Integrated Neighbourhood Teams & AI…

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Healthcare as we know it is becoming more community centred.

NHS Trusts (SCFT and SPFT) can work with Brighton & Hove Council (BHCC), GPs, and Integrated Neighbourhood Teams to deliver trauma-informed care in the community.

This is how it may be achieved, with references to relevant local and national guidance:

1. Shared Understanding and Vision of Trauma-Informed Care:

  • Joint Training and Education:
    • Elaboration: Training should be multidisciplinary, covering the neuroscience of trauma, its impact on health behaviours, and practical skills for responding in a trauma-informed way. This should go beyond basic awareness to include more in-depth training on specific trauma-informed practices.
    • Sources: The Sussex Integrated Care Strategy (referenced by Brighton & Hove City Council) emphasizes a commitment to “expand our support for people with mental health needs and further develop integrated community mental health services… underpinned by a trauma informed care approach.” (Brighton & Hove City Council, The ICB is required to provide a first draft of the SDP by 1st April 2023). This strategic alignment mandates joint training. SCFT’s own Safeguarding Strategy 2023-2026 also states, “we expect staff to have an awareness of how trauma can negatively impact on individuals, and their ability to feel safe within healthcare, and will apply a Trauma Informed approach.” (Sussex Community NHS Foundation Trust, Safeguarding Strategy 2023-2026).
  • Develop a Shared Strategy:
    • Elaboration: This strategy should be a living document, jointly developed and regularly reviewed, detailing specific actions, timelines, and responsibilities for each partner in embedding trauma-informed care across the community. It should align with the broader goals of the Brighton & Hove Integrated Care System (ICS).
    • Sources: The Sussex Integrated Care Strategy itself serves as a foundational document for joint strategic planning.
  • Establish a Multi-Agency Steering Group:
    • Elaboration: This group would be crucial for operationalizing the shared strategy, troubleshooting challenges, sharing best practices, and ensuring accountability. It should include clinical leads, public health representatives, social care managers, GP leads, and, critically, those with lived experience.
    • Sources: The concept of Integrated Neighbourhood Teams and the wider ICS structure implicitly supports such multi-agency governance.

2. Integrated Pathways and Coordinated Care:

  • “No Wrong Door” Approach:
    • Elaboration: This means that whether someone contacts their GP, a community mental health team, or a council service, they are met with understanding and guided to appropriate support without having to re-tell their story or navigate complex, siloed systems. This requires clear referral protocols and shared understanding of each service’s offer.
    • Sources: The Brighton and Hove Wellbeing Service (a partnership including SPFT and Southdown) aims to “help you get the support you need” for mental health, suggesting a commitment to accessible entry points. (Brighton and Hove Wellbeing Service website). SPFT’s “Assessment and treatment services” also highlight a commitment to “signpost to another service that can give you the support you need” if an assessment isn’t required. (Sussex Partnership NHS Foundation Trust, Assessment and treatment services).
  • Multi-Disciplinary Team (MDT) Working:
    • Elaboration: Integrated Neighbourhood MDTs should regularly meet to discuss complex cases, coordinate care plans, and ensure a holistic approach that considers physical health, mental health, and social determinants. For instance, SCFT’s Homeless Health Inclusion Team already works in a “trauma informed way with patients with tri-morbidity” (multiple chronic health conditions) and has nurses, OTs, and physiotherapists working to support engagement with primary and secondary care. (Sussex Community NHS Foundation Trust, Homeless Health Inclusion Team). This model can be expanded across all neighbourhood teams.
    • Sources: The Sussex Integrated Care Strategy mentions developing “integrated community mental health services connecting mental health services with community assets” at the neighbourhood level. (Brighton & Hove City Council, The ICB is required to provide a first draft of the SDP by 1st April 2023). SPFT’s Assessment and Treatment Services are explicitly multidisciplinary, including psychiatrists, psychologists, nurses, OTs, and social workers. (Sussex Partnership NHS Foundation Trust, Assessment and treatment services).
  • Shared Care Records and Information Sharing:
    • Elaboration: Invest in robust and secure IT systems that allow for seamless, real-time sharing of relevant patient information between different services, while respecting patient confidentiality and data protection laws. This prevents re-traumatisation from repeated disclosures.
    • Sources: This is a core component of effective integrated care systems, and while specific public-facing documents on the exact technical solutions are less common, the ambition for integrated care implicitly requires it.
  • Harmonised Assessment Tools:
    • Elaboration: Adopt common screening tools for trauma and adverse childhood experiences (ACEs) across all services. This allows for early identification and consistent data collection to understand population-level trauma burden and tailor services accordingly.
    • Sources: SCFT’s Safeguarding Strategy highlights the importance of staff being “alert to potential indicators of abuse… and have an awareness of how trauma can negatively impact on individuals.” (Sussex Community NHS Foundation Trust, Safeguarding Strategy 2023-2026).

3. Community-Centred and Accessible Services:

  • Co-production with Lived Experience:
    • Elaboration: Actively involve people with lived experience of trauma and mental health challenges in all stages of service design, delivery, and evaluation. This includes representation on steering groups, co-facilitating workshops, and contributing to training materials. SPFT’s PTSD Clinic already has a Lived Experience Advisory Panel (LEAP) that “help clinicians and researchers improve the quality and accessibility of services and support available for PTSD, and to develop new research about PTSD.” (Sussex Partnership NHS Foundation Trust, PTSD Clinic). This model should be replicated more broadly.
    • Sources: The Sussex Integrated Care Strategy explicitly states the aim to “deliver a joined up, integrated service model, co-produced for and by people with lived experience” for people with multiple compound needs. (Brighton & Hove City Council, The ICB is required to provide a first draft of the SDP by 1st April 2023).
  • Community Hubs and Non-Clinical Settings:
    • Elaboration: Utilise accessible community spaces for delivering trauma-informed interventions such as peer support groups, psychoeducation workshops, and social prescribing activities, making support less stigmatizing and more approachable than traditional clinic settings. This aligns with the “connecting mental health services with community assets” vision.
    • Sources: The concept of Integrated Neighbourhoods themselves is built around delivering care closer to home and within the community. BHCC’s “Support with your mental health and wellbeing” page promotes various community-based activities. (Brighton & Hove City Council, Support with your mental health and wellbeing).
  • Social Prescribing:
    • Elaboration: Strengthen pathways from GPs and neighbourhood teams to social prescribing link workers who can connect individuals with a wide range of non-clinical community resources, activities, and groups that promote wellbeing, reduce isolation, and build resilience – all vital for trauma recovery.
    • Sources: Brighton & Hove City Council explicitly mentions Social Prescribing services at GP surgeries, connecting people to “support, services and activities to help address the challenges and issues you may be struggling with.” (Brighton & Hove City Council, Support with your mental health and wellbeing).
  • Addressing Wider Determinants of Health:
    • Elaboration: Recognise that trauma often occurs within a context of social disadvantage. BHCC’s role in addressing issues like housing, employment, and poverty through its services and partnerships with the voluntary sector (e.g., support for domestic abuse, drug and alcohol recovery, money worries) is crucial for a truly holistic trauma-informed approach that goes beyond clinical interventions.
    • Sources: Brighton & Hove City Council’s “Support with your mental health and wellbeing” page directly links mental health support with “money worries and cost of living support, help with housing, support for people affected by domestic abuse, drug and alcohol recovery support.” (Brighton & Hove City Council, Support with your mental health and wellbeing).

4. Workforce Development and Support:

  • Ongoing Supervision and Support for Staff:
    • Elaboration: Provide dedicated clinical supervision and reflective practice spaces for all staff regularly engaging with individuals who have experienced trauma. This helps prevent compassion fatigue and vicarious trauma, ensuring staff can maintain a trauma-informed stance.
    • Sources: While not explicitly detailed in public documents, this is a core best practice in trauma-informed care and should be integrated into staff development plans across SCFT and SPFT.
  • Investment in Specialist Roles:
    • Elaboration: Ensure sufficient numbers of specialist trauma therapists (e.g., those trained in EMDR, TF-CBT, or Compassionate Resilience Groups as explored by SPFT’s research clinic) within SPFT’s community mental health teams, with clear and timely referral pathways from primary care and Integrated Neighbourhoods.
    • Sources: SPFT’s PTSD Clinic is actively researching and evaluating treatments like EMDR and Compassionate Resilience Groups, demonstrating their commitment to specialist trauma interventions. (Sussex Partnership NHS Foundation Trust, PTSD Clinic).
  • Foster a Culture of Compassion and Safety for Staff:
    • Elaboration: An organisation cannot be truly trauma-informed for its clients if it is not trauma-informed for its staff. This includes promoting psychological safety, clear communication, and addressing staff wellbeing proactively.
    • Sources: SPFT’s “good” CQC rating noted “outstanding” for being caring and “good” for being well-led, including “an invigorated and open approach to the direction of the trust and culture in which the staff worked. Staff were excited about the changes and empowered to make improvements to their services.” (Sussex Partnership NHS Foundation Trust – Wikipedia). This cultural aspect is key.

5. Evaluation and Continuous Improvement:

  • Data Collection and Monitoring:
    • Elaboration: Establish shared metrics for evaluating the effectiveness of trauma-informed care across the system, including patient reported outcome measures (PROMs), patient experience data, staff wellbeing indicators, and reductions in crisis presentations or re-admissions.
    • Sources: The Sussex Integrated Care Strategy mentions using a “population health management (PHM) approach” to improve outcomes through “data-driven planning and proactive care.” (Brighton & Hove City Council, The ICB is required to provide a first draft of the SDP by 1st April 2023).
  • Regular Review and Adaptation:
    • Elaboration: Hold regular joint review meetings to analyse data, gather feedback from all stakeholders (including lived experience), and adapt the trauma-informed strategy and its implementation based on learning.
  • Share Learning and Best Practice:
    • Elaboration: Actively disseminate lessons learned within Brighton & Hove and contribute to the wider knowledge base of trauma-informed care nationally. This could include joint publications, presentations, or participation in regional/national networks.

By systematically addressing these areas, leveraging existing strengths, and building on current strategic commitments, SCFT, SPFT, BHCC, GPs, and Integrated Neighbourhoods can collectively build a truly comprehensive and effective trauma-informed care system for the community in Brighton & Hove.

AI offers powerful capabilities that can significantly enhance the implementation of trauma-informed care within the integrated community framework of NHS SCFT, SPFT, BHCC, and GP practices. However, it’s crucial to apply AI ethically and with human oversight, ensuring it supports, rather than replaces, compassionate human interaction.

Here’s how AI can best be utilised, with relevant sources:

1. Enhancing Data Integration and Predictive Analytics for Early Identification and Prevention:

  • Shared Care Records and Insights:
    • How AI Helps: AI, particularly Natural Language Processing (NLP), can analyse vast amounts of unstructured data from GP notes, SCFT community health records, SPFT mental health records, and BHCC social care notes (with appropriate anonymisation and consent).2 This can identify patterns, risk factors, and early indicators of trauma or its re-occurrence that might be missed by human review.3
    • Application: For instance, AI could flag individuals with multiple presentations across different services for seemingly disparate issues (e.g., frequent A&E visits, mental health crises, housing issues) that, when analysed together, suggest underlying trauma. This would prompt a trauma-informed assessment.
    • Sources: The NHS Sussex ICS explicitly mentions using a “population health management (PHM) approach” to improve outcomes through “data-driven planning and proactive care.” (Brighton & Hove City Council, The ICB is required to provide a first draft of the SDP by 1st April 2023).4 SPFT’s organisational strategy for 2025-2030 highlights becoming a “data informed organisation” where “joined up data generates insights and informs decision making.”5 (Sussex Partnership NHS Foundation Trust, Organisational strategy for 2025-2030, HTN Health Tech News).
  • Predictive Risk Stratification:
    • How AI Helps: Machine learning models can analyse historical data (e.g., adverse childhood experiences, social determinants, past service engagement) to predict which individuals or population groups are at higher risk of developing trauma-related conditions or experiencing further adverse events.6 This allows for proactive, preventative outreach.
    • Application: This could inform targeted interventions by Integrated Neighbourhood teams, ensuring support reaches individuals before they reach crisis point, aligning with the shift from reactive to preventative care.
    • Sources: The NHS England AI team’s “Foresight AI” project is explicitly designed to “predict health outcomes… and identify when someone’s condition might be getting worse,” showcasing the national drive for predictive healthcare using AI. (NHS England Digital, Foresight AI case study).7

2. Supporting Clinical Decision-Making and Personalised Care Plans:

  • Clinical Decision Support Systems:
    • How AI Helps: AI algorithms can analyse patient data (symptoms, history, co-morbidities) and integrate it with the latest evidence-based guidelines for trauma-informed care. This can provide GPs and other community clinicians with suggestions for screening, referral pathways, and appropriate interventions, ensuring a consistent trauma-informed approach.
    • Application: An AI tool could prompt a GP to consider trauma as a root cause for chronic physical symptoms, or suggest a referral to SPFT’s specialist trauma services or a community-based peer support group facilitated by BHCC.
    • Sources: NHS Suffolk and North East Essex ICB mentions AI tools supporting “clinical decision support” by “suggest[ing] possible diagnoses or flag[ging] drug interactions, helping clinicians make informed decisions based on the latest guidance.”8 (NHS Suffolk and North East Essex ICB, Artificial intelligence (AI) use in primary care).9
  • Personalised Treatment Recommendations:
    • How AI Helps: AI can help tailor treatment plans by analysing an individual’s unique history, preferences, and progress. This could involve recommending specific trauma-focused therapies or community interventions based on what has been most effective for similar profiles.
    • Application: For complex needs, AI could assist MDTs in identifying optimal combinations of support (e.g., a specific therapy from SPFT, social care support from BHCC, and a social prescribing referral via the GP).
    • Sources: Research on “Transformative AI Solutions for Trauma Management and Advanced Mental Health Care Approaches” highlights AI’s potential for “personalized treatment.” (ijrpr, Transformative AI Solutions for Trauma Management and Advanced Mental Health Care Approaches).10

3. Streamlining Administrative Tasks and Reducing Bureaucracy:

  • AI Scribes/Ambient Voice Technologies:
    • How AI Helps: These tools can listen to consultations (with patient consent) and automatically generate accurate clinical notes, freeing up clinicians’ time previously spent on extensive administrative tasks.11 This time can then be redirected towards direct patient care and building trusting, trauma-informed relationships.
    • Application: GPs, community nurses (SCFT), and mental health professionals (SPFT) could use this in consultations to capture patient narratives efficiently, allowing them to focus on active listening rather than note-taking, which is crucial for a trauma-informed approach.
    • Sources: NHS Suffolk and North East Essex ICB explicitly notes that “some practices have started implementing clinical note support systems using ambient scribing products” and that these “help doctors and nurses create clinical notes or referral letters during your appointment, saving time and reducing paperwork.”12 (NHS Suffolk and North East Essex ICB, Artificial intelligence (AI) use in primary care).13 The Kings Fund also highlights that “AI scribes… are starting to be used across NHS and social care settings.” (The Kings Fund, More than just hype: how emerging AI use is assisting health and social care).
  • Automated Information Retrieval and Referral Management:
    • How AI Helps: AI can quickly process and extract relevant information from patient records to populate referral forms or identify the most appropriate service based on criteria, reducing delays and administrative burden.14
    • Application: For instance, if an individual presents to a GP with trauma-related symptoms, an AI system could instantly identify if SPFT’s PTSD clinic is the most suitable next step and pre-populate much of the referral form based on existing records. Brighton & Hove Integrated Care Service (BICS) already uses a tailored patient referral management system (“Vedas”) for GPs, indicating a local openness to such solutions.15 (One Beyond, Brighton & Hove Integrated Care Service).

4. Enhancing Accessibility and Self-Management Tools:

  • AI-Powered Chatbots and Virtual Assistants:
    • How AI Helps: While not a replacement for human therapy, trauma-informed chatbots (e.g., those trained on principles of safety, trustworthiness, and de-escalation) can provide immediate, accessible support, psychoeducation, and signposting to resources outside of traditional service hours. They can act as a “first port of call” for individuals struggling with overwhelming emotions or seeking basic information.
    • Application: A BHCC-commissioned chatbot could provide immediate, non-judgmental support to individuals experiencing distress, guide them through calming techniques, and direct them to relevant local community support or crisis lines. It’s crucial these are carefully designed to avoid re-traumatisation.
    • Sources: The UK Parliament’s report “AI and Mental Healthcare” discusses how “AI-powered chatbots and digital mental health interventions are being used to assist patients outside of traditional clinical settings, offering real-time support and therapeutic interactions.” (BABL AI, AI in Mental Healthcare: UK Report Highlights Opportunities and Challenges).
  • Remote Monitoring and Digital Therapeutics:
    • How AI Helps: AI can analyse data from wearable devices or patient-reported data through apps to monitor vital signs, sleep patterns, activity levels, or mood fluctuations that might indicate worsening mental health or trauma symptoms.16 This enables early intervention.
    • Application: For individuals undergoing trauma recovery, AI could detect patterns that suggest increasing anxiety or sleep disturbances, prompting a timely check-in from their community mental health nurse or GP.
    • Sources: SCFT’s Digital Strategy mentions implementing “current health wearable devices” and enabling “remote monitoring of patient observations.” (Digital Health, Sussex Community aims to become digital leader as strategy is laid out).17

Critical Considerations for AI Implementation:

  • Ethical Oversight and Bias: AI models are only as good as the data they’re trained on. There’s a significant risk of perpetuating existing health inequalities and biases if data sets are not diverse or if algorithms are not carefully designed and monitored.18 Robust ethical frameworks, co-produced with lived experience, are paramount.19
  • Data Security and Privacy: Handling sensitive trauma-related data requires the highest level of security and adherence to GDPR and NHS data governance standards.
  • Human Oversight and “AI for Social Good”: AI should always augment, not replace, human empathy and clinical judgment.20 The focus should be on “AI for social good,” where the technology supports human connection and improved outcomes, especially in sensitive areas like trauma.
  • Digital Inclusion: Ensure that AI solutions do not exacerbate digital divides. Provisions must be made for individuals who are not digitally literate or do not have access to technology.
  • Interoperability: Any AI solution must be able to seamlessly integrate with existing NHS and local authority IT systems (EPRs, shared care records) to truly enable integrated care.21 This is a current focus for NHS Sussex ICS, which highlights ongoing work on “digital architecture, data flows, and EPR landscape.” (HTN Health Tech News, NHS Sussex ICS highlights digital architecture, data flows, EPR landscape and transfer of care hubs).

By strategically integrating AI, the Brighton & Hove integrated neighbourhood model can enhance its capacity for proactive, personalised, and accessible trauma-informed care, ultimately improving outcomes for the community.

Here are the sources with hyperlinks for easy reference, categorised by the relevant sections:

1. Shared Understanding and Vision of Trauma-Informed Care:

2. Integrated Pathways and Coordinated Care:

3. Community-Centred and Accessible Services:

4. Workforce Development and Support:

5. Evaluation and Continuous Improvement:

6. AI in Implementation (Additional Sources):

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