On the 16th November the NPSA Mental Health team as part of Patient Safety Week focused on self harm and suicide prevention. It seemed fitting to return to Greater Manchester West Mental Health NHS Foundation Trust, the place of origin for the original Inpatient Suicide Prevention Tool kit that was published in 2002.
With 25% of all suicides and self harm occurring when patients are on leave from the ward it seemed appropriate to focus our Take One Step around the assessment of risk when patients leave the ward.
We had the opportunity to meet with ward managers from Children and Young People, Older Adult and from Working Age Adults Directorates – as well as being looked after by staff from the Integrated Governance Teams.
The team talked about their experience of implementing the Inpatient Suicide Toolkit, what lessons they had learnt from the Audit tool and how they had implemented change using the Ward managers Checklist. We were particularly interested in the development of the PIT nurse role and how they had linked the ward manager’s checklist to clinical supervision of staff on the ward.
As a cost neutral intervention the shift leader will nominate one nurse who has all the information required to agree leave from the ward. The PIT Nurse has access to the agreements for authorised leave and in the event of uncertainty can refer to the wider team for discussion. The feedback from young people has been positive as they only have t ask one person to leave the ward and the shift leaders feel the process is much easier and safer as they know by making one enquiry who is on the ward and where those on leave are.
Early anecdotal practice based evidence suggest, that staff and patient opinion feel safer with this intervention and it is an aspiration of clinical staff that the number of missing patient and absence with out leave (AWOL) will decrease over time.
The team are looking at formally focusing on an audit of the AWOL over recent months as they believe this intervention has greatly reduced this high risk area of patient care.
The NPSA Mental Health team have invited the Greater West Manchester Mental HEalth Foundation Trust to hold a webex to share nationally a number of innovative practices which the Trust has developed.