Report finds NHS training ‘inconsistent’ as victims fall through the cracks

DOMESTIC abuse should be treated as a public health emergency, a leading charity has warned, after a new report exposed widespread failings by the NHS in identifying and supporting victims.

According to the latest Office for National Statistics figures, more than 12 million people in England and Wales—around one in four adults—have experienced domestic abuse. The charity Standing Together Against Domestic Abuse (Stada) says that, despite frequent contact with both victims and perpetrators, NHS staff are often ill-equipped to intervene.

Stada reviewed domestic homicide and suicide cases published during 2024 and found that in 9 out of 10 cases, the NHS had failed in its safeguarding duties. The most common failing was a lack of proper training for staff on recognising signs of abuse.

Although national guidance recommends mandatory training for frontline NHS staff, the report found that provision remains patchy and inconsistent across services. Failures to record risk properly, share information between agencies, and link victims with mental health or alcohol support services were also highlighted.

The warning comes as a separate study in The Lancet found that more than one in four women who died by suicide and were under secondary mental health care had previously suffered domestic abuse.

Cherryl Henry-Leach, chief executive of Stada, said: “Treating domestic abuse purely as a criminal justice issue costs lives. The NHS is uniquely placed to help, but it must be properly resourced and trained to do so.”

The report urges the government to fund standardised training and improve data sharing. Without urgent reforms, Stada warns that the government’s stated aim of halving violence against women and girls by 2034 will not be met.

Tim Woodhouse, a suicide prevention expert, said as many as 1,800 suicides a year may be linked to domestic abuse, calling it “a national scandal”.

Andrea Simon, from the End Violence Against Women Coalition, said healthcare workers are often the only professionals victims may encounter: “They must be trained to spot the signs and know what to do. Inaction can lead to serious harm or even death.”

Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, added: “Given the trusted relationships GPs have with patients, it is deeply worrying that chances to help might be missed.”

In response, an NHS spokesperson said: “All NHS staff must complete safeguarding training which includes domestic abuse, and this training is currently being reviewed and updated.”

A UK Government spokesperson said a new strategy to prevent domestic abuse is due later this year. “We remain committed to protecting victims, holding perpetrators accountable, and ensuring healthcare professionals have the tools to support survivors,” they said.

Help is available for domestic abuse victims in Pembrokeshire

Support services offer confidential advice, refuge and counselling

Anyone experiencing domestic abuse in Pembrokeshire is urged to seek help. Support is available 24 hours a day, and no one should suffer in silence.

If you are in immediate danger, call 999.

There are several local and national organisations offering confidential support, practical advice and emergency accommodation:

Key Helplines

• Live Fear Free Helpline (24/7, confidential):
  📞 0808 80 10 800
  📱 Text: 07860 077333
  📧 Email: [email protected]
• Victim Support (for anyone affected by crime):
  📞 0808 16 89 111
• Refuge National Helpline (for women and children):
  📞 0808 2000 247

Local Services in Pembrokeshire

• Pembrokeshire Domestic Abuse Services (PDAS)
  Offers outreach, one-to-one support, refuge, counselling, and children’s programmes.
  📞 01554 752 422
• Stori (formerly Hafan Cymru)
  Provides housing support, drop-in advice and specialist help for women, men and families.
  📍 8 High Street, Haverfordwest, SA61 2DA
  🕘 Open Monday to Friday, 9:00am – 5:00pm
  📞 01437 768 761
  📧 Email: [email protected]
• Welsh Women’s Aid
  A national organisation working with local providers to ensure survivors get the help they need.
  Contact via the Live Fear Free Helpline above.

You are not alone.
Whether you need immediate safety, someone to talk to, or long-term support, these services are here to help. All calls are confidential and support is available for women, men and children.

MODERN ambulances will be responding to emergency 999 calls across Wales, thanks to £22.45m investment by the Welsh Government, it announced this week.

More than 140 new ambulances and vehicles will be part of the first phase of a five-year Welsh Ambulance Services fleet strategy, which will see older vehicles replaced with new ambulances and vehicles fitted with the latest technology, materials, and products.

The wider strategy, which runs to 2030, includes prioritising electric and hybrid vehicles, where viable, to reduce carbon emissions and covers all vehicles operated by the Welsh Ambulance Service.

This includes the Non-emergency Patient Transport Service, which helps people attend hospital appointments and transfers patients between hospitals.

The Welsh Government investment in the fleet of 142 new ambulances and vehicles comes as the Welsh Ambulance Service is poised to introduce improvements to the way it responds to the most serious 999 emergency calls.

The changes, which come into force in July, are designed to save more lives and improve people’s outcomes following a cardiac arrest, a serious illness, incident, or accident.

Health Secretary, Jeremy Miles said: “This investment shows our commitment to ensuring the Welsh Ambulance Service has the modern, reliable fleet it needs to deliver exceptional care for people across Wales.

“The ambulance service plays a critical role not just in emergency response, but also supporting patient flow through the wider healthcare system.

“By replacing 142 vehicles, we’re improving the resilience of our emergency response capabilities and supporting our environmental goals.”

Executive Director of Finance and Corporate Resources at the Welsh Ambulance Service, Chris Turley said: “We’re very grateful to the Welsh Government for the continual investment, which enables us to operate a modern, efficient and fit-for-purpose fleet.

“Embracing the latest technologies and innovations whilst working in partnership with staff and trade union partners is essential to provide the best possible experience for patients, as well as an ergonomically-friendly working environment for staff, who spend the majority of their working day aboard these vehicles.

“As the national ambulance service for Wales, spread over an area of 8,000 square miles, improving air quality is something we’re very committed to, so these cleaner and greener vehicles reinforce our commitment to reduce our environmental footprint in alignment with the Welsh Government’s net zero strategic plan.”

“He didn’t break the law. He just needed help. Now he’s locked in a hospital hundreds of miles away.” — Alun, father of a detained 19-year-old

IN SECURE hospitals across England and Wales, more than 2,000 people with autism or learning disabilities remain locked away under mental health laws — despite never committing a crime.

Many are detained under the Mental Health Act 1983, often after being taken by police during a mental health crisis. The vast majority have no mental illness diagnosis. Some are teenagers. A few have been there for decades.

“It’s a human rights scandal,” said Dan Scorer of Mencap. “They’re being institutionalised because society hasn’t built the support they need.”

Autism is not a mental illness. It is widely recognised that for most autistic people, care in an inpatient unit is rarely helpful – in fact, it can be deeply damaging. 

The average length of stay is around 4.6 years.

The overwhelming majority (92%) of autistic people and people with a learning disability who are detained in hospitals are put there using the Mental Health Act of 1983.

A NEED FOR URGENT REFORM

For years, the National Autistic Society and tens of thousands of campaigners have called for changes to mental health law.

Reform has been promised, and a bill is making its way through Parliament. However, the government will not commit to funding the reforms the legislation will enact. Even then, campaigners say the law change will not end the scandal of detention.

In April, Denise Cavanagh from Hook, a founder of the Stolen Lives campaign, told BBC Wales that she believed people would still be detained via other laws, including the Mental Capacity Act.

She added: “People with learning disabilities often end up in hospitals because there’s a breakdown in housing and community care, and it’s the only place they can go.

“So, if that community care isn’t there, there is nowhere for them to go and they’ll still be detained.”

And even though health is devolved to Wales, the Welsh Government is relying on a Westminster bill to improve how people with learning disabilities and autism are supported during a crisis.

“THEY CAME WITH HANDCUFFS”

Michelle, from Wiltshire, recounts the day her autistic daughter was detained after a meltdown in a supermarket.

“She was 23. She was overwhelmed. She panicked. That’s all. But the police came and took her away. That was three years ago. She hasn’t been home since.”

Michelle’s story is one of many. Some families describe wards where patients are sedated, isolated, and cut off from loved ones.

Bethany – whose surname cannot be published – was locked in a hospital room in Northampton as a teenager. Her only access to the outside world was through a tiny hatch in the door.

Her father, Jeremy, said he could only see his daughter through a plastic screen or through the six-inch hatch.

“It was cruel. It was torture for my daughter,” he said.

“It broke her human rights, her right to family life, her right to freedom from degrading treatment.”

Even now, several years on from Jeremy’s interview on Radio Four regarding Bethany’s treatment, little has changed. In fact, the data shows a worrying trend towards increased detention of those with mental illness or specific learning difficulties.

NO WAY OUT

Official NHS data reveals the extent of the crisis:

Over 52,000 people were detained under the Mental Health Act in April 2024 — the highest figure in five years.

Over 2,000 of those are autistic or have a learning disability.

As of May 2025, 2,025 autistic people and people with a learning disability are in mental health hospitals in England. Of these, 1,455 (72%) are autistic.
There are 240 under-18s in inpatient units who are autistic or have a learning disability. Of these, 230 (96%) are autistic.
The number of autistic people without a learning disability detained in mental health hospitals has increased by 141% since 2015.
This is the most up-to-date record of how many autistic people and people with a learning disability are currently in mental health hospitals in England.
Despite some progress moving people with a learning disability out of hospitals and into the community, the number of autistic people detained has increased. In 2015, autistic people made up 38% of the total number in hospitals, now it is 72%.

Around 60% of learning disability or autism inpatients have no mental illness diagnosis.

Detained patients are often placed in “out-of-area” units, sometimes hundreds of miles from home.

Toni Dymond, an autistic woman, was detained for over 20 years in psychiatric care without a criminal charge.

“She was isolated, broken,” said her brother in a statement. “It wasn’t treatment. It was abandonment.”

34,685 people were detained by police under Section 136 of the Mental Health Act in 2022–23.

Over 60% were transported in police vehicles, not ambulances.

Autistic woman and author of the memoir Unbroken, Alexis Quinn, spent three years “locked inside” various mental health hospitals, including Assessment and Treatment Units (ATU).

She says: “I  was detained under the Mental Health Act and remained so for most of my stay. The Mental Health Act is a piece of legislation which provides a legal framework to detain people when they are mentally ill and require treatment to get better. The interesting thing about a treatment order for an autistic person is that autism is not a mental health condition.

“Whilst mental illnesses, such as depression and anxiety, can be treated, for autistic people, this has to be done in a way that reflects their needs and understands autism.

“When I was detained under the Mental Health Act, I felt like this was because of behaviour relating to my autism, not because I was mentally ill; the whole process lacked any understanding of the difference between autism and mental illness.”

CHANGE PROMISED, BUT NO MONEY ON THE TABLE

The Mental Health Bill, which is currently going through Parliament, will stop people with a learning disability and autistic people from being detained for treatment. However, the government have said that this change to the law will not be enforced until there is sufficient community support. That means the law will not come into effect until there are enough resources to support its operation. There is no commitment to provide that funding.

The Challenging Behaviour Foundation, a national charity, wants a clear plan, co-produced with people with lived experience, families, and those working within the different parts of the system, setting out what steps will be taken to develop this support and accompanied by the resources to make it happen.

The National Autistic Society says: “We are calling on the government to urgently publish a comprehensive and fully-costed plan for how it intends to build this support.” 

So far, that call has been met with silence.