Domestic Abuse-related Deaths: NHS Prevention

Cat Eccles Excerpts

Tuesday 20th January 2026 Westminster Hall

[Cat Eccles (Stourbridge) (Lab)]

It is a pleasure to serve under your chairship, Sir John. I congratulate my hon. Friend the Member for Stroud (Dr Opher) on securing this important debate.

Too often, domestic abuse is framed solely as a criminal justice issue when, in reality, it is one of the most urgent public health crises that we face. The NHS encounters victims and perpetrators far more frequently than any other service, yet the system consistently misses opportunities to save lives. As the British Medical Journal highlighted, fewer than 24% of domestic abuse crimes are reported to the police, meaning that the health service—not law enforcement—is the front line.

A recent review of domestic abuse-related deaths revealed that 89% of domestic homicide reviews contained at least one recommendation for the NHS—recommendations that occur again and again across cases, showing a pattern of missed signs, inconsistent responses and staff who suspect something is wrong but lack the training, systems or confidence to act on that.

NHS staff are uniquely placed to intervene in suspected domestic abuse. In my own career as an operating department practitioner working in theatres, I can recall many instances when we treated patients with what looked like run-of-the-mill injuries, but all was not as it seemed. A young woman came in for manipulation under anaesthesia of her nose after breaking it in a fall, but she became inconsolable when we told her that she could go home after the operation. “Can I not stay overnight?” she cried. As I talked to her more, we discovered that she was being abused at home by her partner.

I also want to highlight honour-based abuse; sadly, I encountered that many times in my career—from extreme female genital mutilation, to the woman undergoing an endoscopy for severe oesophageal pain, which turned out to be from her family poisoning her with battery acid, stripping the lining of her oesophagus and stomach.

Those suspicions are not always explored, despite clinical teams being highly skilled, compassionate professionals. The opportunity to intervene can easily be lost. Mandatory standardised domestic abuse training is essential. Experts estimate that delivering consistent training across the NHS would cost just £2.6 million per year, which is a tiny fraction of the entire NHS budget but has the big potential to save lives.

We also know that poor co-ordination between agencies is repeatedly cited in death reviews, with 35% of them calling for multi-agency working. The Domestic Abuse Commissioner has stressed that domestic abuse deaths require accountability across entire systems—particularly the NHS, which must implement lessons from domestic abuse-related death reviews and participate fully in the new national oversight mechanism.

Preventing domestic abuse deaths also means understanding the complexities of coercive control—something that survivors, including the domestic abuse campaigner from my constituency, Samantha Billingham, have worked tirelessly to highlight. Coercive control is often invisible, yet it is one of the clearest predictors of escalation to serious harm and homicide. If professionals do not understand coercive control they cannot identify the danger. That is why social workers must receive mandatory specialist training in coercive control: they are often the first professionals to see patterns emerging across family, mental health, housing and safeguarding contexts, but too often their training does not equip them to recognise or challenge the dynamics of manipulation, isolation, surveillance or financial control that underpin domestic homicide.

The NHS must also embed specialist domestic abuse support directly into clinical settings. The Government’s upcoming measures, including the Steps to Safety initiative, aim to ensure that every part of England has dedicated NHS referral services for victims and specialist support workers linked to GP practices. These reforms are welcome, but they must be implemented at pace and be fully resourced if they are to prevent future deaths. Domestic abuse deaths are preventable when we train our workforce properly, when agencies work together, when we treat domestic abuse as a health issue, not just a crime issue, and when we equip professionals to understand the controlling patterns that escalate into lethal danger. It is the responsibility of all of us and the NHS to ensure that no victim is left unseen, unsupported and unheard.