Domestic abuse disclosure — immediate safety assessment

PLAB 2 & PRES 3 · safeguarding · hard · 8 minutes

Candidate brief

You are a doctor in a GP practice. Ms Laura Murphy, 36, has attended with bruising on her left arm. Her partner is waiting outside and has asked to join the consultation. Speak with Laura privately, assess her immediate safety and health needs, and agree an appropriate safeguarding and support plan. Verbalise any examination, documentation, referrals or information-sharing you would undertake.

What examiners look for

Always speak with the patient alone and confirm that it is safe to discuss domestic abuse. Use a validating response: “I am glad you told me.” “This is not your fault.” “You do not deserve to be treated this way.” Assess immediate danger, escalation, threats to kill, weapons, stalking, strangulation, sexual violence, pregnancy, separation and risks to children. Ask specifically about strangulation or choking. Serious internal injury may occur even when external marks are absent. Do not pressure a patient to leave, confront the perpetrator or contact police. Leaving can increase danger and should be supported through an individual safety plan. Ask what children have witnessed or experienced. Child safeguarding duties may require information-sharing even when the adult does not consent. Confidentiality is important but not absolute. Explain what may need to be shared, with whom and why. Share only information that is necessary and proportionate. Confirm safe communication methods. Never leave voicemail, send texts, use shared portals or post letters when this could alert the perpetrator. Document objectively using the patient’s own words. Record injuries, threats, children, immediate risks, capacity, consent, information shared and follow-up arrangements.

Guideline references

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