We knew there were issues with self harm on some of our hospital wards

When the NHS develops new approaches to healthcare discovering a flaw down the line can come at great cost.

So why don't we iron out the issues at the outset? and shouldn't the people at the sharp end - staff and patients tell us how it should be done?

Mersey Care is among healthcare organisations in both the US and UK to pilot a pioneering global programme combining leading edge technology and service users who have ‘been there’ to get it right first time.

We look at how it’s working on the ground.

A dramatic rise in the number of people who self harmed while staying in Mersey Care inpatient hospitals – 1400 in 2015 compared to 400 four years previously – caused serious concern.

The Trust is the country’s first to commit to Zero suicides among inpatients by 2020.

People who self harm are 50 times more likely to die by suicide.

The Trust joined a group of UK and USA healthcare organisations taking part in a unique programme with researchers from The Risk Authority Stanford to reduce clinical risk in selected areas.

A mixture of technology and talking, it uses leading edge software (to analyse data and identify the risks) and a new approach known as Design Thinking - gaining an understanding of the issue by talking at the design stage to people who may use the service.

The approach is then tailored to what the software and patients tell.

The plan is to monitor impact over six to twelve months, compare and contrast and roll out the most effective interventions.

Programme Director Tim Riding: “We knew there were issues with self harm on some of our hospital wards and we wanted to address it as a priority because of the obvious impact on those affected. But we need to analyse the risks so we get it right from the beginning. Learning early on what doesn’t work as well as what does is vital in providing the Trust’s vision of perfect care, and also reducing costs. By prototyping, testing, feeding back and adapting at the start of the process rather than, as is often the case, after significant investment of time and resource, improves care, is more effective and saves money. In the case of self harm, as service users develop more positive coping strategies for dealing with their psychological distress inpatient lengths of stay may also reduce.”

While the project team has provided the impetus, ward managers are the real champions of change. Tim Riding: “Their role is key, they have to take account of the evidence, make sure everyone knows their role and is given the support they’ve said they need to make it work.”
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