Meet the team
Senior Research Associate (Qualitative Research)
NIHR Applied Research Collaboration West (NIHR ARC West)
- England - West
GP for the Homeless Health Service
Bristol Homeless Health Service/ One25
- England - West
- Six women who've experienced trauma
- Sarah Moore & Kathryn McGregor, GP trainees
- Helen McGeown, GP
- Maria Carvalho & Kate Lemon - One 25 charity
- Chris Mills - Bristol, North Somerset & Gloucestershire Clinical Commissioning Group
- Natalia Lewis - researcher trauma-informed care
- Jeremy Horwood, Associate Professor (supervisor to Lucy and Michelle)
- Gene Feder, Professor (supervisor to Lucy)
What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?
Women with complex needs (e.g. addiction, mental ill-health) often have experienced extensive trauma such as sexual violence and exploitation, domestic abuse, homelessness and children-taken-into-care. Services are often ill-equipped to meet these extensive needs, worsening already severe health inequalities.
Bridging Gaps is a collaboration between women with lived experience, GPs, University of Bristol researchers, the local CCG and One25, a charity serving some of Bristol’s most marginalised women. Women have shared stories of stigma, discrimination and re-traumatisation when accessing healthcare services; these are key reasons for disengaging.
1. Bridging Gaps women received trauma-informed care training and enriched this with lived experience to co-design training and quality improvement projects (QIPs) for Bristol GP practices.
2. Bridging Gaps supported a local surgery to develop a specialised clinic; the surgery is now seeing patients with complex needs who have not consulted for years.
We now want to develop this work further.
What does your project aim to achieve?
Our overall aim is to improve access to primary care for people with complex needs, ensuring that services are more trauma-informed. COVID-19 is sharpening health inequalities. Primary care has rapidly increased remote consultations, but some clinicians are concerned about their implications on health inequalities. We want to improve access for people with complex needs and will use this project to understand:
1. What components are needed in a collaborative service improvement intervention between women with complex needs, an organisation that supports them and general practice?
2. What outcomes matter to people with complex needs, general practice and commissioners when trying to improve access to trauma-informed primary care?
How will the project be delivered?
This collaboration is steeped in co-production principles, with Bridging Gaps women making key decisions at every juncture. We have blended the knowledge of lived experience from the women, service delivery from GPs and latest research from academics to create trauma-informed training materials. We plan to:
1. Deliver trauma informed care training sessions with GP practices. These will be delivered by our team of clinicians and women with lived experience, supported by researchers.
2. Collaborate further with up to 3 of the surgeries who we have relationships with to co-design other aspects of the service improvement package. These co-design meetings will take the form of collaborative meetings between the Bridging Gaps team and 2 clinicians (or one clinician and one manager) from the GP surgery. The surgeries we collaborate with may be able to pilot some of these changes. We will be meeting regularly as a team to develop our ideas and plans.
How is your project going to share learning?
This award-winning Bristol-based collaboration has been running for 18 months. Learning includes how to successfully engage marginalised groups (and busy GP practices!); combine the knowledge of marginalised groups, GP practices, charities and researchers; and co-produce trauma-informed training and quality improvements. Through our work together Bridging Gaps has learnt many lessons about how to co-produce work together in a more trauma-informed way, working to support service improvements whilst at the same time supporting people’s own personal development.
Several Q community SIGs may be particularly interested in Bridging Gaps including primary care, co-production, measures for improvement, women’s health, mental health and developing improvers. Through these networks, we will share learning. With the Q community we want to further refine the intervention so we can understand which components of it help to enable changes and improve access to primary care, and help expand our work.
How you can contribute
- Sharing strategies and best practice to improve access to primary care for people who face health inequalities and have experienced trauma.
- How to engage with primary care services and create service improvement work when they have multiple demands placed on them - even more so now with the COVID-19 pandemic and vaccination work.
- Any experience/ guidance on what and how to measure improving access to trauma-informed primary care for people with complex needs.
- Thinking through how to potentially scale up the project
- Website design and social media support
|1 Jun 2021||Start delivering GP practice training sessions|
|1 Sep 2021||Collaborate with GP practices to develop service improvements|
|1 Oct 2021||Start developing website & wider communications strategy|
|30 Apr 2022||Finish all training delivery to primary care practices|
|31 May 2022||Finish co-creating communications and scaling up strategy|
|30 Jun 2022||Q Exchange project concludes|