given the widespread acceptance of the myth of the ‘cycle of abuse’.

Black and minority ethnic (BME) staff may be concerned that they will be ostracised in their communities, or accused of bringing dishonour on their families if they disclose abuse. They may be fearful of feeding racist or

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stereotypical views within the workplace which may minimise or dismiss their experiences.

Forms of domestic abuse can vary, e.g. forced marriage or so­called ‘honour’ based violence, which may be perpetrated by extended family members of both sexes as well as a husband/partner.

10.0 Support Staff with experience of abuse

NHS Grampian is committed to creating a working environment that enables employees affected by abuse to feel safe and confident in seeking support and advice from a range of sources i.e. Line Managers who should then seek assistance from Occupational Health and HR staff. Awareness of abuse is the responsibility of all line managers, however support should come from OHS and HR – See Appendix 1.

10.1 What managers can do

Managers have a role to address the needs of employees who have experience of abuse. In responding to staff, they are expected to be available and approachable; to listen and reassure; respond in a sensitive manner and discuss how the organisation can help the employee.

In cases where a member of staff raises her/his experience of abuse, managers should endeavour to provide flexible support, tailored to meet the circumstances of each individual, taking account of any additional needs that they may have. Managers should be aware of the potential barriers that make it difficult for employees to seek support and should be conscious not to make judgements or to provide counselling or advice.

When responding to employees managers should refer to local policies and act in accordance with child/adult protection procedures, referring to Occupational Health and Human Resources as appropriate.

If an employee discloses experience of abuse during procedures in relation to performance, absenteeism etc, this should be taken into account. If it is felt that the issue can be resolved by addressing the support/safety needs of the employee, then the process may be suspended. Managers should refer to local Employee Conduct, Employee Capability and Managing Attendance at work as appropriate.

As a manager you can support staff in a number of ways. Appendices 2 and 3 contain how you can support staff and also give examples of potential signs of abuse.

11.0 Responding to a disclosure of abuse

Be aware of some of the barriers to disclosure for employees e.g. not recognising/wanting to recognise their experience as abusive, fear of bringing

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shame or dishonour to their family, fear that they might lose their children, belief that the abuse is their fault, concerns about confidentiality

• Treat staff with respect and dignity. Be non­judgemental, supportive and sympathetic.

• Be clear about the parameters of your role, i.e. providing information and practical support but not offering opinions or advice or adopting a counselling role.

• Take account of any additional cultural and inequality needs

• Carry out a work place risk assessment to minimise any potential risk to staff members and colleagues.

• Ascertaining risk involves taking account of the information provided by the staff member. The level of risk is likely to vary depending on whether the abuse is past of current and on the behaviour of the alleged perpetrator e.g. is there any immediate danger? Are there threats of harm to her/him/others? Is there sexual violence? What is the employee’s assessment of the threat from the perpetrator? Are there child protection issues?

• If a member of staff discloses that they had been abused/were abusing a member of their family and this was happening in front of children in the home, this should be reported in line with guidance contained in GIRFEC – Getting it right for every child ­ even in the absence of child protection concerns.

12.0 Vicarious Harm

It is recognised that staff may be emotionally affected by staff members disclosing and listening to details of gender based violence/abuse. Staff should be reminded that they can use the services of the Occupational Health Service for support at any time.

13.0 Possible work related adjustments

There is scope within the current workplace adjustment policy for managers to consider a range of work­related adjustments. For example:

• Managers should ensure flexibility for staff and adopt a flexible approach to enable staff to accommodate appointments within their working week. This should follow the provisions of the Special Leave Policy.

• Provide job security for staff attempting to flee an abusive situation and/or where possible give favourable consideration to any request for a change of workplace/work arrangements

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• Change work patterns or adjust workload for a temporary period to make it more manageable.

• At times when the employee needs to be absent from work, mutually agree a safe, confidential method of communication and consider any safety implications that may arise when working from home

If an employee does not wish to take up support:

• Depending on their situation, some employees affected by abuse may refuse support or only take up partial support. This can be concerning, especially if the employee has begun to accept assistance and then decides to go back to an abusive situation or tries to minimise their abuse.

• It is the choice of the employee whether to accept support and the organisation cannot share what s/he has disclosed with anyone unless there are reasons to break confidentiality.

• Respect the employee’s decision, reassure them that your primary concern is his/her safety and remind the employee that support is available if s/he needs it in the future.

14.0 Responding to staff who may be perpetrators

It is acknowledged that a number of employees may be perpetrators of abuse and that committing acts of Gender Based Violence is a serious matter which:

• Contravenes equalities and human rights legislation

• Could constitute a criminal offence

• May breach corporate and professional codes of conduct

It is important that the organisation makes explicit that such behaviour is unacceptable and managers should invoke the Employee Conduct Policy to enable them to respond effectively to allegations of such misconduct.

15.0 Allegations of abuse within the workplace

Employees who are perpetrating abuse might use workplace resources such as transport, telephone, fax or e­mail to threaten, harass or abuse current/ex­ partners or others. Their behaviour might also include stalking, physical assault, sexual violence or sexual harassment.

This conduct could be dangerous for those being abused and could bring the organisation into disrepute. In such circumstances, disciplinary proceedings should be considered and where appropriate, action may need to be taken to

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minimise the potential for employees to use their position or work resources to perpetrate abuse.

16.0 Allegations of abuse outside the workplace

Employees may be perpetrating various forms of Gender Based Violence outside of the workplace. For example, domestic abuse, physical or sexual abuse of children, downloading child pornography, sexual violence, involvement in honour based violence, or stalking.

Given that such conduct could constitute a criminal offence, many of these examples would most likely involve criminal proceedings. However, whether or not criminal charges are involved, or there is a conviction, this behaviour may, in some cases, lead to disciplinary proceedings against an employee because of its employment implications.

Perpetrating these forms of abuse could also breach organisational and professional codes of conduct and potentially bring the NHS into disrepute, especially if an allegation of abuse was not acted upon and allowed to continue.

16.1 What managers can do

•When a disclosure or allegation of abuse is brought to the attention of a manager, this should be acted on. Managers should respond in the same way that they would address any other serious complaint against a staff member by following local policies and seeking advice from HR as necessary.

• Where the source of such allegations is anonymous, or where the allegation relates to abuse outwith the work environment, it may be that NHS Grampian is not in a position to take action. Advice should be sought from HR as the circumstance of each case will require to be considered. There may be considerations for staff that have a Professional Registration. An allegation of abuse will not automatically result in an investigation. See Appendix 3 for flowchart

17.0 Allegations of abuse – criminal proceedings pending

Given that acts of abuse could constitute a criminal offence which could lead to caution, arrest, prosecution and criminal conviction, it is important for managers and HR to take account of the potential impact of any legal action on an employee, using local policies in line with the Employee Conduct policy.

Where an employee has been charged with or convicted of an abuse­related criminal offence, disciplinary action will not be taken automatically. Each situation requires to be considered individually on the basis of whether the staff member’s conduct warrants action because of its employment implications. Refer to the Employee Conduct Policy for detail.

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17.1 Notification of perpetrators, post conviction

There is a list of professions, including health, whereby the police are required to notify the employer and any relevant professional body of a conviction (including cautions). In the case of a conviction for a charge or associated charge relating to GBV, it is possible that such a conviction could compromise the individual’s ability to fulfil their duties and damage the relationship of trust and confidence between employer and employee. NHS Grampian would then consider the charges that had been proven against the employee and an investigation which may result in disciplinary action.

18.0 Links to adult protection

It is recognised that there will be some situations where a member of staff who is experiencing gender based violence may also be an adult at risk of harm under the provisions of the Adult Support and Protection 2007 Act. An adult at risk is a person aged over 16 who is unable to safeguard their own well­being, property, rights or other interests; and, is at risk of harm because they are affected by a disability, mental disorder, illness or physical or mental infirmity. All Health professionals have statutory duties, under this legislation and must report the facts and circumstances to the local Adult Protection Unit when they know or believe that someone is an adult at risk and that action is needed to protect that adult from harm. NHS Grampian staff have a duty to co­operate with the Adult Protection Unit to enable or assist those making inquiries.

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Appendix 1 Support for Staff who have disclosed experience of abuse

Staff member with previous or current experience of abuse

External agencies NHS Grampian

Line Manager Occupational Health HR

Employee counselling service Women’s Aid Men’s Helpline Rape Crisis Survivor Scotland Victim Support Scotland Trade Unions/Professional Organisations

For further information on local and national support available, please refer to Appendix 4

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Appendix 2

As a manager you can support staff by:

• Being aware of the possibility that staff members could be affected by past or current abuse

• Recognising potential signs of abuse

• Initiating discussion if you have concerns about abuse

• Responding sensitively to disclosure

• Considering what workplace supports you could provide within the scope of current NHS Grampian provisions

• Providing information about other sources of help

• Assessing reasons for being persistently late without explanation and/or needing to leave work early

• Recognising there may be a high absenteeism rate without explanation

• Allowing the employee regular time off for ‘appointments’

• Monitoring changes in quality of work performance for unexplained reasons, e.g. may start missing deadlines and show additional performance difficulties despite a previously strong record

• Anticipating interruptions at work, e.g. repeated upsetting calls/texts/e­ mails

• Recognising changes in behaviour; may become withdrawn and quiet, avoid interaction, making acquaintances or friends at work, may always eat alone

• Preparing to see the employee cry at work or be very anxious

• Anticipating the employee may demonstrate uncharacteristic distraction, problems with concentration

• Recognising they may exhibit fearful behaviour such as startled reactions

• Managers and staff may find the following links to further policies useful:

• Asking about Domestic Abuse

• Adult Survivors of Childhood Sexual Abuse

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Appendix 3

Flowchart detailing support to staff

Actively promote the policy to staff

Be alert to the possible indicators of abuse

Ask if employee is experiencing abuse

Create an environment where employee feels safe and able to discuss issues of abuse that are affecting her/him

Take time to talk, listen to the employee and make sure the discussion takes place in private

Respect confidentiality and advise of the limits of this at the outset i.e. risk to the safety of others, child protection etc

Reassure the employee and acknowledge their experience

Provide a sensitive, supportive response that takes account of any additional cultural and inequalities

Discuss potential options for support (internal and external), taking cognisance of existing provisions within relevant NHS Grampian policies

Risk assess, safety plan and work in partnership with other relevant agencies as appropriate

Report to the Adult Protection Unit if the member of staff is an “adult at risk”

Report to the named person if there are Child Protection/Wellbeing issues

If a member of staff has disclosed that s/he is an abuser/has been convicted of GBV the manager should seek HR advice and consider when would be appropriate to investigate such matters.

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APPENDIX 4 NHS GRAMPIAN

DOMESTIC ABUSE POLICY

Details of external agencies which can provide advice and/or support to victims of domestic abuse.

ABERDEEN CITY COUNCIL 01224 264266 Out of Hours: 01224 693936 e­mail: AdultProtection@aberdeencity.gcsx.gov.uk

ABERDEENSHIRE COUNCIL 01651 871246 Out of Hours: 0845 84 000 70

e­mail: adultprotectionnetwork@aberdeenshire.gcsx.gov.uk

MORAY COUNCIL 01343 553140 Out of Hours: 0300 123 0897 e­mail: accesscareteam@morag.gcsx.gov.uk

ABERDEEN WOMEN’S AID The Green, Aberdeen AB116PE Telephone: 01224 59157766 (Monday­Friday

9.30am­4.30pm)

Emergency telephone number: 07702 294064 (out of hours)

Provides refuge accommodation (limited disabled access), information advice and support.

DOMESTIC ABUSE OUTREACH WORKERS (ABERDEENSHIRE)

Telephone numbers: North Aberdeenshire ­ 01779 484221 South Aberdeenshire ­ 01358 725756

The Domestic Abuse Outreach Workers are trained Social Workers who provide support to victims of domestic abuse.

DOMESTIC ABUSE PROJECT (ABERDEEN)

Telephone: 0845 345 6766 (Monday – Friday 9.30am­ 3.30pm)

This is a telephone advice line which provides support and information as required. Where necessary arrangements can be made to meet with the caller.

Professionals only can contact Dorothy on 01224 522714

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GRAMPIAN WOMEN’S AID Crown Terrace, Aberdeen AB11 6HE. Telephone: 01224 5933816 Hours: Monday – Friday 10am­4pm

Provides refuge accommodation, both in Aberdeen City and Aberdeenshire (disabled access available in 3 of the 4 refuges), advice, support and information.

HEMAT GRYFFE WOMAN'S AID DROP­IN CENTRE

Flat 0/1, 24 Willowbank Street, Charing Cross, Glasgow, G3 6LZ. Telephone: 0141 353 0859 Fax: 0141 564 1277 e­mail: womensaid@gryffe.fsnet.co.uk web site: www.hematgryffe.co.uk

Provides temporary refuge accommodation to minority ethnic women fleeing domestic abuse, follow up support and drop in centre.

MORAY WOMEN’S AID 21­27 Murray Street, New Elgin IV30 6DT. Telephone: 01343 548549

Office hours: Monday, Tuesday, Thursday, Friday­ 9.30am­4.30pm

Helpline: Monday­ Friday 9.00am­10.00pm and on call Sat/Sun 4.00pm­10.00pm and on call Wednesday ­9.30am­1.30pm

Provides refuge accommodation (disabled access), information, support and advice (new refuge scheduled for October, 2005.)

POLICE ­ DOMESTIC ABUSE LIAISON OFFICERS

Telephone: 0845 600 5700

Call the above number and ask to be put through to the Domestic Abuse Liaison Officer (DALO) for your area. Grampian is split into four areas­ Aberdeen City, Moray, Aberdeenshire North and Aberdeenshire South.

In an emergency call 999

SCOTTISH DOMESTIC ABUSE HELPLINE

Telephone: 0800 027 1234 (24hrs)

The helpline workers will provide support over the phone as well as information. They are also aware

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of Domestic Abuse services across Scotland and can inform callers where they can obtain assistance in their own area

SHAKTI WOMEN’S AID (SCOTLAND)

Telephone: 0131 4752399 Monday­Friday 10am­5pm

Website: www.scottishwomensaid.co.uk/shakti

Provides refuge accommodation, advice and support for women and young girls from black and minority ethnic groups who are affected by domestic abuse and forced marriage (abuser may be from the woman’s extended family). Disabled access.

SCOTTISH WOMEN’S AID Website: www.scottishwomensaid.co.uk

Provides advice and information on local services, the law, safety and what to expect from a refuge.

There are other services which, while not specialising in Domestic Abuse, may also be able to provide support and information.

It may also be the case that office hours, premises and telephone numbers for the agencies listed above may change. A comprehensive and current list of agencies can be accessed at www.grampiancaredata.gov.uk