Domestic abuse in healthcare professionals: would you ask Rebecca?

Rebecca is 34, and a GP within your ICB. You know her as a distant colleague, but she is also your patient and she presents with shoulder pain, clearly slightly self-conscious about attending. As you examine her, you chat lightly about the pressures of primary care sharing a jokey chat about workload. Then you notice some oddly placed bruising. You pause. Would you ask if she may be experiencing domestic abuse?

It is well known that women are twice as likely as men to experience domestic abuse, and in England and Wales the shocking truth is that two women are killed each week by a current or former partner ONS 2024. But less widely recognised is that healthcare professionals (HCPs) are disproportionately affected. A 10-year UK femicide census identified HCPs as one of the most common occupational groups among victims.

The data are stark. UK female nurses are around three times more likely to experience domestic abuse than women in the general population Cavell Trust. A meta-analysis by Dheensa et al. (2023) found that 31.3% of HCPs report lifetime experience of domestic abuse, rising to 34.4% among nurses and 12.1% among doctors.

Why might this be? Traits valued in healthcare such as compassion, resilience and tolerance of difficult environments may increase vulnerability. A culture that normalises stress, a high emotional toll and even workplace abuse can blur boundaries leading some to tolerate harmful behaviour at home. There is also a persistent assumption that HCPs are supporters of those experiencing abuse, not individuals who might be affected themselves.

Disclosure is difficult for anyone, but additional barriers exist for HCPs. Stigma can be profound, particularly among GPs BJGP2021 with feelings of shame, failure or not fitting the culturally ‘expected’ profile of someone experiencing abuse. Concerns about confidentiality, professional identity and even encountering patients in support settings can further limit help-seeking. Missed cues or disbelief from colleagues can reinforce this silence.

The impact is significant. Affected individuals may experience severe stress, depression, panic attacks and suicidal ideation alongside reduced concentration, confidence and work performance. Many carry a double burden: managing their own trauma while caring for patients with similar experiences in an already demanding role.

Return-to-work reviews after sickness absence offer an important opportunity to identify and support colleagues. Yet many report feeling unsupported after disclosing abuse. Only around two-thirds of NHS organisations have local domestic abuse policies, despite clear recognition in UK legislation of the need for employer support. Notably, HCPs are more likely to disclose to peers than to managers, highlighting the importance of a supportive workplace culture.

So, you gently ask Rebecca if everything is okay at home. After a pause, she nods but then begins to cry. You allow the silence, the consultation shifts and now you can really start to help her. As well as your invaluable and ongoing support, you can also signpost to specialist resources including:

• RCN Domestic Abuse Support for nurses, midwives and HCAs experiencing domestic abuse

• Doctors’ Association UK, resources for doctors and HCPs experiencing domestic abuse

• Practitioner Health the free, confidential NHS service supporting health and care professionals with mental health and addiction

The key message for us is simple. Healthcare professionals are at increased risk of domestic abuse, yet they may be less likely to seek help and when they do we may be less likely to suspect it. This is an important issue, one often described as being ‘hidden in plain sight’. So, when a colleague seems withdrawn, stressed, has medically unexplained symptoms, signs of trauma or is returning from prolonged sickness absence it is worth considering this possibility and asking sensitively. Because sometimes that question will make all the difference.