Introduction of Steps to Safety Programme
The Department of Health and Social Care (DHSC) has initiated the implementation of a new referral service aimed at assisting individuals subjected to violence and abuse within general practices. The Steps to Safety programme is being rolled out in three distinct phases, commencing in April 2026, with the objective of establishing a nationwide service across England by 2029.
This programme is designed to equip staff in general practices with the necessary training to identify the indicators of domestic abuse and sexual violence. This allows them to effectively connect victims and survivors with local specialist support services.
The commitment to the Steps to Safety programme was outlined in the cross-government strategy titled “Freedom from Violence and Abuse,” which was published in December 2025.
Enhancing Patient Support
Patients will have the opportunity to discuss their current or past experiences of domestic abuse or sexual violence with any member of the staff at participating GP practices. These disclosures will be handled with the utmost sensitivity, and if patients consent, they will be referred to specialist support services. A dedicated support worker will serve as a single point of contact, advocating for patients’ needs as they navigate the available specialist services.
Implications for General Practices
Each participating group of practices will have access to independent domestic abuse and sexual violence (DASV) specialist workers funded through the programme. These specialists will work collaboratively with GP practices, receiving referrals and providing essential support. Their responsibilities will include:
- Training staff within GP practices
- Offering ongoing assistance
- Receiving referrals from practitioners
- Advocating for patients
- Developing personalised safety plans
- Conducting risk assessments
- Facilitating access to specialist services
Funding for Integrated Care Boards
Participating integrated care boards (ICBs) will receive targeted funding to support the commissioning of independent DASV providers within their regions. This funding will cover training costs and secure specialist support workers to assist GP practice staff and deliver tailored support to victims and survivors.
First Phase of Implementation
In September 2026, twelve ICBs were chosen to participate in the initial phase of the Steps to Safety programme. These boards will receive a total of up to £34.4 million over three years to either commission or expand local specialist services and enhance referral pathways between general practices and support networks for domestic abuse and sexual violence.
The table below outlines the funding allocations for the selected ICBs during the first phase of the programme.
| 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 and NHS England are collaborating to create national support mechanisms to assist ICBs, specialist providers, and general practices in delivering the Steps to Safety programme effectively and uniformly. This support will encompass:
- Training and resources for all parties involved
- Opportunities for knowledge sharing
- Targeted assistance for ICBs and specialist providers during the setup and execution of their services
An independent national evaluation will be conducted to assess the delivery and impact of the Steps to Safety programme, with the findings aimed at informing future developments and enhancements to the initiative.
Investment in Victim Support Services
In addition to the Steps to Safety programme, the DHSC is investing £15 million across all ICBs over a three-year period to bolster local specialist support services for victims and survivors.
This funding will be allocated to ICBs based on the average number of patients registered at GP practices between April and July 2026. ICBs are encouraged to focus this funding on:
- Enhancing support for victims and survivors
- Alleviating potential pressures on evidence-based support and outreach services
- Strengthening the capacity of local specialist support services within ICBs