The background
Family, domestic and sexual violence (FDSV) remains a critical public health issue in Australia, affecting individuals and families across all demographics. Primary Health Networks (PHNs) play a key role in strengthening the health sector’s capacity to respond to challenges.
In 2018, Brisbane South PHN (BSPHN) co-designed the Recognise Respond Refer (RRR) model, introducing a ‘Local Link’ role to help people navigate services and pathways within and between the Primary Care and FDSV sectors.
By 2022, six PHNs across Australia had piloted the model, tailoring it to meet the specific needs of their communities. Evaluations from these pilots reported significant positive outcomes.
In the 2022-2023 budget, the Commonwealth Government allocated funding to expand and enhance the foundational work of the original six PHN pilot sites, leading to the Supporting the Primary Care Response to Family, Domestic and Sexual Violence pilot.
In 2024 Adelaide PHN (APHN), in partnership with Country SA PHN, received a next phase of funding to implement a statewide approach in South Australia for the next stage of the FDSV pilot.
This project serves as a meaningful example of what can be achieved when organisations, individuals, and communities come together, with a shared purpose and commitment to change.
The partners
Core to this project was a partnership between Adelaide PHN, Country SA PHN, TACSI, LELAN, NINI, and Purple Orange. The partnership intentionally engaged priority populations to ensure their voices co-led both project design and implementation. This was critical in addressing historical disparities and improving care pathways for groups most impacted by FDSV.
The partnership was built upon a co-created and shared set of core principles designed to foster trust, collaboration, and equity. These commitments served as the foundation for all interactions, decision-making processes, and project activities.
The co-design methodology
The co-design methodology engaged diverse contributors, including people with lived and living experience, FDSV sector professionals, Primary Care providers, and people with lived and living experience from priority population communities.
The engagement methods included:
Four co-design workshops that facilitated collaborative exploration and iterative design.
77 community conversations that provided insights into lived experiences and the challenges faced within Primary Care and FDSV systems.
A synthesis process, integrating insights from lived experience and professional expertise to develop practical, community-informed considerations.
The project focus was to refine the Local Link Co-ordinator role (identified original RRR model) for South Australia.
The co-designers also explored three key areas that were not addressed in previous RRR pilots:
Adapting the model to the South Australian context
Expanding the scope to include sexual violence and child sexual abuse
Ensuring a focus on priority population groups
Through co-design sessions and community conversations, the group identified that the Local Link would be most effective in South Australia as an interdisciplinary team, potentially hosted by a consortium or similar partnership approach.
The challenges to overcome
When seeking to support Primary Care to step into its role of recognising, responding and referring to the right supports, complex and abundant challenges experienced by people with lived/living experience, Primary Care and the FDSV service sector were starkly apparent.
For people with lived and living experience challenges looked like; Fragmented and inconsistent support; limited trust and accessibility; accessibility challenges; privacy concerns; lack of access to peer support; lack of culturally responsive environments and lack of trauma-responsive practices.
Within primary care, challenges looked like burden of disclosures on certain GPs; weak connection between Primary Care and FDSV services; inconsistent responses to disclosure.
Challenges for FDSV service responses included limited diversity in expertise; inconsistent practices and capabilities; limited opportunities for localisation and sustainability.
Challenges experienced by all included disparities between metropolitan and regional areas; barriers to support for children and young people; barriers to support for sexual violence survivors, Inconsistent approaches to safety planning; limited cross-sector collaboration and information-sharing; lack of long-term funding and planning.
What’s next
In order to empower the PHNs to commission service providers to deliver upon the adapted Local Link coordinator, the following strategies and practice principles and outcomes were shaped to overcome the above challenges and implement more effective and compassionate service experiences.
Co-design strategies to address challenges:
Create an interdisciplinary LLT with the expertise, qualities and functions needed to deliver trauma-responsive, culturally responsive and person-centred care.
Ensure people with lived and living experience of FDSV receive tailored, person-centred, trauma-responsive, and culturally responsive care that prioritises their autonomy, safety, and wellbeing.
Integrate the LLT into Primary Care to enhance trauma-responsive care, strengthen referral pathways, and improve outcomes for patients by supporting primary care to build their confidence to take action.
Strengthen collaboration between regional and metropolitan LLTs to address unique challenges and enhance service delivery across different contexts.
Co-designed practice principles and outcomes to help hold the integrity of future implementation
Inclusive, accessible, and culturally responsive approaches
“What excites me for these places is the future accessibility in the GP clinics and community centres, they will be easy to reach and support would be more accessible to a wide range of people.” – Person with lived/living experience, CALD
Privacy and confidentiality to build trust
“I believe that we can ensure a safe journey by creating safe spaces where there should be privacy and confidentiality at every touchpoint. Being empathetic without causing re-traumatisation. Clear communication, explaining every process and providing choice for individuals over their decisions, empowering people to choose their care and services.”
– Person with lived/living experience, CALD
Trauma-responsive approaches at every stage
"I believe that trauma-informed and holistic care will ensure that individuals are supported in a way that takes into consideration their emotional and physical needs for holistic healing" – Person with lived/living experience, CALD
Strong, clear referral pathways;
“Have services that are far more responsive. People shouldn't have to jump through ridiculous hoops to get the service and help they need.” – Aboriginal frontline FDSV worker
Children and young people’s safety and wellbeing
“We can start to break the cycles that happen in families, otherwise they become adults in the system whose needs aren’t met - having cycles repeat in their lives.” – Person with lived/living experience
Long term impact and community reflection
“Ongoing feedback from the community keeps us responsive to their needs and challenges” – Primary Care, Aboriginal worker.
Want to learn more?
Adelaide PHN and Country SA PHN are in their final stages of commissioning service providers to deliver the Local Link coordination role across metropolitan and Regional South Australia. Visit Adelaide PHN or the Country SA PHN websites to stay updated.