About

The Greater Manchester Combined Authority (GMCA) aims to promote a shared understanding of the concept of trauma responsive care. Building upon the widespread work of researchers, practitioners, policymakers, and people with lived experience in the field.


The evidence about trauma and ACEs highlights the need for multiagency working and a spectrum of information, support and evidence-based intervention for children, young people, adults and families. The impact of trauma and adversity is borne out across generations and an all- age approach to service delivery is necessary if the long-term consequences are to be understood and addressed.



By taking a whole system and cultural change programme in developing ‘Trauma and Adversity responsive communities’ and ‘Trauma and Adversity responsive organisations’ we intend to:


  • Reduce the incidence of trauma and ACEs across the population via a universal approach.
  • Mitigate the consequences and promote healing of ACEs and trauma within high risk individuals, families and communities via a targeted approach.
  • Avoid retraumatising those people who have experienced trauma and ACEs.
  • Decrease the population prevalence of ACEs and reduce the population’s average ACE score.

Why adopt a trauma-responsive approach?

This large-scale change programme will enable cultural change across Greater Manchester organisations, and within our communities, so that conversations become strength-based and resilience focussed through the perspective and understanding of trauma and ACEs, and where ACEs and trauma can be prevented by building resilient, nurturing communities, families and individuals. It is important that trauma and/or childhood adversity does not remain hidden, is not considered a social taboo and is not about shame or blame. This approach sits alongside the emerging neuroscience of the impact of childhood adversity and the mechanisms of association. We will take a population approach to enable a downward shift in ACE incidence and prevalence, through both universal and targeted approaches.  We will support, develop and align interventions that are from a trauma perspective so that we can coordinate our responses to individuals, families and communities, and promote emotional wellbeing amongst those providing the trauma- responsive support.


The phrase trauma responsive is utilised to build upon the trauma informed work which has been ongoing. It recognises that the formal and informal systems used across services and provision are often trauma-informed in their approach. However, for GMCA, we seek to take that understanding and change how we as a system respond.

A Whole System Approach

We need systemic change to make all this happen, with the NHS, Public Health, voluntary and community services, local authority children’s services, adult social care, housing, education, and youth justice sectors working together to: 


  • Place the emphasis on building resilience, promoting good mental health and wellbeing, prevention, and early intervention;


  • Deliver a step change in how care is provided, moving away from a system defined in terms of the services organisations provide towards one built around the needs of children, young people, and their families or carers;


  • Improve access, so children and young people have easy access to the right support, from the right service, at the right time and as close to home as possible. This includes implementing uncomplicated, evidence-based pathways for community-based care to avoid unnecessary admissions to inpatient care;


  • Deliver a clear, joined-up approach, linking services to ease navigation of care pathways for all children and young people, including those who are most vulnerable;


  • Sustain a culture of continuous, evidence-based service improvement, delivered by a workforce with the right mix of skills, competencies, and experience, and;


  • Improve transparency and accountability across the whole system, being unambiguous about how resources are being used in each area and providing evidence to support collaborative decision making.

Outcome Focused

It is our goal for each Greater Manchester area to:


  • Work with all service users underpinned by a trauma-informed and responsive understanding of mental health and psychosocial difficulties. Including the understanding that these difficulties commonly co-exist as a consequence of exposure to all forms of trauma. Experience and consequences of trauma do not constitute criteria for service exclusion or denial.



  • Provide staff with trauma-informed and responsive information and education, and provide access to training and workplace support required to develop staff skills and knowledge to their specific roles, which may include: assessment and screening where appropriate, support/care planning, development, coordination, and direct service delivery.


  • Develop and maintains partnerships with trauma-specific services, and mental health and related services that are capable of providing trauma-informed and responsive, coordinated, and/or integrated support to clients.


  • Create safe and healthy work environments for consumers, carers, employees, contractors, volunteers, and visitors. With support provided for staff members who may have difficulty addressing trauma related issues. Recognising and acknolwedging the high prevalence of lived experience of trauma in community and helping professions.


  • Foster person-led, holistic, creative, open, and therapeutic culture that supports workers adopt a collaborative approach informed by a recovery-oriented, trauma-informed and responsive practice approach.


  • Ensure all policies and procedures are trauma informed and responsive. With interdisciplinary processes and procedures are consistently managed in accordance with these principles.

Links to other programmes and strategies

The trauma and ACE agenda is multi-agency and cross cutting through the life course, which impacts on a wide range of partners and programme areas and is fundamental to numerous strategies and programmes.


The key programmes directly aligned to this agenda in Greater Manchester include:


  • GM Health and Justice Board and Strategy
  • Local Health and Wellbeing Boards and Strategies
  • GM and local Children’s Partnerships and health and wellbeing workstreams
  • GM Health and Social care Partnership
  • GM Long Term Plan group
  • GM Mental Health Board
  • Local Community Safety Partnerships
  • The GM Violence Reduction Unit, Board and Health and Wellbeing Delivery Group and action plan
  • Domestic Violence strategies and wider GM work to address violence against women and girls
  • The GM Mental Health Transformation Group and plans
  • The work of Local Safeguarding Boards (children and adults)
  • The development of mental wellbeing and resilience focused policies, strategies and whole organisation/setting models
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