New research calls for pocket-sized cards to support NHS patients with trauma
Healthwatch research has found trauma can be a major barrier to seeking medical care.
People who have experienced a traumatic event can be reluctant to engage with health and care services, seek medical attention when they get unwell, and avoid vital check-ups.
Key findings
According to a nationally representative poll of 3,571 adults living in England, nearly a fifth, 18%, of respondents who have experienced trauma said they ‘very often’ or ‘fairly often’ avoid services because of their trauma. This figure is much higher for autistic people and people who have Attention deficit hyperactivity disorder (ADHD)/Attention deficit disorder (ADD): 41% and 37%, respectively.
People who have experienced trauma don’t feel comfortable disclosing the information to medical professionals:
- Over a third, 37%, of respondents who have experienced trauma, have never told a medical professional about it.
- Over a third, 35%, of those who have told a medical professional about their trauma found it uncomfortable.
- The main barrier to disclosing experiences of trauma was people not feeling comfortable talking about it to a medical professional.
- However, other issues are also apparent, such as a lack of confidence in explaining trauma, a lack of confidence in medical professionals handling it sensitively, and previous negative experiences of disclosing trauma.
Trauma is widespread
The UK Trauma Council defines trauma as: ‘the way that some distressing events are so extreme or intense that they overwhelm a person’s ability to cope, resulting in lasting negative impact’. A traumatic event can include being in an accident, experiencing an act of violence, and seeing someone die.
Our research provides further evidence that trauma is widespread. More than half, 55%, of respondents chose the statement “I have experienced trauma in the past”, and nearly one in 12, eight per cent, chose “I’m currently experiencing trauma.”
According to our estimates, this equates to about 25 million and 3.7 million adults living in England, respectively.
Women, autistic people and those who have ADHD were more likely to experience trauma. Around two-thirds, 67%, of female respondents said they had experienced a traumatic event, compared to 51% of male respondents.
The need for trauma cards
Healthwatch England are calling for tangible solutions to help people who have experienced trauma engage with healthcare, including piloting trauma cards.
Healthwatch research follows a pilot project run by Healthwatch Essex in 2022, which made trauma cards available to local people to use during their NHS appointments. The pocket-sized card explains that the holder has experience of trauma and links to further resources to help provide sensitive, appropriate care.
The pilot was hugely successful, showing that a simple intervention can make it easier for people who have been through trauma to get the care they need.
Healthwatch polls shows that of the estimated 3.7 million people currently experiencing trauma, 43% would be likely to use a trauma card. Of the estimated 25 million people who have experienced trauma in the past, around one in three (30%) would be likely to use a trauma card. This equates to about 1.6 million people and 7.4 million people, respectively.
Laura’s story: “The trauma card has empowered me.”
Laura (not real name), 60, from Tendering, has suffered from anxiety about NHS appointments that involve personal examination due to non-recent trauma of sexual violence. This has led her to either cancelling, missing or leaving NHS appointments, including a cervical cancer screening. However, when she does attend a medical appointment, certain sounds and sights trigger memories, affecting her behaviour and relationship with healthcare staff.
She said: “I don’t take in information and will ask for information to be written or in leaflet forms to support this.”
Laura recently used the trauma cards developed by Healthwatch Essex for her personal examination. “The procedure was made easier by presenting the trauma card, and it made me feel more relaxed. It empowered me. This gives me hope that I will have a good experience again,” she said.
The Recommendations
A national pilot of a trauma card
We are calling for NHS England to ensure support for a national evaluative pilot of a trauma card initiative, allowing anyone across England to order a trauma card and have it delivered to them for free, along with an information sheet that clearly explains how and when to use the card.
National awareness raising among the public and staff
The rollout of a national trauma card pilot should be accompanied by investment in a communications campaign. This should raise awareness among both the public and health and care staff of trauma cards, including their purpose and how to use them.
Improved training on trauma-informed care for frontline health and care professionals
Trauma cards are only one part of the solution. The deeply worrying numbers of people who have experienced trauma having negative healthcare experiences mean further training is needed to ensure all professionals are well equipped to give high-quality treatment.
Read the full report from Healthwatch England
Healthwatch Redbridge Findings
In speaking to local women about their experiences accessing cervical screenings, we found that women who had experienced trauma were often hesitant or even fearful to attend these vital appointments.
Past trauma, whether physical, emotional, or sexual, can make medical procedures, particularly intimate ones like cervical screenings, distressing. Fear and uncertainty often leads to avoidance, putting women's health at risk and delaying early detection of potentially life-threatening conditions such as cervical cancer.
To address this, we are advocating for a trauma-informed approach in healthcare settings, where healthcare professionals are equipped with the knowledge and skills to recognise and respond to the unique needs of individuals who have experienced trauma.
This includes creating an environment of empathy, sensitivity, and respect, ensuring that patients feel safe, supported and informed.
Healthwatch England, Chief Executive Louise Ansari said: “A traumatic event can lead to long-lasting health issues affecting a person’s quality of life. Our findings paint a very worrying picture, with one in five people avoiding healthcare because of their trauma.
“When people avoid healthcare, their condition can deteriorate, and their illness can last longer. But for vulnerable people, including those who have trauma, avoiding healthcare can lead to even greater impacts.
“The pilot project in Essex has shown trauma cards can improve experiences for people using health and care services, empowering them and facilitating communication with healthcare staff. With training and better awareness, trauma cards can become a helpful tool for both the patient and medical staff.
“We are calling for NHS England to support a national evaluative pilot of a trauma card initiative. People across England should be able to order a trauma card and have it delivered to them for free, along with an information sheet that clearly explains how and when they can use it. In the long term, and subject to the pilot results, a digital trauma card could be added the NHS App or smartphone wallets.”
When people avoid healthcare, their condition can deteriorate, and their illness can last longer.
