Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

4. How we can make a difference… Psychological interventions – Trauma Falling Out of our NHS Staff Diane explained how her role covers multiple aspects; as well as being the Associate Director of Nursing for NSFT, she is the lead for trauma informed care, the lead for the staff covid support service, the internal trauma therapy service for staff, and also veteran’s mental health. She is also currently mobilising a model called Trauma Risk Incident Management (TRIM) across the Trust. Diane has also developed an international Trauma Informed Care Network, which now has now been running for a year and has in excess of 250 members. Diane told us about a project she has been involved with that was developed in response to the pandemic, as staff have been under immense pressure – being redeployed to areas they are not familiar with, working excessive hours, making difficult clinical decisions and dealing with distress, fear and bereavement. First and foremost, our workforce are human beings who also have their own lived experience, and the pandemic has brought to the service many existing and past traumas and compounded them. They have set up an NHS England funded staff Covid support service which is open to all health, social care and care sector staff across Norfolk and Suffolk. Staff can self-refer or make contact via Suffolk Mind to access the dedicated clinical hub. Within the hub they can have full choice over the background and gender of the therapist they would see, and whether their appointment is face to face, online or via telephone. Following an assessment, they are then given rapid access to trauma focused therapy – whilst counselling can be useful in validating emotions, offering compassion and empathy, it doesn’t get to the root cause of the challenges, unlike NICE guideline, trauma focussed interventions like EMDR, trauma focused CBT, cognitive processing therapies. As the workforce can be fearful of coming forward, confidentiality was a big issue for them, so the recording system is completely separate, ensuring that their records cannot be accessed by any of their peers or managers. The service has now supported 212 staff, and in response to setting up that Covid support service, the NSFT Executive Board identified the need to look at their own staff generally, who are witnessing suicide, serious self-harm or may be the victims of physical or sexual assault within the workplace, and what was being done for them. A dedicated trauma therapy service for NSFT staff called ‘Support for You’ was rapidly mobilised. They have now had 107 staff treated through that service. They are now in the process of mobilising TRiM, with a dedicated group of TRiM practitioners and mangers across Norfolk and Suffolk, as a peer led initiative to ensure that all staff get a rapid response and debrief for any traumatic incidents. Trauma is universal – all staff have the potential to come with trauma: We need to validate that experience and we have to be careful that when we are talking about those who are expert by experience and with lived experience because there are two cohorts of staff – those who will disclose their past trauma and those who don’t. There are the people that feel if they tell you how bad they feel they will be at a disadvantage – fearful that they may lose their nursing or social work registration, or be viewed differently in the workplace; and if they don’t tell you they will internally suffer – without help they will personally implode and be unable to care for themselves or others. The turnaround time for staff to access the service is 1-2 days for an assessment and 2-3 weeks for therapy; Diane Palmer, Associate Director of Nursing, Norfolk and Suffolk NHS Foundation Trust (NSFT) 9 | Suffolk and North East Essex Integrated Care System

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