The Department of Health has published new guidance to help nurses and midwives identify domestic abuse, aiming to standardise how healthcare professionals across Northern Ireland spot and respond to victims. The Routine Enquiry into Domestic Abuse Guidance, launched jointly by Health Minister Mike Nesbitt and Justice Minister Naomi Long ahead of International Women’s Day, updates existing protocols that have been in place since 2006.
Strengthening Routine Enquiry
Routine Enquiry involves asking all women about domestic abuse regardless of whether indicators are present. The practice has been offered during pregnancy and postnatal appointments since 2006. The new regional guidance follows a Public Health Agency (PHA)-led review aimed at strengthening and broadening this process.
The review included a service evaluation and engagement with survivors, facilitated by organisations including Women’s Aid, the Rowan Centre and the Department of Health. According to the PHA, domestic abuse remains prevalent across all communities, with recent statistics showing 30,203 domestic abuse incidents recorded by police in the 12 months to 30 September 2025 — a 2.7% decrease on the previous year according to NISRA.
Ministerial Backing
Health Minister Mike Nesbitt said: “The Domestic and Sexual Abuse Strategy (DSA), jointly launched by my Department and the Department of Justice in 2024, provides a vision for Northern Ireland as a place where domestic and/or sexual abuse is not tolerated, and everyone can be safe and free from fear.
“A key deliverable is that domestic and/or sexual abuse is identified and responded to earlier. This guidance document aligns with that commitment as it aims to improve and standardise care provided to families who may be experiencing domestic abuse through early identification and intervention.
“The guidance was developed in consultation with key stakeholders across the five geographic Health & Social Care Trusts, reflects the findings of the PHA review and crucially, is informed by the recommendations of those with lived experience of domestic abuse.”
Justice Minister Naomi Long said: “I wholeheartedly welcome the publication of this guidance for nurses.
“The nature of domestic abuse requires a unique approach, as it is associated with fear and control, and I recognise the important role that nurses, midwives and other health and social care professionals, as first responders, can play in identifying abuse and supporting victims.
“Opportunities for victims to safely share information on what they are experiencing can open a door to help and to justice. This guidance will support the nursing profession by providing the information needed to help them respond appropriately and bring more victims into safety.
“We must all work to ensure that when anyone comes forward to report abuse they receive the right response; have access to guidance, protection and support; and are clear about their options.
“I am delighted that this guidance has been developed through collaboration including by listening to victims about their experiences.”
Scope and Implementation
The guidance applies to midwives, health visitors, school nurses and family nurses. It specifies that Routine Enquiry should be completed at every core Healthy Child, Healthy Future contact if it is safe to do so, including for same-sex couples and foster carers. School nurses should enquire during targeted home visits and when updating Family Health Assessments, while family nurses should follow the Family Nurse Partnership Intimate Partner Violence pathway.
Information sessions to raise awareness will run throughout March 2026, with revised training programmes scheduled for delivery between April and September 2026.
Emily Roberts, Interim Director of Nursing at the PHA, said: “Domestic abuse has a damaging and lasting impact on the lives of adults, children and young people right across Northern Ireland. It is prevalent in every community and can affect people of all ages, socioeconomic status, sexual orientation, gender identity, race or religion.
“This guidance will help equip organisations, midwives, health visitors and family nurses with the understanding, awareness and training to ask the right questions and respond appropriately to help address domestic abuse.”
Context and Considerations
While the guidance aligns with the gender-inclusive Domestic and Sexual Abuse Strategy 2024-2031 — which defines abuse as affecting anyone irrespective of gender — the Routine Enquiry protocol specifically focuses on asking “all women” about their experiences. This distinction raises questions about how male victims and non-binary individuals will be identified through routine health contacts, particularly given that Women’s Aid statistics show 523 women and 364 children stayed in emergency refuges in 2024/25, with six babies born to women in refuge accommodation.
The guidance qualifies that enquiries should be made only “if it is safe to do so,” leaving discretion to practitioners without clear metrics for assessing safety in the moment. Additionally, while the PHA review informed the guidance, the specific findings of that review — including whether disclosure rates had dropped or specific barriers were identified — have not been published alongside the guidance.
Unanswered Questions
- How will the Department of Health measure whether the updated guidance actually increases disclosure rates, and will this data be published transparently?
- What specific safeguards exist for healthcare professionals conducting sensitive enquiries in patients’ homes, particularly given the “if it is safe to do so” caveat?
- How does the focus on asking “all women” align with the strategy’s gender-inclusive definition, and what protocols exist for identifying male or non-binary victims during routine contacts?
- Given the integration with the Healthy Child, Healthy Future framework launched in September 2025, how will workforce capacity constraints affect the ability to conduct these enquiries at every required contact?
The guidance is available to read in full on the PHA website. With domestic abuse incidents remaining at significant levels despite recent decreases, the effectiveness of this updated guidance in bridging the gap between healthcare encounters and safeguarding support will become clearer as training rolls out across Trusts this spring.