GENDER VIOLENCE FOR HEALTH CARE PROFESSIONALS IN SPAIN. Gerencia Regional de Salud de Castila y León GENDER VIOLENCE FOR HEALTH CARE PROFESSIONALS IN SPAIN. Carmen Fernández Alonso. PhD.Family Physician. Health Service Programs of Regional Health Services of Castilla y Leon (Spain) Coordinator Gender Violence Representative of Gender Violence in the International Group of SEMFYC Lydia Salvador Sánchez Family Physician. Regional Health Services of Castilla y Leon (Spain)

Gerencia Regional de Salud de Castila y León. Spin Gender Violence. Experience in Spain Institutional Framework 2004: Comprehensive law on Gender Violence (GV) 2006: Awareness Plan: includes the training of professionals 2006: Incorporation of the GV care in the NHS services portfolio 2007: Adoption of a Common Protocol for healthcare action against GV 2008:Progressive implementation of the detection and care service to GV in the regional health services. Assessment and annual reports:Epidemiological monitoring and training; data sent to the ministry. 2012 :Update of the Common Protocol 2012: Identification, accreditation and recognition of best practices in GV in NHS 2017: State Pact against women violence. Ministry of Health Deployment of Implementation and Training Plan Women Health Observatory Evaluation Work Group ç Training Work Group Protocol elaboration Work Group Epidemiological surveillance Work Group Ethic and Legal aspects Work Group

How to translate a national strategy to a regional level ? Gerencia Regional de Salud de Castila y León. Spin Gender Violence. How to translate a national strategy to a regional level ? Regional laws. Laws and Plans about Violence and Equality 2010: Law against gender violence in Castilla y león more comprehensive, it covers more types of violence and supplying all existing resources even if there is no complaint. IPV management included in primare care portfolio IPV indicator included in primare health care program contract Local leadership Intersectoral coordination committees Development of the gender violence Plan in the Health Sector Adaptation of protocols and guides to local contexts Resources network of the region

Gerencia Regional de Salud de Castila y León.Spain Barriers But… Development is not homogeneous in all regions Problems in coordination: some security gaps and not appropiate agility in the women attention. Technical difficulties, professional resistences, non-fluid information

Gerencia Regional de Salud de Castila y León.Spain Integrated Model in attention to violence against women “Zero Violence Objective” Basic Principles: Integration in the public system Proactivity Comprehensive and person-centered care Interinstitutional collaboration Integrated resources management through networking

(Social Action Centre) Social Services Juridical Sevices Support and trainning for employment Service Psycological Attention Service women and children Psycologial Attention to perpetrator Program Health Services Education System C.E.A.S (Social Action Centre) Case Manager

(Social Action Centre) C.E.A.S (Social Action Centre) Benefits: Proximity centers: Rural and urban Better accessibility It has the most information of the case Direct communication with Health, Social S, Justice and Police Forces Functions: Case manager: Management and coordination of resources Detection Assesment Attention plan Provision of benefits Follow up the cas Professional profile: Social worker/ psychologist

Social support model in gender violence Women department (per province): Institutional connections, service providers Units specialized in gender violence: support in difficult cases Case manager:screening assesment, provision and monitoring

COORDINATION IN THE ATTENTION TO GENDER VIOLENCE HEALTH SERVICES SOCIAL SERVICES HIGH RISK OF NEW SERIOUS AGGRESSION FIRST LINE SUPPORT LISTEN VALIDATE RISK ASSESMENT SUPPORT EMERGENCY HOSTING CENTRE  JUDICIAL SYSTEM POLICE FORCES CASE OF GENDER VIOLENCE INFORMATION FEED-BACK NO VITAL RISK IS DETECTED SECONDARY SUPPORT IN HEALTH SERVICE Doctor / Nurse / Social Worker / Matron Information Accompaniment Empowerment Escape plan SOCIAL ACTION CENTER CASE MANAGER Psychological Support Legal Support Employment Support CASE COORDINATION OR SOCIAL NEEDS

Gerencia Regional de Salud de Castila y León.Spain Development of a Plan of awareness and training of Gender Violence in the Autonomus Communities CHALLENGES To maintain and enhance the training of the professionals: Joint training between health and social services To promote detection and record in the clinical history and other records To include the IPV training in the curricula of undergraduate and postgraduate in health professions, social workers, judicial and law career…involved in the care of women and in education careers To improve coordination between Primary Care and Specialty Care, Move towards an approach integrated with the participants involved To give more participation to women and their associations both in the development of guidelines and protocols like to hear their voice. (Social and health Commissions) Systematic evaluation of the effects of interventions To promote applied research: results, effectiveness of interventions, analysis       results, consequences, costs, protective factors, etc.   

FUTURE: Integrated Care Systems Intensify the model that is being implemented Improve communication between professionals. Implement technological tools to integrate information

SOCIAL-SANITARY PLATFORM ACTUAL MODEL: INTERDISCIPLINARY COORDINATION FUTURE MODEL: INTEGRATED ATTENTION Coordinated Social and Sanitary Attention INTEGRATED SOCIAL AND HEALTHCARE Collaboration through the platform EMERGENCY HOSTING CENTRE JUDICIAL SYSTEM HOSPITAL CEAS (CASE MANAGER) PRIMARY CARE OTHER SOCIAL SERVICES POLICE FORCES

Dra. Carmen Fernandez Alonso Dra. Lydia Salvador Sánchez Gerencia Regional de Salud de Castila y León Thank you very much Dra. Carmen Fernandez Alonso Dra. Lydia Salvador Sánchez Email: mcfernandeza@saludcastillayleon.es lsalvadorsa@saludcastillayleon,es