"West of Scotland Breast Screening Service No Trauma Training"

I received my first invitation for breast screening in 2014 attending a mobile unit. It was not completed. I have a significant history of trauma. I have little recollection of what occurred as I was triggered; activating my fight/flight/freeze coping mechanisms/ responses, to later ‘coming back’ from my dissociated state, finding myself upset and distressed sitting in my car with a shirt on but no bra. The concerned staff contacted my CMHT. I have subsequently cancelled two further invitations without providing a reason due to this negative and completely re-traumatising experience. I was always scared it would happen again.

I received a further invitation this year. I had an initial call with a call handler and an extended call with the Admin Supervisor; both staff members were lovely. I provided information on TIP/NTTP. The Supervisor commented that what I was highlighting made sense and she would escalate this to senior management/clinicians.

* I asked when a woman cancels an appointment whether there is follow up to ascertain the reason with a view to improving the service and/or removing barriers? She advised no follow up had been undertaken.

* I highlighted the connection between traumatic experiences and the later development of physical illnesses. The established link between trauma making one more vulnerable to developing physical health problems, including long-term or chronic illnesses is well researched and documented.

* I highlighted that some women with trauma may not even recognise they have trauma!

* I suggested if the service had undertaken trauma training it should be included In the invitation.

* This does not apply to both handlers. I have learned from some very negative experiences that the initial call to a service is crucial in helping me to engage. The phrase I used was - ‘if you have rottweilers at the door, no one is coming into your house’! (I’ve encountered quite a number of 'rottweilers' over the years)! I suggested call handlers, as the first point of contact, must also undertake trauma training.

* My view TIP level 1 should be the minimum mandatory requirement for all staff working in the NHS.

* Both advised the Service had not undertaken trauma training but added they work in admin. I responded; ‘I would reserve judgement’ as I was absolutely sure, given the area of work, the clinical staff would undoubtedly have completed trauma training. I would also have thought they would have signed the NES Leadership Pledge to become (TIO). However, I was wrong on both counts!

I received communication from the Superintendent/Clinical Specialist Radiographer; who noted that since my phone call they have been looking into trauma training that is available within the GG&C and the wider area.

They further noted that they are still in the process of rolling out the first stage of this training.

I will be completely honest, I had to read the response three times as I just could not believe that firstly the Service appears to have been unaware of the NTTP and secondly, I was utterly shocked they had not undertaken any trauma training.

This is especially relevant given the Service’s area of work. Inequalities exist in accessing healthcare for women, and more so for those with a history of trauma; cervical smear tests, invasive and intimate procedures etc. This is currently being considered by others including the CPG on Women’s Health with a view to reducing barriers and improving access. My own experience of being unable to attend cervical smear screening and being unable to tolerate an endoscopy and colonoscopy further evidencing this view.

However, my recent extremely positive experience of attending the New Victoria Hospital for an x-ray clearly highlights the importance of TIP in reducing barriers, improving access and reducing inequalities for women (and men with trauma) in accessing healthcare services.

In 2018 The Scottish Government made a commitment to working with partners to facilitate a trauma-informed and trauma-responsive workforce and services across Scotland to support anyone affected by psychological trauma.

While I am reassured and heartened that the West of Scotland Breast Screening Service has listened and HEARD my concerns and acted in a timely manner to address the lack of training. I am concerned that it took my phone call to prompt this action.

Given the Scottish Government’s recent announcement of a new ten year cancer strategy with a focus on early detection, where screening will play a crucial role, my immediate reaction was; this could have already and may continue to cost lives.

Consequently, given the seriousness of the issues identified I have sent in a substantive submission (with a MSP covering letter) to the Ministers for Wellbeing and Women's health; where I outlined my concerns of the lack of trauma based training for not only The West of Scotland Breast Screening Service but other NHS services/ staff I previously identified to the Scottish Government.

I have also contacted the CPGs for Women’s Health and Survivors of CSA who share my concerns, and those of many others affected by the profoundly devastating impact of psychological trauma to not only physical and mental health but to all areas of an individual's life across the lifespan. Both CPGs and other charities/organisations I've contacted have indicated their intentions to raise the issues identified further.

As I said in my submission I know the professionals who work(ed) with me value lived experience as being as equally important as professional expertise. My view;

The only ‘expert’ on an individual’s trauma is the individual themself!

I found the Service's response somewhat condescending as I’d mentioned almost everything and more they included. In my reply which was dated over a month ago, to which I have still not received a reply; which in my opinion is poor , I asked the following;

* Before I offer any further comment or make a decision to attend screening I would respectfully ask you to consider the following question: For any trauma training to work your response has not included a key component/ element/ requirement?