Blog: Trauma-Informed Practice in Primary Care

By Lesley Anne Pratchett, Clinical Lead at Break the Silence 

Q1. What exactly does ‘trauma-informed’ mean, and is it really relevant to a GP surgery? 

Trauma-informed belongs in every healthcare setting. At its heart, it means slowing down, listening very carefully, and being mindful of the spoken language and non-verbal communication being used in every interaction. It means recognising that a patient who seems passive, indifferent, abrasive, resistant, inconsistent, or even evasive may not be difficult – they may be a trauma survivor responding in the only way they know how. It also means having an appreciation for the impact of touch and proximity and understanding how these can feel very different for someone with a history of trauma. 

Q2. How many patients is this relevant to? 

Trauma is far more prevalent in our communities than many clinicians realise, and it shows up in GP surgeries every single day, often unrecognised. Survivors may present with a wide range of physical and mental health complaints, and without a trauma-informed lens, the connections between their experiences and their health can easily be missed.  

Q3. What does a trauma-informed interaction actually look like? 

A trauma-informed GP or clinician slows down. They read the room. They pay close attention not just to what a patient says, but how they say it, and the non-verbal cues that tell a fuller story.  

They’re alert to the fact that a patient who seems compliant and agreeable during a physical examination may actually be experiencing high levels of internal distress and their compliance is actually a sign that the patient doesn’t feel safe enough to say otherwise.  

They might ask “Is there anything I can do to make this easier for you?” This shows a willingness to adapt their approach, even if the GP doesn’t fully understand how to be trauma-led.  

Clinicians who are trauma-informed are aware of the power dynamic present in the therapeutic relationship and understand that this dynamic can feel unsafe for patients. This lack of safety may affect the patient’s ability to be open and honest with the healthcare team.

Q4. What can go wrong when trauma-informed training hasn’t been part of the picture? 

Without trauma-informed training, the experience by the patient might feel judgemental, intrusive, insensitive, perhaps even disbelieving. Physical investigations, even routine ones, can be distressing and re-traumatising.  

The consequences are real and measurable: patients cancel appointments, fail to attend, or disengage entirely from the healthcare services they need most.  

At other times, patients may become agitated or aggressive during physical examinations – a response that, without context, can be misread entirely. And for those who respond with submission rather than resistance, the risk is that their distress goes unseen, and they quietly stop engaging with future healthcare interventions altogether.

Q5. Are there wider health implications if trauma goes unrecognised in primary care? 

Clinicians who are not trauma-informed may not relate emotional distress to the physical symptoms being presented and may not recognise the high correlation of poor mental health, autoimmune conditions, pain conditions, and functional disorders that coexist in a population impacted by trauma.  

In short, unrecognised trauma doesn’t just affect how patients feel emotionally – it shapes how they present physically, and can lead to years of misdiagnosis, inadequate treatment, and unnecessary suffering. Trauma-informed training can go some way to helping to mitigate this.  

But if a GP and their team understand what they are seeing in a patient, that perspective shapes the rest of the patient’s healthcare journey. It impacts the sense of safety and confidence the patient has in the services they’re referred to. It shapes the language used to describe how the patient presents. And it models to everyone in primary healthcare a level of empathy and understanding of how multifaceted and complex the impact of trauma is on every aspect of a patient’s day-to-day experience.

Q6. Why is it important that all staff receive this training, not just GPs? 

This is a really important question, and one that’s sometimes overlooked. A patient’s experience of a healthcare setting begins the moment they call to make an appointment or walk through the door. Reception staff and practice nurses play a vital role in helping patients feel safe or unsafe in a GP practice. A trauma-informed approach has to be embedded across the whole team, not just the clinicians. A warm, unhurried interaction at the front desk can make the difference between a patient staying for their appointment or walking away. Trauma-informed training for all staff is not a bonus – it’s a cornerstone of genuine patient-centred care. 

Q7. Time to undertake training is always the challenge. How realistic is it to fit this in? 

In practice, being trauma-informed doesn’t require dramatic changes to how you work, but the impact on patients can be profound. We understand that the demands placed upon primary care practitioners are high and this squeezes the time available for things like trauma-informed training.  

The good news is that Break the Silence offers in-person training. Whether you’re already looking to upskill your whole team as part of your CPD programme, or you’d like to start with a conversation about what trauma-informed practice could look like in your surgery, we’d love to hear from you. 

We distil what you need to know into a short workshop which will leave your team feeling more confident, more connected, and better equipped to support some of the most vulnerable patients in your community.

Ready to find out more? 

Getting your team trauma-informed is one of the most impactful steps you can take for your patients and for your practice.  

Get in touch with us today to find out more about our training programmes, what’s involved, and how to get started. 

📧  info@breakthesilence.org.uk