Bridging Gaps: Improving access to healthcare for women who have experienced trauma

Project aims

Our goal was to improve access to primary care for people who have complex needs and have experienced trauma, in collaboration with GP practices and people with lived experience. We wanted to offer tailored approaches for different GP practices, to improve access for people who may otherwise struggle to get the services they need.

What we did

We developed a training course together and facilitated this at five different GP practices. We worked in more depth with three practices to develop service changes to improve access for people with complex needs.

We also developed a specialised clinic for people with complex needs at one of these practices – Wellspring in east Bristol. This new service is helping people with complex needs who haven’t seen a GP for many years.

A researcher who wasn’t involved in developing Bridging Gaps interviewed those who’d taken part in the project’s work to improve access, including:

• Bridging Gaps members with lived experience
• Researchers
• Charity staff
• GPs

These interviews aimed to understand:

• How collaborative approaches need to be developed to ensure safe and effective working relationships with people who have experienced trauma
• Key issues, challenges and strategies to improve access to primary care for people who have complex needs

Together with the women involved in Bridging Gaps, we have presented at national and international conferences about what we have achieved and how primary care can be more inclusive for people who have complex needs.

How we involved people

We have tried to put the principles of co-production into practice. This includes sharing decision-making and power, and valuing everyone’s knowledge and point of view.

We worked with women with lived experience of complex needs from the start and developed the Bridging Gaps project together. We shared decision-making as much as possible at every stage. We share our learning about how collaborative approaches can be tailored to support people who have experienced trauma in an article published in Health Expectations.

What we found and what this means

Our improving access work with general practices has been written up and submitted. This article is available whilst it is being peer reviewed. In this part of the project, motivated general practice staff worked with lived experience members to combine everyone’s insights, alongside time and funding opportunities.

This resulted in service changes such as developing care coordinator roles, patient lists to support access to patients in greater need and an information sharing tool. Helping establish a new clinic at Wellspring GP practice for people with complex needs was a great achievement for those involved in Bridging Gaps:

“Working in collaboration with Wellspring has been such a positive experience. I was surprised at how willing they were to work with Bridging Gaps and how seriously they took our suggestions and feedback.”

The chance to make real changes to services was an important reason for women with experience of complex needs to get involved:

“Working with Bridging Gaps has given me a real sense of pride and fulfilment, to actually see changes happening because of such amazing and strong women is fantastic. Working with GPs to be more trauma-informed in services is such a vital part of supporting women who have been through so much in their lives.”

Bridging Gaps was awarded two Great Practice Awards 2020 for ‘Inspiring Change’ and facilitating ‘Independent Futures’. These were awarded by Golden Key, a partnership which works to improve services for Bristol citizens with the most complex needs.

We have also been awarded the 2022 University of Bristol Open Research Prize in the category of Widening Reach.

What next?

We want to influence regional plans for health and social care that meets the needs of those who have experienced trauma. We are working with decision-makers from the Bristol, North Somerset and South Gloucestershire Integrated Care System. Working with these policy and decision-makers will help our work to be part of the plans for the region.

Using the work from Bridging Gaps at a regional level will avoid duplication of effort. We hope our interventions can be used across the whole region. Most importantly, the voices of those with lived experience will be heard when decisions are being made.

We are developing a website to share our tools and learning about how to improve access with GP practices, funded by the NIHR School for Primary Care. We are also looking to work with more GP practices in the local area. Lucy Potter is working on a PhD to improve access to primary care for marginalised patients.