1. 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)

2. 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

3. 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

4. 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

5. 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

6. (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

7. (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

8. 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

9. 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

10. 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.   

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

12. 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

13. 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