- Training offered across all sectors to bring about widespread culture change
- Ambassador’s network encourages sharing of trauma-informed practice
ACTION
A network of ambassadors in South West England is increasing awareness of adverse childhood experiences (ACEs) by helping to promote trauma-informed practice in the workplace.
The scheme, spearheaded by Bristol City Council, has been rolled out across the city and four neighbouring local authorities covered by the area’s clinical commissioning group (CCG).
For Bristol in particular, the initiative forms part of its One City Plan, launched last year outlining long-term objectives to improve the city’s outcomes on issues such as mental health, the environment and equality.
A mission pledge is for children to grow up free of ACEs having had the best start in life and supported as they reach adulthood. Making the whole city “ACE aware” and trauma informed will go a long way to delivering this, explains Helen Godwin, the council’s cabinet member for women, children and young people, and lead member for children’s services.
A key priority has been to train a fifth of the city’s public sector workforce in trauma-informed practice this year, says Godwin. Bristol is close to achieving that target despite the challenges presented by the Covid-19 pandemic, she adds.
Meanwhile, 100 people have received ACE awareness training since the launch of the ambassador scheme in 2019. Around 60 are in roles related to education, including head teachers, safeguarding leads, special needs co-ordinators, education welfare officers and children’s centre staff, says Bonnie Curran, a planning and development manager for the council’s adults, children and education policy, improvement and partnerships team.
Curran says a further 50 education-based staff received training online this summer as part of modifications to the scheme as a result of the coronavirus crisis.
Once trained, the city’s ambassadors are tasked with taking their knowledge and skills into their own workplaces to start a “dissemination of practice”, says Godwin.
To support them, the council has built its own website as well as providing access to resources such as Resilience: The Biology of Stress and the Science of Hope, a documentary exploring the science of ACEs.
“The film is the pinnacle of the benefits of trauma-informed practice,” says Godwin. “We’ve bought the licence for it and have been offering our partners the chance to screen it for their employees for free.”
Godwin is hopeful the ambassador scheme will achieve its expected outcome of bringing about not just a change in practice, but a cultural shift in the workplace.
“It’s really important that it’s not a top-down way of doing things – it’s more about peers working together and seeing the benefit of it,” she explains.
“It’s a key part, but it can’t be everything which is why our long-term health and wellbeing plans for Bristol have got ACEs and trauma-informed practice running right through them.
“The ambition is to be a city where we aren’t seeing children experience ACEs.”
Until that point, the council wants practitioners to recognise the impact trauma has had on children and adults so that they are not “labelled” as being problematic, Godwin says.
The ambassador scheme was launched after securing funding from Bristol Health Partners as part of its Health Integration Team (HIT) programme of work (see box).
Godwin says this means the work is multi-agency and covers not just the city of Bristol but the other four rural authorities covered by the region’s CCG.
South Gloucestershire Council, one of these authorities, has already trained nearly 250 ACE ambassadors across all sectors after rolling out its own version of the scheme.
Of those trained, more than 40 per cent are in education services, including early years, with the rest divided between health, social care, housing, criminal justice, and the voluntary and community sector.
Some schools in the area have one ambassador, while larger settings may have up to three, says Milla Churchill, a specialist health improvement practitioner at the council, responsible for delivering the training.
She says the ambassador network has been successful in increasing capacity for ACE awareness raising activity. This in turn has been integral to a “rapid” culture change that has been seen as a result of the ACEs evidence base, she explains.
“Ambassadors are enthusiastic about the raising and understanding of ACEs, and the importance of providing a joined-up message of hope,” she says.
“They share stories, science and experiences to raise awareness within their own professional network.”
IMPACT
Godwin says anecdotal feedback offers clear evidence that the scheme is already having an impact “on a human level”, and hard data will follow in time.
“We also need to keep things moving culturally, so we talk about ACEs all the time and other organisations take on the training and move it forward,” she adds.
The scheme’s work with long established organisations such as the Family Nurse Partnership continue to show the importance of supporting young parents at such a vulnerable time in their lives.
“There is something tangible in their success – these children would potentially not be growing up with their birth parents if it wasn’t for the inclusion of ACE-aware practice,” says Godwin.
Feedback from attendees at ACE awareness training in South Gloucestershire also illustrates the culture change taking place.
One attendee said: “I have been in education for more than 20 years and I thought I was up to date with the needs of the students, but after an ACE awareness session, I realised I still have lots to learn.”
Another ACE ambassador said: “Personally and professionally, understanding ACEs has made me more empathetic.”
An early help support team manager said understanding ACEs had been a “light bulb moment” allowing her to reflect on previous practice with families.
“We never actually spoke about the parents and what happened to them,” she said. “I’d like to bring that to their family now.
“It’s not about that child’s behaviour, it’s about what happened to that child’s parents for them to be presenting as they are. It now makes sense.”
ACES PROVE A HIT IN BRISTOL
Bristol Health Partners – a strategic collaboration between the city’s three NHS trusts, three clinical commissioning groups, two universities and its local authority – is supporting ACE ambassador work through one of its health integration teams (HIT).
The HIT model is unique to Bristol Health Partners and brings together academics, public health and social care experts, clinicians, community organisations, patients and the public to work on specific health and care themes.
HITs harness high-quality research and involve patients and the public to help solve “seemingly intractable” problems by using a whole-system approach.
The ACE HIT aims to raise awareness and understanding of ACEs and trauma, as well as contributing to the developing evidence base in this area.
It also seeks to develop policy and practice approaches to prevent ACEs and trauma, and to build a “case for change” setting out how organisations can work differently together to prevent adversity and trauma, and improve health and wellbeing.
Bristol Health Partners announced earlier this year it plans to invest £170,000 in its health integration teams this year.
The funding will support the HITs’ original work and help them respond to challenges presented by the Covid-19 pandemic.
