Using a trauma-informed approach for serious violence victims

Thirty teenagers were murdered in London in 2021, the largest figure on record for a 12-month period. This tragic loss in human life resulted in public concern over rising rates of violent crime, posing a risk to wider confidence in the Metropolitan Police Service (MPS).

The Royal London Hospital (RLH) is the busiest of four major trauma centres (MTCs) in London. MTCs specialise in the care of patients who have serious and often multiple injuries where there is a strong possibility of death or disability. Of the patients it sees annually, around 700 will have been stabbed or shot.

In January 2021 we piloted a new approach to victims of serious violence in London by setting up a team based at RLH. Working closely with partners to reduce violent crime, the trauma support team (TST) consists of a detective sergeant and eight police constables (PCs) or detective constables (DCs).

In a time of crisis in the perceived legitimacy of the police, the team work to improve interactions with victims of violent crime by taking a trauma-informed approach and instilling greater confidence in reporting crime and supporting the criminal justice process. Our focus is to use experienced officers to improve the quality of evidential capture.

Usual police response

The usual initial police response to serious violence with injury is to send a PC to hospital with the victim to act as continuity. Continuity officers collect initial evidence, seize victim clothing, take swabs and take an initial account from the victim.

In the MPS this role is often performed by more junior officers and the secondary investigation is conducted by DCs or trainee detective constables (TDCs).

The complexity of these investigations and heavy resource/time demand adds pressure to these officers. These factors may result in challenges in obtaining evidence to secure a charge and contribute to a trend in victims being unwilling to support the investigation.

Whole-system approach

The TST is co-located on the RLH’s dedicated trauma ward alongside clinicians, the St Giles Trust (which offers diversionary opportunities for those aged 16 to 25) and the NHS After Trauma Team, who plan safe discharge for patients with other agencies such as local authorities.

Together, the co-located teams strive to adopt a whole-system approach to meet the shared goal of tackling and preventing further incidents of violence. Cross-partnership communication and information sharing has improved, increasing the efficiency and quality of safeguarding measures and diversion referrals put in place.

Understanding the impact of trauma

The approach taken by the TST is novel. Officers on the team are trained in taking a trauma-informed approach to victims of serious violence.

This approach is grounded in the understanding that trauma exposure can impact an individual’s neurological, biological, psychological and social development. It is a more human and empathetic approach that enables the officers to access the best outcomes for the victim. There is a police office on the UK’s first dedicated trauma ward and an on-call bleep to respond to every trauma patient who enters the hospital.

After establishing whether the admission is related to potential criminal activity, the team begin the initial steps of the investigation with a focus on forensic capture of evidence and building rapport with the victim. They visit the victim repeatedly in the hospital, in what we describe as a ‘reachable’ moment.

The aim is to build the trust and confidence of the victim and engage them in the secondary investigation, as well as gathering intelligence and safeguarding risks. This is all then fed back to the investigating teams in fast time.

Early data shows that when a victim attends the RLH compared to one of London’s three other MTCs, there is a higher percentage of positive outcomes, increased intelligence capture (up 417% year on year) and improved safeguarding.

• This article was peer reviewed by Detective Sergeant Adam Cockerton, West Midlands Police.

Read a full write-up of this project by the Metropolitan Police Service in our practice bank