The impact of Sexual Trauma on attendance for health appointments Report - July 2024
Introduction
One of our key purposes is to gather feedback from people who use health services. Sometimes people contact us independently to tell us about their experiences, sometimes we reach out to ask community members questions to find out specific information. Often we run surveys based on feedback we have received from the public.
One issue that has been raised with us by patients and has also been discussed within NHS Cheshire & Merseyside, as well as nationally, is the impact that sexual trauma (which may be experienced when someone either touches another person in a sexual manner without consent or makes another person touch them in a sexual manner without consent) has on patients’ attending for screening appointments for cancer, or other conditions, or feeling comfortable with health care professionals touching them in an intimate way in the course of legitimate/ required treatment or clinical investigations.
Key Findings
This research shows that experiences of sexual trauma can significantly impact people’s decisions about whether to attend cancer screenings and other health screenings and appointments.
Where people do decide to attend screenings/appointments, the attitude of staff, the level of trauma-informed training received by staff, and the information made available to patients – including the ways/formats in which information is made available – can make a significant difference to patients’ experience. At worst, it can, in some cases, re-traumatise people and make them less likely to attend in future. At best, it can potentially save lives.
Our report focuses on people’s experiences and their thoughts about what may help to make health screenings and intimate examinations feel safer and less traumatic.
This report sets out findings including:
- Feelings of anxiety are experienced by many survivors of sexual trauma before, during and after intimate health screenings and appointments.
- Many patients felt unable to take their time and have control over the pace of their appointment.
- Patients are not routinely offered adjustments or support.
- Many patients did not have confidence in asking for adjustments or support if they are not offered them.
- There are actions that healthcare practitioners could take to improve the experience of patients who are survivors of sexual trauma.
Key Recommendations
Based on the report’s findings, we set out the following recommendations for decision makers, including primary and secondary health care providers, and integrated care systems (ICS):
- NHS Screening staff to work with diverse patients to co-produce invitation letters.
- GP practices to proactively call patients who don’t respond to screening invitations, with an offer to answer their questions, and book them an appointment, with support to reschedule if required.
- Allow patients with digital access to book or re-schedule screenings (for instance if they are having a period) online or via an app. Include a range of language options and a BSL video option.
- NHS commissioners to consider providing alternative screening provision to allow
patients a choice about whether to go to their GP practice or elsewhere. - If the current national work on self-screening for cervical cancer proves it to be an effective method, seek to roll this out locally as quickly as possible to allow those who would prefer to self-administer the test to have this choice.
- Health passports and #CheckWithMeFirst cards to be available at GP practices, Walk-In Centres and hospital waiting rooms, accompanied by training for staff about their purpose
and use. - Encourage NHS staff to undertake existing NHS Learning Hub training on trauma informed care, e.g. ‘Trauma-Informed Approaches to Healthcare’ and to consider ways in which their patient care and clinical environments can be made more welcoming and safer for patients who have experienced sexual trauma.
Our full list of recommendations can be found on page 37 of the report.
We look forward to working with partners from across the health sector – including commissioners, providers and voluntary/community sector partners - to make these happen.
"The Survivors Trust is delighted to support Healthwatch Liverpool in publishing this crucial report, enabling a deeper understanding of the impact on survivors of sexual violence attending health appointments and the barriers this trauma presents. Through our programme #checkwithmefirst, we have solid research to demonstrate that the simple act of frontline staff attending a half-day workshop and raising awareness of how previous sexual trauma presents in healthcare appointments can dramatically reduce 'do not attend' rates, as well as improve staff well-being and retention. We hope to see this report used by other trusts throughout the country as a tool to help, not add to, existing workloads."
Downloads
If you need this report in a different format, please email enquiries@healthwatchliverpool.co.uk or call 0300 77 77 007.
Read our Frequently Asked Questions page about accessing healthcare appointments as a survivor of sexual trauma.
