Evaluating the Humber and North Yorkshire children and young people’s trauma informed care programme
CORC conducted an independent evaluation of the Humber and North Yorkshire children and young people’s trauma informed care programme between August 2023 and July 2025.
Strong evidence exists of the association between exposure to childhood trauma and cognitive changes, as well as mental health and wellbeing difficulties including anxiety, depression and social challenges, and physical health difficulties over the life course [1-5]. This includes difficulties in education and employment [6]. However, these outcomes are not inevitable.
NHS England’s Framework for Integrated Care (Community) [7] is designed to deliver system transformation by providing new structures to offer a ‘scaffold’ to existing local services, to facilitate organisational change, to develop and enhance services that promote safeguarding and prevent re-traumatisation, and to help children and young people thrive.
In the Humber and North Yorkshire Integrated Care System (ICS), this is being realised through the implementation of a programme that commenced in 2022. An ICS-wide steering group was established to progress the implementation of the Children and Young People’s Trauma Informed Care Programme. The programme is also overseen by the Children and Young People’s Trauma Informed Care Programme Strategic Alliance.
Different organisations from the health and care and voluntary sectors are formally collaborating through the Humber and North Yorkshire Health and Care Partnership across six places, to provide health and care services to improve outcomes for children and young people, particularly those who have experienced trauma and those at risk of encountering the youth justice system. To meet the objectives of the framework, the phased implementation was designed around four key areas:
- ICS-wide scoping: trauma informed initiatives, data and service provision.
- Building a trauma informed Integrated Care System.
- Strengthening multi-agency relationships and improving co-ordination of existing services.
- Implementation of place-based models of intervention as test and learn sites and pilot projects.
We undertook a mixed-methods realist process evaluation which explored the two main aspects of the programme in Humber and North Yorkshire, which comprises a ‘hub and spokes’ model: four test and learn sites based in Hull, North East Lincolnshire, North Yorkshire and North Lincolnshire, two pilot projects in York and East Riding, and system change activity across the Partnership which is headed up by a core programme team of system and programme leaders. This includes 1) training, 2) communities of practice, 3) organisational toolkit, and 4) participation across the system. We analysed online staff surveys, focus group and interview transcripts, as well as routinely collected administrative data.
This leaflet provides a a summary of our evaluation and our findings:
References:
[1] Allen, S.F., Gilbody, S., Atkin, K. and van der Feltz‐Cornelis, C.M., 2023. The associations among childhood trauma, loneliness, mental health symptoms, and indicators of social exclusion in adulthood: A UK Biobank study. Brain and behavior, 13(4), p.e2959.
[2] Dye, H., 2018. The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), pp.381-392.
[3] McCrory, E.J., Gerin, M.I. and Viding, E., 2017. Annual research review: childhood maltreatment, latent vulnerability and the shift to preventative psychiatry–the contribution of functional brain imaging. Journal of child psychology and psychiatry, 58(4), pp.338-357.
[4] McKay, M.T., Cannon, M., Chambers, D., Conroy, R.M., Coughlan, H., Dodd, P., Healy, C., O’Donnell, L. and Clarke, M.C., 2021. Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies. Acta Psychiatrica Scandinavica, 143(3), pp.189-205.
[5] Nanni, V., Uher, R. and Danese, A., 2012. Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. American Journal of Psychiatry, 169(2), pp.141-151.
[6] Jaffee, S.R., Ambler, A., Merrick, M., Goldman-Mellor, S., Odgers, C.L., Fisher, H.L., Danese, A. and Arseneault, L., 2018. Childhood maltreatment predicts poor economic and educational outcomes in the transition to adulthood. American journal of public health, 108(9), pp.1142-1147.
[7] NHS England, 2018. Framework for Integrated Care (Community).