National Trauma Transformation Programme: Trauma-Informed Substance Use Pathfinders – Learning Report

Polices and Processes

Policies and processes direct how an organisation operates and as such should embody its values and culture. They can support trauma-informed practitioners and make explicit that an organisation is trauma-informed. They can direct and reinforce the application of trauma-informed knowledge, skills and processes, make these consistent and embed them throughout the organisation.

Challenges in the Pathfinder areas

Due to the time constraints of the Pathfinder project, collaborative work with HR to review Staff Health and Wellbeing policies was limited. As a result of capacity pressures there was also a preference from HR colleagues to adopt a TI lens to policies once they were expiring and already scheduled to be redrafted (e.g., existing “Staff Mental Health and Wellbeing” policies). Only HR and senior management are able to review these policies, rather than frontline staff. The latter were only able to review ‘guidance’ documents (documents that were not NHS wide) and this shows the importance of involving HR colleagues as core partners at an early stage of the process.

Language is an important part of everything that is done in an organisation. However, it was not possible within the timeframes of the pathfinder to consider the drafting of a trauma-informed language document, primarily because this policy would have to be NHS wide.

Enablers in the Pathfinder areas

In one area, work was already being completed with HR outwith the pathfinder (with their TPTIC) to produce a policy on supporting staff who have experienced traumatic events in the workplace and the use of debriefing.

A key finding from the TI lens event and the organisational assessment was the frequency people with lived experience of trauma had to recount their trauma histories in assessments and whilst collaborating with other agencies. There was evidence staff were applying a TI lens to these front facing assessment documents and had set up two working groups to start reviewing documents and guidance documents.

As a result of the pathfinder, pathways were being reviewed/ designed to minimise barriers to accessing psychology including reviewing the existing drug and alcohol abstinence criteria in place in both areas. One area had started to discuss how to implement trauma screening guidelines as part of their trauma-informed implementation plan.

Pathfinder Recommendations relating to Polices and Processes

• HR play a key role in drafting and managing NHS wide policies. Consideration should be given to providing trauma training for HR staff alongside senior managers to ensure HR have the knowledge and support to apply a TI lens when reviewing and drafting policies.
• Creating working groups to review existing documentation and guidance appears to be a sensible way forward for progressing the organisational capacity and catalyst necessary to facilitate change.
• Staffing levels need to be sufficient to complete the review of policies, guidance, and documents necessary to fully implement TI Practice.