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Special White Book chapter for primary care providers in Victoria

Introduction

This chapter provides an overview of Victorian family violence policy reforms, which aim to:

  • increase the safety of adult and child victim survivors of family violence, and hold perpetrators of violence to account
  • promote the wellbeing and safety of children.

From 19 April 2021, general practitioners (GPs) and primary care nurses (PNs) working in general practice have been included in two new schemes:

  • Family Violence Information Sharing Scheme (FVISS)
  • Child Information Sharing Scheme (CISS).

A third reform, the Multi-Agency Risk Assessment and Management (MARAM) Framework, provides a system-wide approach to support services to effectively identify, assess and manage family violence risk.

Mandatory reporting for GPs in relation to child abuse remain unchanged under Victorian law.

Family violence

Family violence is defined in Section 5 of the Family Violence Protection Act 2008 (Vic) and includes sexual, physical, emotional, psychological, and economic abuse, as well as coercive control.1 Under this Act, children are considered victim survivors if they experience family violence directed at them, or they are exposed directly to family violence and/or its effects. Family violence is deeply gendered and is rooted in structural inequalities and an imbalance of power between women and men. While people of all genders can use violence or be victim survivors of family violence, overwhelmingly those who use violence are men who largely perpetrate violence against women (who are their current or former partner) and children. 

Around one in 10 women attending general practice have experienced one type of family violence behaviour or a combination of physical, sexual and emotional abuse by a partner within the past 12 months.2 GPs are a key source of support to victim survivors of family violence and other family members, including children, who might also be victim survivors, and those who use family violence, which is recognised by the MARAM Framework and the two information-sharing schemes. Specific guidance on identifying, risk assessment and responding to victim survivors of intimate partner violence is discussed in Chapters 2–4 of The White Book, and on child abuse and neglect and men who use intimate partner abuse and violence, and will not be discussed here. It is expected that these should be read in conjunction with this chapter.

Purpose of the Multi-Agency Risk Assessment and Management (MARAM) Framework and Family Violence Information Sharing Scheme (FVISS)

After the death of Luke Batty in 2014, a Royal Commission into Family Violence was established in Victoria in 2015.3 This commission found that information relevant to family violence risk was not being shared adequately between organisations, which could have tragic consequences for victim survivors of family violence. The commission made 227 recommendations, which were all accepted by the Victorian Government, including new legislation resulting in the creation of the MARAM Framework to address the existing gaps identified in the Royal Commission and to ensure services are appropriately assessing and managing family violence risk.4 

It is useful for GPs and PNs to be across the four pillars of the MARAM Framework, as it helps their information-sharing practice to:

  • have a shared understanding of family violence
  • participate in consistent and collaborative practice (including risk assessments and information sharing)
  • understand their level of responsibilities for risk assessment and management
  • undertake systems, outcomes and continuous improvements at an organisational level.

Purpose of the Child Information Sharing Scheme

The CISS was developed in response to numerous independent reviews and inquiries over the past decade. These inquiries have recommended streamlining Victoria’s information-sharing arrangements to improve outcomes for children by promoting shared responsibility for their wellbeing and safety, and increasing collaboration across the service system. 

New legislation covers the way that information is shared across services and organisations to promote safety for adult and child victim survivors.

Information-sharing schemes

Family Violence Information Sharing Scheme
This scheme can be used if a patient is experiencing family violence or is perpetrating family violence. 

Child Information Sharing Scheme
This scheme can be used when there are concerns about a child’s wellbeing or safety. This scheme is applied at a significantly lower threshold than that to make a report to child protection.

Both these schemes increase collaboration between organisations, with the aim of keeping victim survivors safe and holding perpetrators to account.5 

Where there is pre-existing legislation, such as the Mental Health Act 2014 or the Children, Youth and Families Act 2005, these obligations still apply. Information sharing or other obligations under these schemes should not impede the information-sharing processes if other legislation applies, such as the need to report child abuse to child protection. For example, an obligation by a GP to make a report to Child Protection under mandatory reporting obligations might occur at the same or similar time to a request under the FVISS and/or CISS. GPs should be clear which legal permissions they are sharing information under and document this as required. 

In addition to FVISS and CISS, the Health Records Act 2001 already states that an organisation can disclose information about an individual if it reasonably believes that the disclosure is necessary to lessen or prevent a serious threat to an individual’s life, health, safety or welfare.6 

Who can share information under the schemes?

Only services and organisations that are prescribed as information-sharing entities (ISEs) can share information under the FVISS and CISS. 

GPs and PNs are prescribed as ISEs under the FVISS and CISS. 

Some other examples of ISEs include:

  • police, and the Magistrates’ Court of Victoria and the Children’s Court of Victoria
  • public hospitals, maternal child health, community health and mental health services
  • specialist family violence services, child protection, sexual assault services and homelessness services
  • schools, kindergartens and day care centres.

A full list of organisations and individuals who can share information under the schemes is available here.

Under the FVISS, some ISEs are also prescribed as risk-assessment entities (RAEs), which is a special type of ISE (Table 1). RAEs can request information for undertaking comprehensive risk assessments, including establishing risk where the presence of violence or the identity of the perpetrator is unknown.

 
Table 1. List of prescribed information-sharing entities (ISEs)7

ISEs that are also Risk Assessment Entities (RAEs)
  • Child Protection
  • Child FIRST services (excluding broader family services)
  • Risk Assessment and Management Panel (RAMP) members (including those services that would not otherwise be prescribed, but only when participating in a RAMP)
  • State-funded sexual assault services
  • State-funded specialist family violence services (including refuges, Men’s Behaviour Change Program, family violence counselling and therapeutic programs)
  • The Orange Door Network
  • Family Violence Restorative Justice Service
  • Victim assistance programs
  • Victims of Crime Helpline
  • Victoria Police

Reproduced with permission from Family Safety Victoria. Family Violence information sharing guidelines: Guidance for information sharing entities. Melbourne: Victorian Government, 2021; p. 328.  [Accessed 4 March 2022].

 

  1. Victorian Government. Part C: Pillars. Victoria: Victorian Government, 2021 [Accessed 24 October 2021].
  2. Hegarty KL, Bush R. Prevalence and associations of partner abuse in women attending general practice: A cross‐sectional survey. Aust N Z J Public Health 2002;26(5):437–42. [Accessed 24 October 2021].
  3. Victorian Government. About the Royal Commision into Family Violence. Melbourne: Victorian Government, 2021 [Accessed 7 March 2022].
  4. Victorian Government. Family Violence Multi-Agency Risk Assessment and Management Framework. Melbourne: Victorian Government, 2021 [Accessed 7 March 2022].
  5. Victorian Government. Family Violence Information Sharing Scheme. Victoria: Victorian Government, 2021 [Accessed 24 October 2021].
  6. Office of the Health Services Commissioner (Victoria). Health Records Act 2001 (Vic). Proposed statutory guidelines. Issues paper. Victoria: Office of the Health Services Commissioner, 2001 [Accessed 24 October 2021].
  7. Family Safety Victoria. Family Violence information sharing guidelines: Guidance for information sharing entities. Melbourne: Victorian Government, 2021 [Accessed 4 March 2022].
  8. Family Safety Victoria. MARAM practice guides: Chapter summaries. Melbourne: Victorian Government, 2020 [Accessed 4 March 2022].
  9. Family Safety Victoria. MARAM practice guides: Foundation knowledge guide – Guidance for professionals working with child or adult victim survivors, and adults using family violence. Melbourne: Victorian Government, 2021; pp. 28–31 [Accessed 4 March 2022].
  10. Family Safety Victoria. Responsibility 3: Intermediate risk assessment – Appendix 5: Brief risk assessment tool. In: MARAM practice guides: Foundation knowledge guide – Guidance for professionals working with child or adult victim survivors, and adults using family violence. Melbourne: Victorian Government, 2021; pp. 153–15 [Accessed 4 March 2022].
  11. Family Safety Victoria. Family violence information sharing guidelines: Guidance for information sharing entities. Melbourne: Victorian Government, 2021; p. 104 [Accessed 4 March 2021].
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