Introduction of the Steps to Safety Programme
The Department of Health and Social Care (DHSC) has initiated the rollout of a new referral service within general practices aimed at assisting individuals affected by violence and abuse. The Steps to Safety programme is being introduced in three distinct phases, commencing in April 2026, with the objective of establishing a nationwide service across England by 2029.
Through Steps to Safety, general practice personnel will receive training to identify signs of domestic abuse and sexual violence, enabling them to connect victims and survivors with local specialist support services effectively.
This initiative stems from the DHSC’s commitment to combatting violence and abuse, as outlined in the cross-government strategy, Freedom from Violence and Abuse, released in December 2025.
Support for Patients Experiencing Abuse
Patients visiting participating GP practices will have the opportunity to discuss their current or previous experiences of domestic abuse or sexual violence with any member of staff. Such disclosures will be handled with utmost sensitivity, and, where patients consent, they will be referred to specialist support services. Each individual will have a dedicated specialist support worker who will serve as their primary point of contact and advocate for their needs when seeking access to these services.
Benefits for General Practices
Each cluster of general practices will have access to independent domestic abuse and sexual violence (DASV) specialists funded through the programme. These specialists will collaborate with practices, receiving referrals and offering essential support. Their responsibilities will include:
- Training practice staff on recognising and responding to abuse
- Providing ongoing support to both staff and patients
- Receiving and managing referrals
- Advocating for patients’ needs
- Developing personalised safety plans
- Conducting risk assessments
- Facilitating access to specialist services
Funding and Support for Integrated Care Boards
Participating integrated care boards (ICBs) will benefit from targeted funding aimed at commissioning independent DASV providers within their regions to deliver the programme. This funding will also cover training expenses and secure specialist support workers to assist GP practice staff while providing tailored support to victims and survivors.
Initial Phase of Implementation
In September 2026, twelve ICBs were selected to participate in the first phase of Steps to Safety. Over the next three years, these boards will collectively receive up to £34.4 million to enhance local specialist services and fortify referral pathways between general practices and support services for domestic abuse and sexual violence.
Funding Allocation Details
The funding allocations for the selected ICBs during the first phase are as follows:
| ICB | Year 1 – 2026 to 2027 (£) | Year 2 – 2027 to 2028 (£) | Year 3 – 2028 to 2029 (£) | Total (£) |
|---|---|---|---|---|
| Cheshire and Merseyside | 363,803 | 670,467 | 676,523 | 1,710,793 |
| North East and North Cumbria | 856,446 | 1,900,756 | 1,927,358 | 4,684,560 |
| Essex | 949,525 | 1,769,524 | 1,735,075 | 4,454,124 |
| Norfolk and Suffolk | 487,155 | 1,151,767 | 1,168,706 | 2,807,628 |
| Black Country | 227,863 | 412,191 | 424,713 | 1,064,767 |
| Birmingham and Solihull | 950,000 | 1,005,000 | 1,050,000 | 3,005,000 |
| Coventry and Warwickshire ICB | 1,280,052 | 2,649,710 | 2,742,451 | 6,672,213 |
| Herefordshire and Worcestershire ICB | As above | As above | As above | As above |
| Surrey and Sussex | 1,522,984 | 1,263,901 | 1,258,416 | 4,045,301 |
| Kent and Medway | 225,112 | 982,811 | 987,615 | 2,195,538 |
| Bristol, North Somerset and South Gloucestershire | 1,089,245 | 969,025 | 996,692 | 3,054,962 |
| Cornwall and Isles of Scilly | 194,586 | 267,112 | 260,620 | 722,318 |
| Total | 8,146,771 | 13,042,264 | 13,228,169 | 34,417,204 |
National Support for Implementation
The DHSC, in collaboration with NHS England, is developing comprehensive national support to assist ICBs, specialist providers, and general practices in the consistent delivery of the Steps to Safety programme. This support will encompass training resources, opportunities for shared learning, and targeted assistance for ICBs and specialist providers as they set up and execute their services.
An independent national evaluation is set to assess the implementation and impact of Steps to Safety. The insights gained will be instrumental in guiding the future development of the programme.
Investment in Local Specialist Support Services
In addition, the DHSC is allocating £15 million across all ICBs over a three-year period to enhance local specialist support services for victims and survivors. This funding will be distributed to ICBs based on the average number of patients registered at GP practices from April to July 2026. The focus of this funding will be on:
- Improving support mechanisms for victims and survivors
- Alleviating potential pressures on evidence-based support and outreach services
- Strengthening the capacity of local specialist support services within ICBs
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