Freedom of Information Request – Ref: FOI 050-2025
Thank you for your recent Freedom of Information request. Please find our response below.
You asked:
1. Does your trust have any specific clinical care pathways, protocols, or service guidance specifically for the treatment or management of patients with:
Dissociative disorders (including DID, OSDD, DPDR etc..) or Complex post-traumatic presentations involving dissociation?
Our response:
Gloucestershire Health and Social Care NHS does not have any specific clinical care pathways, protocols or service guidance for the specific treatment of patients with dissociative disorders or complex trauma presentations involving dissociation.
We do aim and benchmark ourselves against NICE guidelines, and review evidence based best practice as it develops. We have trained mental health professionals in a number of our services who can provide evidence based treatments and interventions for these disorders and presentations.
You asked:
2. If yes, please provide copies of any relevant documentation or pathway flowcharts.
Our response:
We do not have any specific Gloucestershire Health and Care NHS Foundation Trust documentation in this area.
You asked:
3. Which clinical teams or services (e.g. CMHTs, trauma services, personality disorder services, psychology/psychotherapy teams) typically provide care for patients with dissociative disorders and dissociative presentations?
Our response:
Our services are commissioned, so that different teams and services work in a stepped way. We have services focused on helping with more common and relatively less severe mental health presentations which include post-traumatic stress disorder, and our NHS Talking Therapies Service provides evidence-based interventions for a large number of post-traumatic stress disorder presentations and related dissociative presentations.
For more severe presentations of complex trauma and dissociative disorders, our Integrated Recovery and Complex Psychological Intervention teams provide multi-disciplinary interventions for individuals. These teams are made up of psychological, psychiatric, nursing, and allied health professionals who work with people with complex trauma and dissociative presentations.
People with mental health problems related to trauma, including dissociative presentations can be supported across our specialist services when their specific specialty is required. For example, our Perinatal and Psychosis services often work with people with trauma and dissociative presentations.
In line with national recommendations Gloucestershire Health and Care NHS Foundation Trust is also working to ensure that all of our care becomes increasingly trauma informed, and that staff at all levels are aware of the need and have the ability to work with patients in a way that reflects the traumas they have experienced and the resulting difficulties (including dissociation) they may have.
You asked:
4. Does your Trust offer or commission any specialist assessment or treatment (e.g. SCID-D diagnostic assessment) specifically for dissociative disorders?
Our response:
Our Trust does not routinely commission external provision for the specialist assessment or treatment of dissociative disorders. This is because we are commissioned to locally provide a range of services for these problems.
When we are unable to provide an indicated evidence-based intervention, we can look to commission this externally as we have funding from the Integrated Care Board to meet such circumstances. These commissions are assessed and managed by our Specialist Treatment and Rehabilitation team.
You asked:
5. Are patients with dissociative disorders referred to external providers (e.g. Centre for Dissociative Studies, Pottergate Centre, or other independent services)? If so, under what circumstances?
Our response:
When we are not able to provide the service or we are not locally commissioned to provide an indicated evidence-based intervention, we are able to commission external providers to provide assessments and interventions. These commissions are assessed and managed by our Specialist Treatment and Rehabilitation team.
You asked:
6. Has your Trust delivered any training or guidance for clinicians on dissociative disorders in the past five years?
Our response:
We current commission Bespoke Mental Health to provide a wide training offer that is available to all staff. This has included training on Working with Dissociation. Our Complex Emotional Needs team also provide training to our staff and partner agencies about understanding and working with trauma related presentations including dissociation.
We also support individual clinicians to develop their skills through supporting them attending training, accessing resources and the option of providing specialist clinical supervision. This has included supporting clinicians working with clients with dissociative identity disorder and other complex post-traumatic presentations. We have worked with staff from the Centre for Dissociative Studies, supporting individual clinicians to develop their skills, as well as working to ensure that the interventions we offer are in line with recommended practice.
You asked:
7. If possible, please provide the number or percentage of current patients under your care who have a diagnosis of a dissociative disorder. This may include conditions coded under ICD-10 (e.g.. F44.8), ICD-11 (e.g. 6B64) or equivalent SNOMED CT terms. (If your trust uses other diagnostic classification systems such as DSM, please indicate where applicable.)
Our response:
Please see the link below:
Next steps:
Should you have any queries in relation to our response, please do not hesitate to contact us. If you are unhappy with the response you have received in relation to your request and wish to ask us to review our response, you should write to:
Louise Moss
Head of Legal Services / Associate Director of Corporate Governance
c/o Gloucestershire Health and Care NHS Foundation Trust
Edward Jenner Court
1010 Pioneer Avenue
Gloucester Business Park
Brockworth, GL3 4AW
E-mail: louise.moss@ghc.nhs.uk
If you are not content with the outcome of any review, you may apply directly to the Information Commissioner’s Office (ICO) for further advice/guidance. Generally, the ICO will not consider your case unless you have exhausted your enquiries with the Trust which should include considering the use of the Trust’s formal complaints procedure. The ICO can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.