Prioritise healthcare

Getting the right healthcare for you and your loved one is fundamental to ensuring the best chance of a successful recovery.

You and your loved one’s health is more important than anything else.

As we all know, the NHS is stretched. Advocating and supporting your loved one to access services can be very difficult but in general, once you have navigated the system, healthcare professionals are kind and want to help offer the best service they can to their patients. For some survivors of sexual or violent crime, the sheer number of different health professionals they need to work with is daunting. One bad experience can negatively impact expectations of the next person they need to see, regardless of the branch or specialism. On the other hand, a good experience will add confidence and make the next appointment, regardless who it’s with, easier.  Carers and loved ones can help enormously by ensuring that health professionals are well-informed and prepared with the right information before treatment starts.

People living with trauma and their carers face health inequalities that reduce life expectancy and quality. Sometimes this is blamed on lifestyle ‘choices’ but it is also due traumatic experiences, anxiety, assumptions by healthcare professionals and accessibility.

Looking for information about Mental Health?

You will find comprehensive information in our dedicated section on Mental Health.

Find out about our training for GPs and hospitals

Restitute offer training for GP practices, hospital staff and allied health professionals – bespoke to your needs.

Know your services

Below are some suggestions of the types of services you should be receiving from various health care providers and how to get the most out of each service. Be aware that whilst each service should coordinate and liaise with each other, the reality is that they often use different IT systems that don’t connect, so they may not be aware of other services you’re receiving.

Never assume that the various specialists you or your loved one sees has any idea what anyone else is doing. It’s realistic to assume that you may have information that a specialist does not know about. It may be stuck in the system or another specialist may not have updated their records before you see someone else. Writing down the names, specialisms and current treatment of people your loved one is seeing, plus any medication they are taking will save time, assist health professionals to treat your loved one better and reduce your own stress and anxiety.

GP and primary care

Of all the health services available to you, your most frequent appointments are likely to be at your GP Practice.

Doctors

Having a good relationship with your GP is essential.

Your GP should treat you as a carer with respect, trust and be keen to support you.

If you don’t feel a level of rapport with your assigned GP, ask either the practice manager or friends who use the same practice who they would recommend. If you don’t feel any of them are right – consider moving practice if that’s feasible.

GPs often have additional training in specialisms such as Mental Health, minor surgery or chronic pain. Others are inevitably better with teenagers and young people that others. Find out the specialisms within the practice.

Whilst it is common for patients to see ‘any’ doctor, you can make appointments with specific doctors, you can ask to see your GP or another one with a specialism.

My GP practice was brilliant – juggling their lists so my son could see ‘his’ doctor – even for short-notice appointments.

You will inevitably have to evidence concerns, issues and challenges in order to meet the demands of education, compensation and benefits. Your GP will find this information useful in order to care for you and your loved one but when you need to provide information or ask your GP for support, having all the information documented independently will be very useful. Tell your GP everything!

Tips and timesavers

  • Make sure your GP is aware of your caring role
  • Always ask for a double appointment
  • Talk to your GP about telephone appointments
  • Book another appointment as soon as you finish one
  • Take advantage of all health-screening invitations and vaccinations

Nurses

Practice nurses are often highly qualified and have prescribing rights. They often have appointments sooner than a doctor, acting as a triage. Very often, a practice nurse can offer an alternative relationship for your loved one that isn’t quite as intimidating or perhaps will be a different gender to their normal GP which can be very useful, especially for those recovering from sexual crimes.

Tips and timesavers

  • Nurses have stocks of wound dressings and are good at assessing if a self-harm wound needs hospital attention
  • They are great at discussing sexual health, contraception and have condoms!
  • If you can’t get an urgent appointment with a doctor, try to get one with a nurse – they will get your loved one in front of a GP if it’s urgent far quicker than you will!
  • Most nurses specialise in chronic health conditions such as pain management or asthma for example
Check the quality of the services provided by your GP

Pharmacies and medicines

There has been a great deal of publicity in recent years about the additional services that pharamcists can offer to the general public.

For third party victims of crime and their loved ones pharmacists can both save time and help keep people safe.

Tips and timesavers

  • If you find yourself spending a great deal of time sorting and dispensing medicines, your pharmacist can create dosette box dividing and sorting the medication into days and times. This may not always be a free service but ask to see if it is from your pharmacist. Having the medicines pre-sorted saves a lot of time and is incredibly useful if your loved one is at risk of overdose as you can see very easily if there’s something amiss.
  • If storing medication at home is risky due to deliberate overdose, or prescription medication abuse, then pharmacists can dispense a four week prescription in weekly or fortnightly lots, reducing the quantity of medication at home.
  • You can buy steristrips from pharmacies
  • If you aren’t eligible for free prescriptions and you or your loved one takes more than one prescription per month, you can buy an annual pass and pay for it via direct debit. The claim forms are really complicated, the penalties for claiming free prescriptions when you aren’t eligble (and the benefit rules aren’t straightforward) are horrendous so getting a prepayment pass could save a lot of money, anxiety or a fine. It costs around £100 per year or £10 per month. There is more information about free prescriptions here and the pre-payment scheme on this page.

Staying in hospital

Staying in hospital is stressful for everyone. For survivors of crime it can be particularly stressful when routines are disrupted, the reason for admission may be self-inflicted and therefore accompanied by extreme mental distress, there is almost no privacy and most hospital wards are incredibly noisy.

If the stay is planned then preparation such as pre-ward visits can usually be arranged and ward staff can be notified of your loved ones additional needs or anxieties. Most wards have good information for people living with mental health conditions and will try to accomodate patients in a quieter area of the ward and try to ensure they are less likely to encounter more disruptive patients or people of different genders half-clothed! If, however, there are any risks that the patient may pose to themselves or other people then patients are usually put within sight and sound of the nurses desk and check-ups are made frequently. This is reassuring for carers but can feel incredibly intrusive to the patient.

Planned admissions – Tips and timesavers

  • Make sure you and your loved one knows exactly what the hospital stay is for and be prepared to repeat information several times.
  • You may have a choice of hospitals to attend for treatment – this is very useful if one hospital has been the scene of a traumatic admission.
  • Visit beforehand and with consent or encouragement make sure that ward staff are aware that your loved one is a survivor of sexual or violent crime. It may be useful to have some information written down if there are particular concerns or triggers.
  • Take any prescription medication with you but make sure you take the boxes with the doseage and frequency documented. If your loved one takes any medication when needed (sometimes called PRN) make sure the ward staff are aware of this and that your loved one has it with them.
  • If sleep is often disturbed or your loved one has frequent nightmares, discuss with nursing staff where your loved one can go if they need to walk around or deal with any distress.
  • If appropriate, find out if there is somewhere you can sleep over, if this is what you want to do.
  • Plan what your loved one needs to take into hospital and make sure they have chargers for any electronics. A battery pack is very useful.
  • If your loved one smokes, get some nicotine inhalers but also discuss with ward staff how this can be accommodated. Be aware that under 18s are never accomodated to smoke and this is something that can cause great agitation.

Physiotherapy and exercise

Chronic pain and mobility issues are common for people who are living with trauma – and this can include 3rd party victims of crime who live physically and mentally demanding lives and rarely prioritise their own health. For people who are immobile due to long periods of depression, moving again after a period of weeks or months in bed might require support and a structure. Any kind of injury can be debilitating but especially for people who are offering care or living with trauma as it wrecks routines and can lead to depression or isolation so keeping on top of phyiscal aches, pains and injuries is important.

Inevitably, some physiotherapy requires hands on treatment that your loved one will want to feel comfortable about. An initial discussion with the practitioner about past trauma should ensure that the physiotherapist takes the treatment at a pace that your loved one can tolerate.

In some areas it is possible to access physiotherapy directly. Alternatively you may need to contact your GP for a referral. Exercise on prescription is often available via your GP and graded exercise for people living with Chronic Fatigue Syndrome can also be effective.

Emergency Healthcare

Attending A&E is a sadly too common event for victims of sexual and serious violent crime. Whatever the cause for needing attendance it can be distressing and may not lead to a satisfactory outcome. A&E is busy, wait times are long and the waiting area is often busy with people who can be frightening.

Tips and timesavers

  • During the day, phone your GP or mental health services first, unless the issue obviously requires emergency treatment. Some GPs can deal with minor wounds. Many mental health trusts have a duty worker who may be able to support your loved one far better than via A&E.
  • If you know you need to attend A&E and are planning to transport yourself, phone up in advance and warn them that you are coming. Explain (with consent) your loved ones history and ask if there is somewhere quieter that you and they can wait upon arrival.
  • If the reason for attendance is mental health without physical harm or overdose, phone the crisis line first if you have access to it, although realistically out of hours, you’ll probably be told to go to A&E.
  • If you have been up for a very long time and it isn’t safe for you to drive (or to drive back having been there for several hours) call an ambulance. Do this too if your loved one is very distressed or agitated unless you have someone else who can come in the car with you. Your safety is paramount as well.
  • If there is a 111 service in your area, phone them before leaving home. An out of hours doctors, walk-in centre or urgent care facility might be quicker and more appropriate.
  • If your loved one has taken an overdose, they have to go to A&E. This is really important for paracetamol so don’t waste time. Try to make a list (or take with you any packets) of anything they might have taken.
  • If your loved one has self-harmed or taken an overdose, it is likely that they will need to see a mental health worker before they are discharged. If you aren’t happy you can keep your loved one safe at home and they are planning to discharge them, you can ask for an assessment under the Mental Health Act. If the hospital seems to dismiss this, you can phone the Duty Social Worker at your council and ask them directly. There is more about the Mental Health Act and assessment in the section about Mental Health.
  • Keep coins in the car for the carpark and the coffee machine and take something to read or do – you’ll be waiting a long time.

Tests, scans and xrays

The lack of control, the enclosed spaces and the wait for results can make any kind of diagnostic procedure acutely distressing for survivors of violent or sexual crime. As a 3rd party victim of crime, one of the everyday challenges is an expectation from loved ones that you will be able to offer reassurance and explanations to quell anxiety.

Tips and timesavers

  • Let the person doing the test know (with consent) that your loved one lives with trauma.
  • Find out as much in advance what the test is for, how long the results will take to come through, how the test will be conducted and what information the test operator will be able to offer on the day.
  • In the days leading up to the test, repeat information as often as you are asked. Remind your loved one what to expect but if in desparation, you find yourself making stuff up – stop and admit you don’t know.
  • Expect and anticipate a sudden unexpected reason to delay or cancel the appointment – your loved one may be frightened.
  • Health anxiety is a common problem for people who have survived violent or sexual crimes so be aware of catastrophisation (imaging the worst possible outcome and taking every negative thought to its most dreadful conclusion) and encourage your loved one to use mindfulness or relaxation techniques to bring their thoughts back to a more realistic place.
  • Encourage your loved one to make choices about being ready for the test and choosing the site of blood tests for example. Sadly, some people living with trauma self-harm – there may be parts of their body that they aren’t keen to expose, or where – more practically – scar tissue makes drawing blood more difficult. If you think your loved one may be anxious about exposing scars, encourage a three way discussion of this with the test operator before your loved one removes any clothing!
  • Cervical smear testing and bowel cancer screening can be extremely traumatic for survivors of sexual crimes and can trigger flashbacks and suicidal thoughts. Work with your loved one, your GP or a practice nurse to begin a programme to allow these tests to happen. You may need to call on psychological support to facilitate this. There is more information on this website from Sarsas about preparing for these kinds of tests after sexual assault. Although it is written about smear tests, the suggestions may work well for men as well.

Dentists and opticians

Any treatment that requires someone living with trauma to put their trust in a stranger, or that requires physical contact and someone controlling their movements can be disconcerting and upsetting. Whilst the treatment might be beneficial or necessary, the anxiety through lack of control or potential pain can prevent survivors of violent or sexual crime accessing treatment.

Dentists

Not many people like going to the dentist and inevitably it can be a source of anxiety for victims of crime and their loved ones. Dental hygiene is commonly neglected when someone is struggling with their mental health, and combined with smoking, drinking fizzy drinks and vomiting all play havoc with teeth. For parents of victims of crime, turning up to the dentist with a child with teeth in poor condition can be an additional source of shame and guilt.

When my child was self-harming every single day and it felt like we were fighting to keep them alive – getting them to brush their teeth was way down the list of priorities

Tips and timesavers

  • If your loved one hasn’t visited the dentist for a long time, arrange as many non-treatment appointments that build up to treatment as required.
  • Consider the gender of the person giving the treatment.
  • Choose a quiet time of day for the appointment and see if there is a separate waiting area.
  • If you are scared of the dentist yourself – find someone else if possible to take your loved one! Try to keep on top of your own appointments as well which can be difficult if your own time is limited or disrupted.
  • If teeth cleaning is a battle, use a phone alarm, a cooker timer or a smart speaker to set a reminder. For some reason children (in particular) argue less with electronics!
  • If regular dental pain or infections are common for you or your loved one, talk to your GP about an emergency packet of antibiotics – explain that you’re a carer and / or your loved one’s past trauma and they might help out. Dental pain always seems to start on a Sunday evening…
  • Don’t dismiss fears and anxieties – acknowledge the feelings but point out the benefits
  • The dentist can prescribe toothpaste and mouthwash that is higher in intensity than over-the-counter products.
  • There is more information about coping with dental fear on this NHS page.
  • Pre-payment prescription passes don’t cover dental treatment – you’ll have to pay unless exempt.

Opticians

Visits for eyetests are generally painless but can be disconcerting. Some of the tests require the optician to put their faces very close to their patients and some of the equipment can be intimidating. Some of the tests are carried out in almost darkness which can be frightening. As with all medical treatment control, consent and an understanding of what will happen and the reasons for the test will lead to a more successful outcome.

Tips and timesavers

  • Commercial opticians are crowded high-street shops – a traditional optician might offer a more relaxing experience
  • Consider the gender of the optician
  • Ask the optician to explain what will happen with each test before starting and if necessary offer to have each test done first so your loved one can see what will happen and make sure they are clear that they can opt out at any point.
  • Details of costs and exemptions are on this NHS page but many of the high street stores offer free tests every so often so it’s worth doing an internet search before booking a test.

Well-being

There is a reason that health professionals ‘bang on’ about well-being and that’s because it works. Having a routine, eating well, sleeping regularly and doing some exercise can improve everyone’s physical and mental health – even those living with significant trauma. It’s unlikely to be the solution to all of your problems but it’s a really good place to start. Anything that’s added on will work better if these basics are achieved.

There is more information on this page of our website about well-being.

Need to make a complaint about medical treatment?

Making a complaint about health care is extremely complex with seemingly different rules for different parts of the NHS and different support services depending on where you live in the UK.

In the first instance, raise your complaint or concern with either the person who has provided poor service or with their manager. At the same time, ask for a copy of their complaints procedure which should explain how the complaint will be dealt with and how it is escalated.

The information on this page of our website explains why people don’t complain… and why they should if they are unhappy with a service they’ve received.