Number 4 - May 2007 /
Wave 1 / /
Welcometo the fourth newsletter for Wave 1 teams.
Re-audit data has now been collected and we will be providing each team with their follow up report shortly. We hope that all you hard work to makes positive changes will be reflected in your team’s follow up report. Each report will include a summary of your local achievements along with recommendations for maintaining the quality of care and further improving aspects of the care in the future.
This newsletter shares some local team action plans and gives you the chance to express interest in an achievement workshop to be held later in the year. Read on for links to the latest news stories around the topic of self-harm as well as details of external conferences and details of the RoyalCollege’s of Psychiatrists new training course for staff in emergency care settings.
Contents click the links below to skip to the relevant section
/ Wave 1 Achievements Workshop
Interventions and ActionPlans
Improving the assessment room
Samaritan’s referralscheme
Wave 3 of the Programme
Training Course
Self-Harm News
Resources for Service Users
External Conferences &Workshops
Contactus / Some of the web links in this newsletter are in a pdf format which requires Acrobat to view. Adobe Acrobat can be downloaded free by clicking on the ‘Get Acrobat Reader’ button below.
Wave 1Achievements workshop
/ Achievements Workshop
celebrating success and sustaining change
We are keen to hold a workshop for Wave 1 teams to celebrate local achievements. The workshop would be held in London during September.
Aims of the day:
-To look in detail at the aggregated re-audit findings and the achievements and recommendations from these
-Hear from a number of teams about successful changes in their local area
-Work on local action plans for maintaining quality of care
-Discuss local experiences of Service User involvement on local project teams
-Look at factors affecting sustainability of your team’s changes – group work and discussion
-network with other local project teams
-Award certificates of involvement to each local team
This workshop will be free of charge to attend. It will be held subject to interest from local team members. Please clickhere to let us know whether or not you or your team members would be interested in attending the workshop. If we do not hear from your team by 8 June 2007 we will assume that members of your team do not wish to attend.
Interventions and action plan ideas
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Below are a selection of the action plans that wave 1 teams chose to work on:
Train administrators/receptionists on customer care issues, using service users’ experiencesSet up an office in A&E open daily 9.00–10.00, staffed by a liaison psychiatrist, offering drop-in support and supervision to any staff
Establish a multi-agency group (including service users) to produce a discharge care plan with helpful information and more information leaflets on self-harm and support services available
Introduce a close observation policy or timed patient checks to reduce likelihood of patients absconding or being left for long periods of time
Develop a multi-disciplinary integrated care pathway for each patient who attends the emergency department having self-harmed.
Improving the Assessment room
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A team in Chester make positive changes…The wave 1local project team at the Countess of Chester hospital in Cheshire felt that they needed to make the psychosocial assessment room more attractive and less institutionalised. They achieved this by redecorating and refurnishing with a new settee, easy chairs, coffee table, colour prints, cushions, low lights, plants and original artwork donated by a local artist. There was real enthusiasm from staff to make the changes and members of ED team even took part in a ‘fun run’ to raise money for the decorating materials.
Sian Langmead, the local project team lead, described thejoint effortthat
achieved this change:
“This is a good example of teamwork between liaison psychiatry and the staff in A&E, particularly the A&E matrons. The room looks great and is a positive reminder of what the Better Services project is all about.”
Feedback from service users has also been positive with many service users being pleasantly surprised by the new room. Feedback back surveys during the wave 1 re-audit has also showed that service users appreciate the change:
“The assessment room much nicer and helped to make me feel less nervous”
Samaritan’s referral scheme
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A local team’s view…Michael Anderson from the Mental Health Liaison Team at Gloucester Royal Hospital reflects on the direct referral service that the Samaritans offer in their area.
Seeking information…
The Samaritans came to our attention at a meeting of the local prevention suicide group in September 05, which had members of the PCT, statuary and non-statuary agencies. A member of the Gloucester Samaritans spoke about the scheme and how they were trialling it with some GP’s surgeries and were keen to expand.
This was a good opportunity for the Emergency Department (ED) with potential to be explored further within my role as project manager, mental health liaison. A meeting was arranged with the chair and co-ordinator of Gloucester Samaritans to gain more information about how the scheme would work within the ED.
Working in partnership…
An information sharing agreement (acute trust document) was signed between the acute trust and the Samaritans to allow the ED staff to fax the referrals to the Samaritans. The acute trust signed a Joint Working Partnership with the Samaritans (a Samaritans document). Implementation took affect from April 06 when our ED was able to fax referrals.
The process…
Following meetings with the acute trust, head of information, data protection and the documentation group about the form and referral process, a flow-chart was designed for the ED staff to use (see box 1). The fax machine in the ED was pre-programmed with the Samaritans fax number to avoid misdialling.
The referral form, designed by the Samaritans. only required the person’s name (first name okay), phone number, time the person would like to be contacted and a signature. The Samaritans would then ring the person at the agreed time.
Once the form has been faxed it is kept by the mental health liaison staff for two months before it is destroyed, with a note made in the ED notes.
Initially we had meetings between myself, mental health liaison staff and the Samaritans every three months at the start of the scheme but now it is every six months for review purposes only. / Referral to Samaritans
Health professional (Doctor, Nurse, or Mental health liaison practitioner) decides that patient could benefit from talking to Samaritans
Patient is asked if they consent to
bereferred to Samaritans
No Yes
Document patient declined
-No further action
Need Samaritans consent form signed;
agree a time Samaritans will ring,
information leaflet given.
Health Professional faxes referral to
Samaritans using fax at reception
with pre-programmed number.
Once form has been faxed please put in mental health practitioner in tray to be shredded two months later and write in notes form faxed to Samaritans. / ,
Due to the success in Gloucester Royal Hospital the scheme was expanded to include Cheltenham General Hospital.Since each branch of the Samaritans are run separately, the agreements had to be signed between the Cheltenham Samaritans and the acute trust.
Feedback…
The feedback from all users, patients, mental health staff, ED staff and from Samaritans has been positive:
Paul Adamson from the Samaritans says:
“The main benefit of our service is that we can provide emotional support to people who are being discharged from A & E's, over the telephone, by email, text and in some cases face to face, particularly people who self-harm, who are often highly vulnerable in the interim period between discharge and going back to see their GP's or other health worker”.
For more information on the Samaritans’ direct referral scheme contact Paul Adamson
Wave 3 of the programme
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Wave 3 of the programme will begin in June 2007 with an introductory workshop for all new members. We will be accepting applications from teams until the end of May 2007. If colleagues from another emergency department within your trust would like to form a team to join the programme they should contact the project team or visit our web site:Training Course
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The central project team have been working with the Royal College of Psychiatrists’ Centre for Education and Training (CETC) to develop a training course for those who work with people who self-harm in an emergency care setting. The content of the course has been largely informed by views of the 1000 staff and 500 service users who completed a survey as part of the ‘better services’ programme for wave 1 of the programme.The course will be run by the CETC and delivered by a multidisciplinary
team of trainers including Helen Blackwell the central project team’s
National service user adviser.
For an information leaflet on this course, and
details of how to book your place please contact
Louise Mead, Training Programme Administrator on
020 7977 6652 or email
Questions about the content of the course? please contact Helen Blackwell -
Self-Harm News
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Health Minister in Northern Ireland vows to prioritise suicide prevention, 11 May 2007Test to predict self-harming behaviours, 8 May 2007
New research in Scotland shows self-harm is misunderstood, 1 May 2007
Voluntary Sector organisation in Scotland develop self-harm leaflet for young people in 6 different languages, 16 April 2007
Mental Health chiefs urged to involve service users, 14 April 2007
Supervised Community Treatment could prevent suicides, 11 April 2007
100 schoolchildren hospitalised each week due to mental health problems, 1 April 2007
8,000 in Ireland treated in hospital for self-harm in one year, 22 March 2007
Access to Mental Health services in London deemed inadequate, 3 March 2007
LifeSIGNS published booklet to raise awareness of self-injury, 28 February 2007
Fish oils thought to help those who self-harm, 1 February 2007
‘Young People’ room for teens in London A&E, November 2006
Resources for Service Users
Royal College of Psychiatrists new leaflet on self-harmInformation sheet on self-harm from the Samaritans
The UK Advocacy Network
The Self-injury Forum - a quarterly newsletter from the Basement Project for people who self-harm.
External Conferences/Workshops
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Mental Health 2007 conference, risk management and service user involvement22 & 23 May, London
Self-Harm in Young People, one day workshop
5 June 2007, Glasgow
Mind Training Day, Service User Involvement
13 June & 12 September 2007, London
Depression and self-harm in Young People, one day training course
12 May 2007, Cambridge
Patient involvement empowerment and information
16 May 2007, London
Contact us
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We are looking for two or three team members to write short pieces for the next newsletter about changes they have made to their service and the impact of these on the care provided. If you would like to contribute please email you text (photos also very welcome) to Philippa Strevens .If you would like to ask questions, discuss topics and share information with other local project team members you can use our email discussiongroup. Simply send your message to
The Central Project Team
Philippa Strevens, Quality Improvement Administrator
Lucy Palmer, Programme Manager
Helen Blackwell, National Service User Advisor
Contact Details
‘Better Services for People who Self-Harm’ Project Team
Royal College of Psychiatrists’ Centre for Quality Improvement
4th Floor Standon House, 21 Mansell Street, London E1 8AA
Tel: 020 7977 6643/6642 Fax: 020 7481 4831
Email: Web:
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