Improving access to trauma-informed primary care for people with complex needs
Funding
BNSSCG CCG Research Capability Funding (Local development)
What is the research question?
Is a co-produced service improvement intervention aiming to improve access to trauma-informed primary care for people with complex needs:
- Feasible
- Acceptable to primary care and people with complex needs
- Effective
- Cost-effective
What is the problem?
Women with complex needs (including homelessness, domestic violence, substance misuse and poor mental health) encounter significant barriers to accessing primary care, despite high levels of clinical need and the harshest health inequalities. Women are more vulnerable than men to sexual exploitation and domestic violence, and a substantial proportion of women with complex needs have children removed from their care. Their engagement with mainstream health services is limited and can be re-traumatising, so they may not return.
What is the aim of the research?
We are aiming to change practice and systems such that people with complex needs feel comfortable and empowered to seek primary health care, and that the care they have access to is trauma-informed, responsive, without prejudice and appropriate to their needs. We aim to develop and evaluate a co-produced model to improve access to trauma informed primary care in practices regionally and nationally.
In order to achieve this, we need to develop a service-improvement intervention in collaboration with GP surgeries, commissioners and people with lived experience, and One25 (a charity serving these highly marginalised women). We intend that our evaluation will influence leaders of Primary Care Networks (PCNs), primary care commissioners in Clinical Commissioning Groups (CCGs) and CCG colleagues across the country looking to improve services for marginalised groups and reduce inequalities.
How will this be achieved?
We plan to conduct a feasibility study with a mixed method process evaluation to evaluate the feasibility of conducting a service-improvement intervention across several sites. We will investigate the acceptability of the intervention to primary care, people with complex needs and commissioners using evaluation forms, interviews and focus groups. We intend to explore what outcomes are important to patients and commissioners, and may include patient and clinician satisfaction measures and service adherence to trauma informed care. We will make plans for a health economic analysis of the intervention.
Who is leading the research?
Dr Lucy Potter, Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol.
Further information:
For more information or to get involved in this project, please contact bnssg.research@nhs.net.