According to the Department of Health and Social Care, Steps to Safety is now being rolled out through general practice as a new referral route for people experiencing domestic abuse or sexual violence. The programme is being introduced in three phases, with rollout having started in April 2026 and national provision in England set as the target for 2029. The policy was first committed in the December 2025 strategy Freedom from violence and abuse: a cross-government strategy. In practice, this places general practice more clearly within the early-identification and referral chain, with NHS settings expected to act not only as places where abuse may be disclosed, but also as structured entry routes into specialist support.
The Department says patients in participating practices will be able to speak to any member of staff about current or past abuse. Where a patient agrees, the practice can refer directly to a local specialist service, with a dedicated worker acting as a single point of contact and speaking up for the patient's needs when other services are involved. The operational change is significant because the model is built around consent and continuity. For victims and survivors, the intended shift is not simply that a disclosure is recorded in primary care, but that it leads to a managed referral pathway designed to reduce repeated retelling of traumatic experiences and improve access to specialist help.
For general practices, the scheme is designed around externally funded domestic abuse and sexual violence specialists working alongside groups of surgeries. DHSC says those workers will train staff, provide ongoing support, receive referrals, complete risk assessments, draw up safety plans and help arrange access to specialist services. This is a service redesign rather than a limited awareness exercise. It creates a defined specialist function around primary care teams, which may be particularly important for reception, care navigation and administrative staff who are often the first point of contact for patients but have not always had a formal route into specialist safeguarding support.
Integrated care boards are central to delivery. Under the scheme, participating ICBs receive targeted funding to commission local domestic abuse and sexual violence providers, cover training costs and secure specialist workers for practices. For phase one, announced in September 2026, DHSC has allocated up to £34.4 million over three years across 12 ICB areas. The annual profile rises from £8.15 million in 2026-27 to £13.04 million in 2027-28 and £13.23 million in 2028-29, which indicates that the department expects the service to expand after the initial set-up period.
The selected areas are Cheshire and Merseyside, North East and North Cumbria, Essex, Norfolk and Suffolk, Black Country, Birmingham and Solihull, Surrey and Sussex, Kent and Medway, Bristol, North Somerset and South Gloucestershire, and Cornwall and Isles of Scilly, alongside a joint bid spanning Coventry and Warwickshire with Herefordshire and Worcestershire. According to the DHSC allocation schedule, the largest phase-one award goes to the joint Coventry and Warwickshire and Herefordshire and Worcestershire bid at £6.67 million. North East and North Cumbria receives £4.68 million, Essex £4.45 million and Surrey and Sussex £4.05 million, while Cornwall and Isles of Scilly receives £722,318. The spread suggests that funding has been matched to local scale and commissioning plans rather than applied through a flat national formula.
DHSC states that NHS England and the department are also developing national support so that local services do not have to build the model from scratch. That package is due to include training materials, shared learning arrangements and targeted implementation help for ICBs and specialist providers. An independent national evaluation is also planned. For policymakers, that is one of the more important features of the rollout, because it should show whether general practice referral routes improve take-up, how consistently the model is delivered between areas and what extra pressure is placed on local specialist services.
A separate victims and survivors support fund sits alongside Steps to Safety. DHSC says £15 million will be distributed across all ICBs over three years, with allocations based on the average number of patients registered at GP practices between April and July 2026. The department has asked ICBs to use that funding to strengthen support for victims and survivors, ease pressure on onward evidence-based services and outreach, and build local provider capacity. Taken together, the two funding streams show a dual approach: create new referral routes in general practice while trying to ensure the specialist services receiving those referrals can absorb higher demand. The programme's effectiveness will therefore depend not only on GP training, but on whether local commissioned services have the workforce and capacity to respond.