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£34.4 million and 12 areas: the question your GP surgery may now be trained to ask

Qurexa Editorial Team29 October 20267 min read 0 0
£34.4 million and 12 areas: the question your GP surgery may now be trained to ask

What happened

On 23 October 2026, the Department of Health and Social Care confirmed that a programme called Steps to Safety has started in 12 areas of England. Steps to Safety trains staff in GP practices to recognise domestic abuse and sexual violence, and to refer patients to local specialist support. At a participating practice, a patient can speak to any member of staff about abuse, whether it is happening now or happened in the past. It does not have to be the doctor. If the patient agrees, they are referred to an independent specialist support worker. That worker becomes a single point of contact, helps build a safety plan, carries out a risk assessment and advocates on the patient's behalf with other services. The specialist workers are not NHS staff. They come from independent domestic abuse and sexual violence organisations, and part of their job is training the practice team. Phase one covers 12 integrated care boards, which are the NHS bodies that plan services for an area. They were selected in September 2026 and share up to £34.4 million over three years. The areas are Cheshire and Merseyside; North East and North Cumbria; Essex; Norfolk and Suffolk; the Black Country; Birmingham and Solihull; Coventry and Warwickshire with Herefordshire and Worcestershire, which bid jointly; Surrey and Sussex; Kent and Medway; Bristol, North Somerset and South Gloucestershire; and Cornwall and the Isles of Scilly. Separately, DHSC is putting £15 million across all integrated care boards in England over three years to strengthen local specialist support. The programme runs in three phases, starting in April 2026, with the aim of national coverage in England by 2029. It delivers a commitment made in the Home Office strategy Freedom from violence and abuse, published in December 2025.

Why this matters

Most people who are being abused do not walk into a police station. But they do go to the doctor. That is the logic behind Steps to Safety. A GP surgery is one of the few places someone can visit regularly, alone, without needing to explain why. For many people it is the only service they are already in contact with. The gap this programme is trying to close is not willingness. It is training and routes. A receptionist or practice nurse may notice something is wrong and have nowhere obvious to send it. A GP may ask the question and then face the harder one: and now what? Without a named specialist to refer to, disclosure can lead nowhere, and a patient who takes the risk of speaking up learns that speaking up does not help. By funding independent specialist workers attached to practices, the programme tries to make sure there is something on the other side of the conversation. It is also worth noting what the money is for. The £34.4 million is not going on leaflets. It is going to integrated care boards to commission specialist providers, pay for training and secure those specialist workers.

What the evidence actually says

This is an early-stage programme, and the government is treating it as one. DHSC and NHS England say they are developing national support alongside the rollout, including training, resources and chances for areas to share what they learn. Crucially, an independent national evaluation will examine how the programme is delivered and what impact it has. That matters, because the honest position today is that we do not yet know how well this works at scale in England. The approach of placing specialist advocates in healthcare settings has been used before, but phase one is 12 areas out of a much larger country, and the evidence on this specific programme is still being gathered. Anyone claiming it is proven would be getting ahead of the facts. The funding is also unevenly spread, by design. Allocations in phase one range from £722,318 for Cornwall and the Isles of Scilly over three years, to £6,672,213 for the joint Coventry and Warwickshire with Herefordshire and Worcestershire bid. The separate £15 million fund is allocated to all integrated care boards based on the average number of patients registered at GP practices between April and July 2026. For readers in Lincolnshire, where we are based, there is a plain fact worth stating: Lincolnshire is not in phase one. The £15 million fund does reach every integrated care board in England, including ours, but the trained-practice model is not here yet. Phases two and three are intended to extend it, with national provision targeted for 2029.

Qurexa perspective

We deliver medicines to people's homes, so we will keep this brief and honest rather than claiming expertise we do not have. We are not a domestic abuse service and our drivers are not trained specialists. What we are is one of the small number of services that regularly turns up at someone's front door. Community healthcare of any kind, including ours, sits in that same category as a GP surgery: a routine, unremarkable point of contact. The lesson we take from Steps to Safety is the one about routes. Noticing is not enough on its own. Knowing where something goes next is what turns a concern into help. That is a reasonable thing for any organisation working in people's homes to think about, including us.

Practical advice

If you are in immediate danger, call 999. If you cannot speak, you can call 999 and then press 55 on a mobile to alert the operator. The National Domestic Abuse Helpline, run by Refuge, is free and open 24 hours a day on 0808 2000 247. If calling is not safe, you can fill in a form at nationaldahelpline.org.uk and ask to be rung back at a safe time. In Scotland, the helpline is 0800 027 1234. In Wales, Live Fear Free is 0808 8010 800. You can talk to anyone at your GP surgery. Under Steps to Safety, in participating practices this explicitly includes any member of staff, not only the doctor. You do not have to have a medical reason for the appointment, and you can ask for a double appointment if you need more time. You can disclose abuse that happened in the past. Support is not only for people currently living with an abuser. A referral needs your agreement. The specialist support worker route in this programme happens with the patient's consent. If you are worried about someone else, you can ask the helpline for advice about how to raise it. You do not need to be certain before seeking guidance. If you are reading this on a shared device, remember you can clear your browser history, and most helpline websites have a quick-exit button.

What to know

Steps to Safety is now running in 12 integrated care board areas in England, backed by up to £34.4 million over three years. It trains GP practice staff to recognise domestic abuse and sexual violence and connects patients, with their consent, to an independent specialist support worker who acts as a single point of contact. A further £15 million over three years goes to every integrated care board in England to strengthen local specialist support. The programme runs in three phases from April 2026, aiming for national coverage in England by 2029, and an independent national evaluation will test whether it works. Lincolnshire is not in phase one, so the trained-practice model has not arrived here yet. The separate £15 million fund does reach our area. The core message is simpler than the funding tables. If you are being hurt or controlled, a GP surgery is a legitimate place to say so, and in a growing number of practices the staff have been trained for that conversation. Sources: Department of Health and Social Care, "Steps to Safety initiative introduced in 12 areas across England", 23 October 2026, https://www.gov.uk/government/news/steps-to-safety-initiative-introduced-in-12-areas-across-england; Home Office, "Freedom from violence and abuse: a cross-government strategy", 18 December 2025 (updated 26 May 2026), https://www.gov.uk/government/publications/freedom-from-violence-and-abuse-a-cross-government-strategy. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional.

#domestic abuse#GP services#NHS England#safeguarding#DHSC#Lincolnshire

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