Addressing Workforce Training Gaps in Domestic and Family Violence in Primary Healthcare Settings: A Scoping Review

Background: Domestic and family violence (DFV) is a persistent and complex challenge in primary healthcare, particularly in general practice, where care is continuous and patient-practitioner relationships are long-standing. Although doctors and nurses are well positioned to support patients affected by DFV, training gaps remain. These are compounded by inconsistent screening, limited referral pathways, and a lack of structured education. This is especially true for receptionists, who are often the first point of contact. Aim: To explore and synthesise DFV knowledge and training gaps in primary healthcare reported in the literature. Method: A scoping review guided by the PRISMA-ScR framework was conducted. Literature published between November 2014 and April 2026 was searched in PubMed, Web of Science, CINAHL, and Scopus. Search terms included variations of "domestic violence", "general practice", and "training". Following eligibility screening, data were extracted and analysed thematically. Results: Fifteen studies were included. Only two explored the training needs of administrative staff, despite evidence supporting their role in DFV response. Three categories of barriers were identified: (1) patient (victim-survivor)-level factors, including economic barriers, cultural dynamics, and fear of disclosure; (2) professional-level challenges, including inadequate training, low confidence, emotional burden, and safety concerns; and (3) organisational/system-level limitations, including inconsistent protocols, limited referral pathways, and time constraints. Discussion: The literature highlights a clinical-centric bias in DFV training, with administrative staff often excluded from policy and protocol development despite their role in practice processes and first contact with victim-survivors. Effective DFV responses require a whole-practice model that includes administrative staff. Cultural and organisational barriers affect disclosure and staff readiness. Trauma-informed care, cultural competency training, and clear procedural frameworks were identified as priorities. Sustained funding, policy reform, and ongoing evaluation are needed to strengthen training. Conclusion: To improve identification and support of victim-survivors, this review recommends interdisciplinary DFV training that integrates non-clinical and clinical staff. Training should address emotional preparedness, cultural sensitivity, and organisational capacity while supporting the needs of other family members. Future research should evaluate collaborative, trauma-informed approaches across general practice and primary healthcare teams.