Scotland's Redress Scheme: combined annual report 2025

4.16 NHS Boards

This report sets out examples of wider (i.e. in addition to the redress scheme including non-financial) redress activities undertaken by NHS Scotland Health Boards from 7 December 2023 to 6 December 2024 as indicated in the Redress for Survivors (Historical Child Abuse in Care) (Scotland) Act 2021: Statutory Guidance.

Individual Support

As per previous reports, all 22 NHS Boards have confirmed that their corporate websites include the Public Statement to confirm their participation in the scheme created by the Redress for Survivors (Historical Child Abuse in Care) (Scotland) Act 2021. In addition, NHS Health Boards confirmed that individuals who have been in contact regarding the Redress Scheme have been made aware of the support available to them by both the Health Board and through the Scottish Government Redress Scheme.

The following paper identifies themes reported in the Board’s submissions and examples of the comprehensive approach taken by the various NHS boards to support survivors of historic childhood abuse, ensure safeguarding, and promote trauma-informed practices, such as:

• Trauma-Informed Care: Boards confirmed the importance placed on providing trauma-informed support to individuals disclosing historic childhood abuse within mental health services. Staff are trained to an enhanced/specialist level and complete mandatory training in Adult and Child Protection.
• Psychological Interventions: Evidence-based psychological therapies and interventions are available across various NHS Boards, including CBT, Trauma-Focused CBT, EMDR, Compassion-Focused Therapy, Schema Therapy, ACT, and IPT.
• Specialist Services: Referral to specialist third-sector organisations and NHS psychological services for survivors of childhood abuse is a common practice. Examples include the Kingdom Abuse Survivors Project, Safe Space, and the Fife Rape and Sexual Assault Service.
• Chaplaincy and Spiritual Care: Provision of compassionate listening support and holistic care through chaplaincy services. NHS Ayrshire and Arran, NHS Fife, and NHS Greater Glasgow and Clyde offer these services, including Community Chaplaincy Listening (CCL) Service and spiritual care teams.

Examples of the range of support provided to individuals by NHS Health Boards are noted as follows:

NHS Ayrshire and Arran (A&A) advised that any individual who discloses historic childhood abuse within mental health services are supported by trauma-informed staff trained to an enhanced/specialist level. Staff are aware of the Redress for Survivors Act and associated third sector supports available, and they complete mandatory training in Adult and Child Protection. Evidence-based psychological interventions and therapies are provided within Adult Mental Health, Learning Disabilities, and Older Adults teams, governed by Psychological Services. Escalation paths are included in Standard Operating Protocols, and support for wider NHS/Acute/HSCP staff is provided by the NES Funded Transforming Psychological Trauma Implementation Coordinator. Decision-making pathways are bespoke and based on individual needs.

The A&A Chaplaincy service offers compassionate listening support for those with childhood wounds from historic abuse. The NHS A&A Spiritual Care team provides holistic support for residents and staff, covering a range of adverse childhood events, including abuse. Onward referral or signposting to relevant therapies within the wider wellbeing MDT, including psychology and psychiatry services, is also provided where appropriate.

NHS Fife direct any adult seeking support to specialist third-sector organisations such as the Kingdom Abuse Survivors Project, Safe Space, or the Fife Rape and Sexual Assault Service. Alternatively, they may be referred to the NHS Fife Psychology Service, with decisions guided by the individual’s needs and preferences. Specialist psychological therapy for survivors of childhood abuse, including those who experienced abuse in care settings, is a fundamental part of the Psychology Service’s work in Fife. Additionally, NHS Fife have increased their provision of ‘Survive and Thrive’ groups and are working collaboratively with NHS Tayside to jointly deliver Survive and Thrive groups for male survivors.

NHS Fife recognise that a significant proportion of individuals receiving care from Addiction Services have faced adverse childhood experiences. To address this, staff are trained in trauma-informed approaches to support these patients. For individuals requiring more specialised care, referrals are made to appropriate third-sector organisations or the Psychology Service, as determined by patient choice and clinical assessment.

The NHS Fife Spiritual Care Team offers a Community Chaplaincy Listening (CCL) Service, providing one-to-one support through GP referrals. This service enables individuals to share their experiences in a safe environment, helping them find meaning and purpose in their stories.

Similarly, NHS Forth Valley confirmed that they provide a range of support, including therapeutic interventions such as CBT, Trauma-Focused CBT, EMDR, Compassion-Focused Therapy, Schema Therapy, ACT, and IPT.

NHS Grampian provides access to a range of evidence-based Psychological Therapies designed to ameliorate the effects of childhood trauma. Psychological Therapy services are available at primary and secondary care levels, with self-referral options at the primary care level. Services are equitably accessible for all patients who have experienced childhood trauma. In addition to 1:1 psychological therapy and group therapies are available, including Safety and Stabilisation, Survive and Thrive, STEPPS, MBT, and ERG. Psychological therapy services are accessible across the care pathway, from child to older adult services, inpatient and outpatient services.

NHS Grampian are also developing the wider mental health workforce’s expertise in responding effectively to trauma, led by dedicated Trauma Practice Training Implementation Coordinators (TPTIC). Staff initiatives include psychological therapy for the workforce and trauma response initiatives spearheaded by the Trauma Risk Management service (TRiM). An overarching trauma-informed practice strategic group is working towards developing an organisational-wide strategy to ensure all therapy services, environments, and staff supportive structures are delivered through a trauma-informed lens.

NHS Greater Glasgow and Clyde (NHSGGC) have identified a number of services in place to support survivors through a variety of different mechanisms, as noted below.

Public Protection Strategy “Safeguarding – It Matters To Us”

NHSGGC is fully committed to reducing the risk of harm to babies including the unborn, children, young people and adults. The National NHS Public protection Accountability and Assurance Framework provided a platform to develop NHS Greater Glasgow and Clyde Public Protection Strategy 2023 - 2026’, ‘Safeguarding - It Matters To Us’. The Public Protection Strategy has six strategic aims which are underpinned by eight public protection principles. Every member of staff and those commissioned to provide services have a pivotal role in safeguarding whether in an overseeing, delivering, practising or a supportive role and has been used to benchmark our performance and highlight key areas of priority.

NHS GGC Public Protection Strategy Delivery Plan 2024-2026 provides an overview of the key deliverables over the next two years in safeguarding and protecting the population from harm across NHS GGC. It affirms their commitment to improve capacity and capability to manage public protection risk across all clinical, staff and corporate governance; formalises public protection roles and responsibilities and supports drive continuous quality improvement and have a positive impact on the quality of care, staff and overall efficiency and effectiveness. Public protection is an organisational priority for NHS Greater Glasgow and Clyde for 2024/2025.

NHS Scotland Public Protection Accountability and Assurance Framework

This public protection framework is key to supporting and enabling benchmarking activity across NHS Greater Glasgow and Clyde. This will lead to a consistent approach with partners in public protection and promotes a culture of reporting, governance and evaluation. NHS GGC are currently developing a public protection quality assurance dashboard which will support local and corporate reporting, monitoring and oversight.

NHS GGC Public Protection Service is a dedicated service to support all organisational responsibilities and requirements in Child and Adult Protection. This includes advice and support for staff, contribution to Interagency Referral Discussions (IRDs), learning and education opportunities, child protection supervision and child protection medicals.

NHSGGC works closely with partner agencies to fully implement the National Child Protection Guidance (2023) and has fully implemented IRDs for children and unborn babies across all 6 HSCPS within board area and also IRDs for out of board inpatients within RHC. This includes concerns about non-recent harm that a child or young person has experienced. All staff are encouraged and supported to raise concerns about unborn babies, children, young people and adults who are experiencing harm including reports of non-recent harm. Complaints made by a child, young person or adult are fully explored, shared with partner agencies and appropriate interventions including medicals undertaken.

GP Child Protection Pathway Guidance in NHSGGC noted that it is not uncommon in general practice for adults to disclose previous sexual and other forms of abuse when a child. In such circumstances GPs and other professionals are required to consider both if any child or children are currently at risk of harm and therefore may be required to share relevant information with Police Scotland and Social Work in order to protect those children and also support adults to raise complaints with appropriate agencies.

Bairns Hoose Development NHSGGC is fully committed to upholding children’s rights and recognises the importance of engaging with children and young people for them to be heard and their views obtained in matters affecting them. The Bairns Hoose development in Scotland has allowed a child friendly and safe space for them to give evidence, take part in decisions about their protection and get support to recover from the trauma they have experienced.

NHSGGC works in partnership with six local authority areas and currently three children’s houses are in various stages of development. The North Strathclyde Partnership Bairns Hoose (Inverclyde, East Renfrewshire, Renfrewshire and East Dunbartonshire, HSCPs, G and K Divisions Police Scotland, NHSGGC, Children 1st, SCRA and COPFS) is benefitting children and young people from this approach. One venue within Glasgow City is under development and another within West Dunbartonshire who will collaborate with NHS Highland and respective partner agencies.

The North Strathclyde Child Interview Team aims to ensure that when children are jointly interviewed by Police and Social Work that they are supported by highly skilled interviewers utilising proven techniques to achieve best evidence. In addition, the child / young person and their non-abusing care giver will have access to trauma-informed support and advice throughout the Joint Investigate Interview (JII) process from the Childrens1st recovery and participation workers who provide the child/young person and their families an opportunity to express their views, needs and concerns.

Alcohol and Drug Recovery Services (ADRS) provides a stepped approach to psychological therapies, specialist psychiatric support, and community/third sector links. Staff receive training in trauma-informed care, including pathways to specialist interventions like trauma-focused CBT and treatments for emotional dysregulation. Group interventions help develop coping skills. ADRS staff are trained in ‘Safety and Stabilisation’ to deliver trauma-informed care and low-intensity psychological interventions within existing drug and alcohol treatments.

Mental Health Services can refer to the Glasgow Psychological Trauma Service (‘The Anchor’) which is a specialist mental health service which offers multidisciplinary psychological interventions and treatment to patients who have complex post-traumatic stress disorder following complex trauma experiences.

Children and Adolescent Mental Health Services (CAMHS) Specialist Children’s Services (SCS) works with children and young people up until their 18th birthday both within CAMHS and community paediatric services. CAMHS has a trauma-informed action plan to support the National Trauma Training Program, ensuring the workforce can recognise and deliver evidence-based trauma interventions. A specialist CAMHS team supports trauma-experienced and care-experienced young people, including those involved in the justice system. CAMHS also has a forensic service for young people in secure settings, working with various agencies to assess and plan care. SCS has a Public Protection Forum to train staff according to national child protection guidance

NHS Highland has also adopted a trauma-informed approach to initial health assessments for Care Experienced infants, children, and young people, focusing on a relationship-based approach and aligning with UNCRC requirements. The Integrated Children’s Service plan is rooted in the UNCRC, striving to uphold children’s rights and support their development and education.

NHS Lothian provide the specialist CAMHS Meadows Team which offers care and support to children and young people who have experienced sexual trauma and those displaying problematic sexual behaviour. The team collaborates with social care, schools, and other partners to provide psychological treatment and support. NHS Lothian also hosts the Adult Mental Health (AMH) services, including the Rivers Service and General Adult AMH, which offers psychological treatment for adults who have experienced abuse, many of whom have complex PTSD. Clinicians work with individuals to help them report abuse to the police if needed.

The Rivers Centre for Traumatic Stress has been reconfigured to provide consultation and supervision to wider health professionals and services. The service has support workers dedicated to those who have experienced childhood sexual abuse and require social support while accessing psychological therapy.

As part of its statutory duties and wider responsibilities, NHS Tayside continues to work to ensure services provided to children and young people meet or exceed the relevant standards of care, with a strong focus on the Getting It Right for Every Child (GIRFEC) national practice model across all children and families services, underpinning all work undertaken with all infants, children and young people in Tayside.

In addition, the past 12 months has seen refreshed focus on the national ‘Plan 24-30’, to enable sustained efforts towards achieving the ambitions of The Promise, as well as a keen level of attention to children’s rights, given the enactment of the UNCRC (Incorporation) (Scotland) Act 2024 in July 2024.

The Public Protection Service supports continuous improvement in Child Protection, Adult Protection, MAPPA, and Violence Against Women and Girls/Gender-Based Violence, the public protection team collaborates with key partners to promote wellbeing and safety. NHS Tayside’s Child Protection Policy aligns with national guidance, supported by internal policies and a daily advice line. Forensic medical examinations are provided through a trauma-informed service at Seymour House in Dundee.

Furthermore, examples of support provided by national Boards include NHS Healthcare Improvement Scotland’s offer of an Employee Assistance Programme with a 24/7 helpline and Gender-Based Violence (GBV) Policy to support staff affected by GBV, including child abuse. NHS Education for Scotland focuses on education and training for NHS and social care staff although as a board they do not directly deliver care. NHS 24 hosts the Sexual Assault Referral Centres (SARCs) service, providing support and access to services for survivors.

All NHS Boards reconfirmed their commitment to the Redress for Survivors of Historical Child Abuse scheme, to provide continuous support to survivors, and to offer all necessary assistance in accessing historical records when requested.

Collective and Wider support

NHS Boards reported a range of collective activities to provide ongoing support and recognition to survivors, including various group therapies for trauma survivors and offer of therapy to survivors of historical child abuse, with the flexibility to tailor services to specific cases as needed.

NHS Fife hosts the Transforming Psychological Trauma Implementation Coordinator (TPTIC), who collaborates with the Fife Trauma-Informed Practice Steering Group to embed trauma-informed practices across the region. This includes integrating lived experience perspectives, offering specialist consultations, providing trauma-informed coaching, and delivering training and reflective practice sessions.

NHS Boards have committed to create a community of practice, sharing best practices and supporting the dissemination of trauma-informed principles. In response to the National Child Protection Guidance (2021), NHS Fife has revisited and strengthened child protection and safeguarding processes. New safeguarding pathways and protocols have been developed, and NHS Fife continues to work closely with partner agencies to optimise digital solutions for information sharing and IRD processes; and in 2023 were selected as a pathfinder for Bairns Hoose, integrating justice, health, and therapeutic support services for child victims and witnesses of abuse and harm.

Likewise, NHS Forth Valley offers group therapies for individuals who have experienced psychological trauma, including ERG, Mindfulness, Change Up, Brief Group Schema Therapy (BGST), and Compassion Focused Therapy (CFT). They work with local authorities to follow National Child Protection guidelines and host the Electronic Inter-Agency Referral Discussion (eIRD). NHS Forth Valley is developing a local Bairns Hoose and supports the rollout of trauma-informed practice through the Transforming Psychological Trauma Implementation Coordinator role.

NHS Highland operates under a Lead Agency Model, responsible for integrated Health and Social Care for Adults, while the Highland Council leads for Children. Governance is managed by the Joint Monitoring Committee, including representatives from the Third Sector, independent partners, service users, and carers. NHS Highland partners with the Highland Child Protection Committee and Argyll and Bute Child Protection Committee to introduce Bairns Hoose services. Care for children and adults who have experienced sexual violence is delivered through The Shores facility, a designated Sexual Assault Response Coordination Service with a forensic nurse manager. Patient feedback is consistently positive.

NHS Highland has also established a clinic for unaccompanied asylum-seeking young people and works with the Highland Council and third sector to ensure health screenings. The Highland Child Protection Committee (HCPC) and Argyll and Bute Child Protection Committee (A&B CPC) coordinate prevention activities, provide guidance and training, and assure quality responses to child protection issues. They also align working practices with Adult Protection Committees for effective all-age public protection.

NHS Lanarkshire provides resources, advice lines, training, and supervision for staff involved in child and adult protection. They have a dedicated Public Protection Service and a strong culture of collective leadership for public protection.

NHS Boards are committed to providing ongoing support to all survivors and to ensure that advice and assistance is provided to any request from survivors in relation to accessing historical records or tracing and reuniting families. NHS Boards acknowledge the harm caused and offer a full and sincere apology to survivors

Summary

The NHS Scotland Health Boards have demonstrated a comprehensive and coordinated approach to supporting survivors of historic childhood abuse. By participating in the Redress for Survivors (Historical Child Abuse in Care) (Scotland) Act 2021 scheme, Boards have ensured that survivors are aware of and have access to a wide range of support services.

The emphasis on trauma-informed care, psychological interventions, specialist services, and chaplaincy and spiritual care highlights the commitment to addressing the complex needs of survivors. The examples provided by various NHS Boards illustrate the diverse and tailored approaches taken to promote healing and recovery for individuals affected by historic childhood abuse. Additionally, collective and wider support activities, such as group therapies and safeguarding initiatives, further enhance the support provided.

Each NHS Board continues to prioritise the well-being of survivors, ensuring tailored and comprehensive care, and reaffirming their dedication to ongoing support and protection.