Perspectives of a newly developed UK major trauma and plastics psychology service: A qualitative service evaluation.

Abstract

Despite evidence of frequent adverse psychological reactions including PTSD in major trauma survivors, psychological support represents a frequent gap in UK major trauma care pathways. North Bristol Trust Major Trauma and Plastics Psychology Service has been newly developed in response at an NHS Major Trauma Centre (MTC). The service aims to address patients' psychological needs early on and throughout recovery from major trauma, alongside physical and functional recovery. Thus, a qualitative service evaluation was conducted. It aimed to explore major trauma clinicians' perspectives and experiences of the psychology service and to identify areas of strength and opportunity for development. Semi-structured interviews were conducted with a purposive sample of seven major trauma clinicians working at the MTC who make referrals to, and interact with, the psychology service. Data were thematically analysed using a codebook approach. Thematic analysis of qualitative data revealed five themes: (1) Necessity of specialist psychology for major trauma patients; (2) Psychological involvement facilitates patients' recovery; (3) Psychologists have an important role in supporting clinicians; (4) Requirement for service expansion; (5) Importance of psychologists' integration within a multidisciplinary team. Overall, the importance of the psychology service in facilitating patients' holistic recovery was emphasised, as well as its role in emotionally and professionally supporting major trauma clinicians. Service expansion was suggested to better meet patients' needs by permitting increased provision of training and formalised support sessions for clinicians, greater involvement of psychologists in rehabilitation, and psychological support for patients' families. Findings highlighted a perceived positive impact of integrated, specialist psychological support on the recovery of major trauma patients and the psychological wellbeing of major trauma clinicians. A need for future service expansion to overcome current capacity pressures and permit suggested developments was also emphasised. Replication of the psychology service in additional NHS MTCs to reach patients in other regions offers a potential solution to current inequities in post-major trauma psychological care in the UK.