Written evidence submitted by Violence and Society Centre, City St George's University of London (VAWG0072)
Summary
The UK Prevention Research Partnership funded Violence, Health & Society (VISION) research consortium presents the following concerns and recommendations for change in relation to tackling violence against women and girls:
- Use existing national data to improve estimates of VAWG among under 16s
- Continue to collect CSEW domestic abuse data from household population of all ages to estimating prevalence of violence among older women
- The extent and nature of violence and abuse in teenage relationships requires better understanding through improvement of data collection by the police
- There is a potential to improve the use of Health administrative data and Specialist Services data in research on violence
- ‘Knife crime’ policies must recognise fatal violence against women
- There is much to be learning across statutory reviews for violence prevention
The UKPRP VISION Submission
Introduction to the UKPRP VISION research consortium
Violence, Health and Society (VISION) is a research consortium funded by the UK Prevention Research Partnership. The consortium consists of thirty researchers from across eight UK universities. We work in partnership with central and local government responsible for violence prevention policy and data provision in justice and health, academics, and Third Sector specialised services to survivors of domestic and sexual violence. Our research seeks to improve the knowledge base on violence and inform changes to policy and practice.
Below is our submission for the Public Accounts Committee’s inquiry into violence against women and girls.
Definitions of Violence Against Women and Girls (VAWG)
The National Audit Office (NAO) report finds that the absence of a uniform definition for VAWG among public bodies, along with their varied methods for measuring its extent, has hindered the ability of the Home Office (HO) to track progress in reducing violence against women and girls. Our research (below) also emphasises the need for a shared conceptualisation and measurement of violence across different fields of study and practice (see (a) below), as well as broadening the definition of violence using the Crime Survey for England and Wales (CSEW) to capture its full extent and impact (see (b) and (c) below).
To avoid siloing violence within a specific sector, a shared definition of violence needs to be accompanied with other information including information on the form of violence, victim characteristics, and perpetrator information, etc. For this purpose, we have developed a violence measurement framework which uses shared conceptualisation and measurement of violence between health, justice and other fields (Blom et al, 2023). The framework includes individual and event identifiers, forms of violence and abuse (including physical, sexual, psychological, and other forms), subsequent harm, and individual and event characteristics. With the current lack of a shared conceptualisation and measurement of violence across sectors, there is a need to utilise a systems approach to violence, triangulate information, and estimate the full societal costs of violence. For defining and recording of violence, it is important to not focus only on (potential) crimes, but to be more inclusive. Women and girl’s wellbeing is not only affected but violent crime, but also by, for example, catcalling and other forms of harassment - behaviour that was until recently considered legal. This illustrates how the law is not always a good measure of whether something should be considered violence.
The Office for National Statistics (ONS) headline measure of ‘violent crime’ currently excludes sexual violence, robberies, threats of violence, and many incidents of violence where criminal damage was also involved. The ONS provides national estimates of violence using two separate parts of the CSEW – ‘violent crime’ estimates are from the main face to face victimisation survey and domestic abuse and sexual victimisation modules are from the self-completion part of the survey. While the latter is used by the HO to track progress in reducing violence against women and girls, the former could also be made more useful by improved reporting by ONS.
We therefore recommend a headline measure of violence from the face-to-face part of the Crime Survey for England and Wales (CSEW) reported by the ONS should include a wider range of crimes which involve violence to better measure the extent and impact of violence in society, particularly impact on women. The narrow measure of violent crime, which is widely used as a headline measure of violence in England and Wales, including by ONS, undercounts the rate of violence in society by a factor of 3, and especially violence against women. We propose a broader measure which incorporates ONS’ violent crime measure as well as sexual violence, robberies and threats of violence (VISION Policy Briefing, 2024 & Davies et al 2024).
Monitoring change in VAWG prevalence
Both the 2021 VAWG government strategy and the 2022 VAWG plan utilise estimates from the domestic violence/abuse, and sexual victimization statistics from the CSEW to monitor progress in reduction of violence against women nationally. This requires continuous collection of CSEW data over time. Additionally, the option of undertaking a distributional analysis of violence prevalence and impacts by protected characteristics relies on the ability to combine multiple waves of consistently collected data, as the relatively small annual sample sizes for these groups do not yield robust estimates. The current government will soon unveil its new VAWG strategy, and it is presumed that it will also rely on the CSEW for national estimates of domestic violence/abuse, and sexual victimization among women in England and Wales.
Last year the ONS ran an experiment where half of the CSEW sample completed the domestic abuse module broadly used since 2005, and the other half completed a new module that is not comparable with the previous one. As of February 2025, the ONS are still considering whether or not to move over entirely to the new module in the next data collection (2025/26).
VISION is concerned that the loss of the existing module would be catastrophic for monitoring progress made in reducing violence against women and girls in England and Wales: it is world-leading, questions are based on the globally comparable Conflict Tactics Scale (CTS) and provides trend data going back to 2005. Without retaining some consistently administered core items from the original domestic abuse module, it will no longer be possible to:
- Produce long-term trends in domestic violence and abuse against women and girls over time. We cannot rely solely on the new data collection by the ONS from this point onwards, as change happens gradually over time, and we need a longer-term record to meaningfully understand and monitor progress.
- Group survey years together to have sufficient cases to robustly examine domestic abuse in particular regions, minoritised groups, and by other protected characteristics for many years to come. It will therefore not be possible to make any inferences about progress made in violence and abuse reduction for these groups over the period of the next VAWG strategy. This will hamper our understanding of inequalities in violence and subsequent service contact.
The new module is problematic for many reasons:
- It is not a standardised measure, has undergone little validation or psychometric testing, and is not comparable with anything used previously or in any other country or study.
- It separates all data collection between former and current partner based on relationship status at the time of the interview, not at the time of the abuse. While the reason for doing so is based on the fact that it produces a higher response rate among those in current abusive relationships, this distinction creates confusion for interpretation of analysis and may be misinterpreted. We highlighted this issue in our submission to the redevelopment of domestic abuse statistics survey. Some analysts use the data to say, for example, that physical violence is more likely to be from a current partner and stalking - as continuation of abuse from an ex. But since the coding relates to ex or current at the time of the interview, and not at the time of the abuse - then the above interpretation is much harder to make sense of. The distinction is also problematic for classification of casual and other relationship types.
- The justification for the complete overhaul of the module was to align measurement of DA with the Domestic Abuse Act 2021 definition. However, it is still not clear to what extent the new module is successful in achieving it. Member of VISION highlighted this issue in detail in their submission to the redevelopment of domestic abuse statistics survey. Therefore before the old domestic abuse module is replaced by the new one, the ONS should publish an explicit evaluation of how well the new measure of DA reflects the 2021 DA act.
We urgently recommend that before losing this world-leading time series and relying on an untested, noncomparable, and potentially flawed new approach to DA measurement in England and Wales, the ONS:
- Pause: continue the split-sample data collection for one more year.
- Test the new approach: fully compare data collected using the new and old modules so the validity and utility of the new measure can be evaluated appropriately, and its impact on inequalities assessed.
- Publish these results publicly: and run a full public consultation once stakeholders understand how the new module performs, and all the implications of having data collected in each way, before the decision to roll out new data collection is finalised.
- Use this information to consider all the options: such as maintaining some of the existing questions alongside adding new coercive control items. This straightforward approach would ensure the utility of the survey for national trends (in both England and Wales) and analysis of inequalities and minoritised groups, while also improving the measurement of coercive control.
VISION is a research consortium focused on the analysis of data from multiple sources on violence and abuse, across the health, specialist services and justice sectors. These data allow the analysis of service provision and access, but we strongly urge not using such data to inform progress made towards halving VAWG as it cannot be used as a proxy for VAWGs itself. We support the use of survey data to monitor prevalence of VAWG, as that is independent of whether victims go to the police/other services or not.
The UK has a strong tradition of collecting data on the subjective experiences of the general population through high quality social surveys. The CSEW is a good source, in part due to its large sample size and its frequent (annual) data collection. However, as a ‘crime’ survey, it may lead to lower reporting of a range of types of abuse than that obtained from surveys framed as being about more social surveys or general health. The Department for Health and Social Care funds the Adult Psychiatric Morbidity Survey (APMS), which includes detailed questions on a wide range of forms of violence and abuse. The last wave of data from that survey was administered in 2014, the next one becomes available in Spring 2025.I We recommend triangulating estimates for VAWG from the CSEW with the APMS where possible.
Utilisation of existing national data for estimating prevalence of VAWG among under 16s could be improved
While the Home Office uses estimates from the CSEW to measure prevalence of violence, it does not include children under the age of 16, even though they are included in the VAWG Strategy and the Istanbul Convention. This is a problem and an omission of the CSEW. While it cannot be fully addressed, it is still important to monitor progress on violence reduction for girls under 16, which is possible to an extent using the CSEW:
- CSEW youth questionnaire can be used to monitor prevalence of physical violence victimisation among 10 to 15 year olds, although the measure of it is very broad and does not, for example, specifically include intimate partner violence (IPVA) which we know is prevalent at this age (Young, H., et al 2021).
- CSEW for 2016/17 collected retrospective data from adult respondents on their experience of emotional, physical, sexual abuse as well as neglect when aged under 16. This data collection should be repeated regularly and monitored.
- There is a potential to use CSEW to monitor exposure to domestic abuse of children under the age of 16 (by identifying households with domestic violence and abuse using the adult self-completion module of CSEW, and identifying the number of children living within these households) – e.g. Chowdry, H. (2018); Vizard, Burchardt, Obolenskaya et al (2018: p.32).
Continue to collect CSEW domestic abuse data from household population of all ages to estimate prevalence of violence among older women
There is a lack of data on the extent and nature of violence in older age. Due to the ageing population, the extent, costs, and consequences of violence in late life can become more prominent. Our work (Fadeeva et al., 2024) showed that violence especially from an intimate partner and domestic violence, which are more likely to affect women, are still evident in later life. Removing the upper age limit on the self-completion part of CSEW is a welcome step. However, a few waves of collected data will be needed to assess the trends and potentially conduct an analysis on the differences between different groups (including by gender and ethnicity and age categories).
The extent and nature of violence and abuse in teenage relationships requires better understanding through improvement of data collection by the police
Violence and abuse in teenage relationships is poorly documented in police data due to the statutory definition of domestic abuse excluding under 16s. Policing practices therefore often fail to flag domestic abuse in under 16s, leading to inconsistent data collection. For example, the murder of 15 year old Holly Newton was classified as knife crime rather than domestic abuse (Weir and Barrow-Grint, 2025). Deputy Chief Constable Katy Barrow-Grint, who has been collaborating with VISION is currently surveying all forces to understand how they are responding to and recording abuse in teenage relationships. There is also a data collection pilot underway in Thames Valley Police to record and risk assess domestic abuse in under 16s.
There is a potential to improve the use of Health administrative data in research on violence
VISION research has highlighted how experiences of violence are not consistently or adequately captured in healthcare data systems (Fadeeva et al., 2024). While administrative health records could be valuable sources of information for measuring violence, they remain underutilised in violence-related research. VISION research examined the suitability of violence indicators in emergency care, primary care, and linked healthcare datasets. Descriptive analyses were conducted with the 2015/16 Hospital Episode Statistics Accident and Emergency (HES A&E) and the 2021/22 Emergency Care Data Set (ECDS). The potential of the Clinical Practice Research Datalink (CPRD) and the South Wales Violence Surveillance dataset (a police and emergency department (ED) dataset linked by Public Health Wales) were shown using available evidence. Among the discussed datasets, the South Wales Violence Surveillance dataset has the most detail about violent acts and their contexts, while the CPRD includes a more extensive range of socioeconomic factors about patients and extensive linkage with other datasets. Currently, detailed safeguarding information is routinely removed from the ECDS extracts provided to researchers, limiting its utility for violence research. In the HES A&E, only physical violence was consistently recorded. Addressing these issues has the potential to improve the use of health administrative data in research on violence.
There is a potential to improve the use of Specialist Services data in research on violence
In the UK, specialist services provide support to victim-survivors and their children, and perpetrators, of domestic and sexual violence and abuse. These services collect rich data on experiences and impacts of violence, both routinely and for the purpose of research and evaluation. This data has the potential to improve understanding of violence in the UK, however, our research has highlighted several challenges for the utilisation of this data. VISION researchers conducted two critical reviews of the literature to identify a) the nature and purpose of specialist services’ administrative data and challenges of using it to inform policies on violence reduction (Bunce et al., 2024a); b) the challenges of measuring violence using specialist services’ data, and of evidence synthesis (Bunce et al., 2023). To address these challenges and optimise the value of specialist services administrative data for informing our understanding of VAWG, we recommend:
- Improved consistency in data collection procedures and outcome measurement is needed across specialist services to support standardisation of data and facilitate data linkage that could improve understanding of trends and patterns in service use. This could be incentivised by current funders and commissioners of DSVA services.
- Central government ring-fenced funding is needed, including for smaller services, as opposed to piecemeal funding from multiple departments which means services currently have to collect different things for each funder. Attention should be given to holder of funding pot and cross-government department collaboration should ensure that all departments with statutory duty related to violence reduction should be contemplated and actively engage in funding decision making. Consistency across commissioning frameworks would facilitate consistent data collection, evaluation and evidence synthesis.
- Data collection prioritised by funders/commissioners and resources allocated appropriately, including specific resourcing for specialist services to make their data ‘research ready’ and support collaborations with university-based academics to ensure responses to DSVA are evidence-based.
- Ring-fenced funding for specialist services led ‘by-and-for’ Black and minoritised women, disabled women and LGBTQ+ survivors, including funding specifically for data collection and data-related capacity building at DVSA services. This will enable more comprehensive analysis of inequalities in violence experienced by minoritised groups and inform where resources and interventions should be targeted.
‘Knife crime’ policies must recognise fatal violence against women
Violence against women and girls (VAWG) is often considered as separate from ‘other’ forms of violence, with its own strategy and specialist services. While these recognise the specificity of VAWG and are much needed, recognising and responding to violence against woman and girls must form a part of every violence reduction strategy and activity. For example, Elizabeth Cook’s work has highlighted how in recent years, the knife has become an object of fear and panic in England and Wales when used in public by mostly young men on other young men. Overlooking the use of knives against women in ‘private’ spaces, much media coverage of ‘knife crime’ has centralised it as a problem confined to young Black men in urban environments (Cook & Walklate, 2022). This attention has triggered a number of strategies and powers to tackle ‘knife crime’, primarily focusing on expanding stop and search powers, increasing prisons spaces, and launching (discriminatory) public awareness campaigns. However, all of these policy measures fail to tackle the use of knives in private spaces.
Viewed through three lenses of space, gender and materiality, this article analyses the gendered and spatialized aspects of ‘knife crime’ which are very often hidden in public and policy discourses. Situated in this way, the contemporary preoccupation with ‘knife’ crime illustrates the ongoing and deeply held assumptions surrounding debates on public and private violence. We argue that policy must recognise ‘knife crime’ as more than a problem faced only by young men in public, and addressed as a threat to women in private space.
There is much to be learning across statutory reviews for violence prevention
Dr Elizabeth Cook, City St George’s UoL, working with a range of specialists, has produced a series of publications (e.g. Rowlands & Cook, 2024), including a VISION policy briefing summarises themes around Learning across statutory review practices: origins, ambitions and future directions. The symposium was led by Dr Cook,, and Dr James Rowlands, University of Westminster. The briefing explores how different statutory reviews are conducted and practised, their ambitions a tool with relevance for violence prevention, and challenges for the future.
Impact and costs of VAWG
Our recent research, described in more detail above, shows that a broader definition of violence than ‘violent crime’ currently used by the ONS in national reporting would better capture harm and inequalities of violence, particularly among women. Including sexual violence, robberies, threats of violence, and incidents of violence where criminal damage was also involved in the definition of violence estimates a greater number of people physically and emotionally harmed by violence, particularly affecting estimates for women (also see Davies et al 2024). The health and wellbeing impact of violence is 30% higher for injuries and 260% higher for emotional impacts when a broader measure of violence is used compared to the violent crime measure, indicating a much higher health burden on society. This has implications for estimating societal and economic costs of violence.
Using data from the CSEW, our research shows that 3.6% of those who experienced intimate partner violence lost their jobs in a given year because of the abuse. Furthermore, 1 in 10 of those who experienced intimate partner violence took a period of leave from work, with 1 in 4 of those who took leave needing to take a month or more off work.
We show that job loss is associated with all the five forms of IPVA examined and the risks were highest for those who experienced: stalking, sexual violence and physical threats by an intimate partner. The research also includes qualitative findings from those with lived experience of IPVA and abuse. Participants noted an ongoing stigmatisation of victims of abuse, which had serious impacts on disclosure. Victim-survivors noted their fear of being declared ‘unfit for work’ and of becoming a ’marked person’ should they disclose their abuse to relevant managers.
Our analysis of data on workplace bullying and harassment (WBH) collected by the Adult Psychiatric Morbidity survey found that rates of past-year experience of WBH are higher in women (12%) than men (9%), and that experience of WBH is strongly associated with poor mental health, with common mental disorder being more than twice as likely in employees with experience of WBH compared to those without (Bunce et al 2024b).
Violence harms the families of victims too. Being the relative of a victim of violence is not uncommon in England, especially among people living in social housing and more deprived neighbourhoods (Cook and McManus, 2024). We found that relatives of victims had worse mental health and were more likely to self-harm and experience suicidality compared with people not related to an assault victim. Socioeconomic factors – including being more likely to live in areas with a higher reported crime rate – explained some, but not all, of this association. While their own direct experiences of violence and abuse explained most of their elevated rates of post-traumatic stress and suicidality, even when accounting for such experiences close relatives of victims were more likely to experience depression and anxiety disorders than the rest of the population. Therefore, while relatives often experienced violence themselves directly, this did not fully explain their worse mental health. This suggests that the assault of one person often has knock-on effects on the mental health of others in the family.
Specialist support services need additional resource if they are to meet indirect victims needs too. For health and victim support services, practitioners and advocates need to be aware that the relatives of victims of violence are more likely to live with financial strain and have often been victims themselves, and thus that relatives may already have been experiencing stress and heightened vulnerability in a context of reduced resources. The additional distress experienced by relatives may be especially likely to manifest in feelings of fear (limiting the extent to which they may feel able to engage in support activities outside the home) as well as in feelings of anxiety and depression. Support services may need to adapt to reflect this potential poly-victimization and context of multiple adversity. While as a group, relatives were more likely to experience signs of PTSD and suicidality, our results indicate that these particular symptoms may result more from their greater direct experience of victimization and multiple adversity. Such evidence is key to estimating the scale of demand for and better targeting and adapting services to support the needs of families.
Include harm to victims’ families in estimates of the costs of violence. For policy makers, the analyses here demonstrate that violence is associated with enduring adverse outcomes for indirect victims. Economic estimates of the costs of violence should therefore count not just the harm caused to the quality of life of direct victims, but also of indirect victims, where further costs of treatment, recovery, and impacts on productivity can be factored in. In the UK, the Victims and Prisoners Act provides some advance towards this more inclusive definition of victimization. However, these provisions are aims largely at relatives who have been bereaved, rather than those affected by non-fatal violence, and a narrow legal definition of victims is still employed. Future developments of victim policy should also recognise the potential impacts of violence on the mental health of the relatives of victims of non-fatal violence.
When economists estimate the health, social, and economic costs of violence, they often apply the common economic practice of ‘discounting’. Discounting involves reducing the estimated value of the future relative to the present, year by year, by a given percentage.
We argue that economists should more fully recognise the longer-term harms of violence in their cost-benefit analyses and re-examine the practice of discounting future health costs. Such a change could lead to a re-evaluation of the level of public funds to invest in violence prevention and support the health needs of victims.
VISION research uses the experience of violence in trafficking as a case study to illustrate the impact of discounting on costing violence.
Implementation of interventions to reduce VAWG: survivor-centred approach
In the UK, a range of support services and interventions are available to people who have experienced or perpetrated domestic and sexual violence and abuse (DSVA), but it is unclear which outcomes and outcome measures are used to assess their effectiveness. VISION researchers conducted a scoping review to summarise, map and identify trends in outcome measures in evaluations and reports of DSVA services and interventions in the UK (Carlise et al., 2024); the results from which were used to inform the design of a systematic review of evidence on the effectiveness of interventions (Carlise et al., in press). Both reviews were developed with input from an advisory group consisting of representatives from six third sector organisations. The scoping review found that, across the 80 included studies, a total of 426 outcomes were measured, less than half of which were used more than once. Of the 282 unique outcomes identified, 57 were used more than once, and 226 were used only once. The most commonly reported outcome subdomain was DSVA perpetration, and cessation of abuse according to the Severity of Abuse Grid was the most common individual outcome. This wide variation in outcomes measured when assessing the effectiveness of DSVA interventions has implications for systematic reviews and evidence syntheses looking to assess the state of the literature, as well as for the allocation of funding and the development of policies related to outcome measurement. Findings from the scoping review were fed back to VISION’s specialist services stakeholder group via a co-production workshop, to sense check and provide insight and context regarding the challenges in measuring the effectiveness of support services. The consensus reached was that, although safety outcomes (i.e. reduced perpetration) are of paramount importance and it is therefore unsurprising that these came out as the most commonly measured, there are other outcomes that are important to survivors which go beyond the criminal justice outcomes but are sometimes underutilised by policymakers. As well as being free from violence (and often, in order to be), women also want to feel empowered, regain their independence, be in good health physically and mentally, be able to support themselves financially etc. (i.e. wellbeing outcomes).
We took the results from our scoping review and feedback from our stakeholders on board for the next stage of our research, the systematic review (Carlise et al., 2023). We adjusted our analysis approach for our systematic review to try to synthesise evidence relating to victim-survivor wellbeing and perpetrator attitudes and behaviour, rather than focusing only on outcomes directly related to violence cessation. Our stakeholders also pointed out that it was not appropriate to apply one outcome to each and every type of intervention in our systematic review, because they do not all have the same aims and so would not be expected to impact the same outcomes. As a result of this, the most commonly reported outcomes for each individual intervention were identified from our scoping review to inform the systematic review. This led to four types of interventions and four distinct outcomes being included in the review. We found positive effects of UK-based advocacy and outreach intervention on cessation of abuse, of psychological support interventions on self-esteem and of perpetrator programmes on attitudes towards sexual offending. However, high risk of bias and methodological heterogeneity means there is uncertainty regarding the estimated effects.
On the basis of these reviews, we recommend:
- Establishing a core set of common, reliable metrics to aid comparability. Further work to determine which outcomes and outcome measures are most appropriate, valid and relevant, in order to work towards a consensus and build a shared evidence base to enable future meta-analyses.
- This work should be carried out as a collaboration between people who have experienced abuse and their families, service providers and, in the UK, commissioners, to ensure researchers and evaluators are measuring the outcomes that matter most to the people who matter most.
Our analysis of referral outcomes for victim-survivors accessing specialist sexual violence services found that victim-survivors with a broad spectrum of experiences of sexual violence (wider than rape and sexual assault, such as having witnessed sexual violence, trafficking and revenge porn) engage with third sector services, and it is their support needs over and above demographic characteristics or the type of abuse experienced which determine referral outcomes (Bunce et al 2024c). However, certain vulnerabilities and difficulties effect people’s ability to access and engage with services, for example men, those with a disability, those with unstable housing tenure or employment, and those with substance use or mental health support needs. We recommend:
- Specialist sexual violence services are provided with adequate funding and resource for consistent and high-quality data collection, and collaboration with academic researches is supported, to enable mixed methods and longitudinal research to improve understanding of the complexities of victim-survivors pathways in and out of services, including reasons for (dis)-engagement.
- Focus on the cultural sensitivity of services and how they can best meet the needs of clients with specific vulnerabilities such as being in economic or housing crisis.
- Clearer messaging and awareness-raising regarding the availability of specialist sexual violence support services, such that victim-survivors of sexual violence know what support they can get and how to access the services they need.
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February 2025