Self harm:

1. Self harm: Salena Williams UHBristol June 2015

2. Who’s involved? David Gunnell UoB Blanka Robertson BCC/Public Health Lisa Foote SISH Dominique Thompson GP Kyla Thomas Public Health Jonathon Benger UHB/UWE Jacky Keane NBT Jon Hayhurst CCG NHS England Claire Thompson CCG Rowena Green UHB

3. Progress to Date • The Self Harm Register – extended to all Bristol hospitals • PPI involvement • ED improvements – from posters to education to PSP’s • ED resource z card and website development • New 7 day 14 hour service to ED • GP training • 3 research publications • recruited over 100 patients to NIHR funded research projects

4. The SHR: 40 item dataset all self harm attendance • Postcode and GP area • Day of the week • Hour of the day • Precipitating factors • Gender, age • What taken • Risk assessment • Psychosocial assessment? • Outcome – GP, CMHT, in-patient • repetition

5. Numbers of patients • Incidence stable at BRI with ~1500 attendances annually

6. Key Indicators

7. Challenge

8. InterveningGP prescribing of drugs lethal in overdose • SHRegister: identify admissions to ITU • GP pilot to Student Health Centre: blister pack/1 weeks supply • Meet GP forums across Bristol • Government/NHS England pressure

9. Success

10. research plans • Evaluate the impact of the new investment in self-harm services on patient outcomes and costs • Develop patient-centred outcomes for self-harm • Maximise patient involvement with self-harm service research • RCTs of interventions to improve self-harm outcomes

11. Future Plans 2015/16 • Ambulance crews pilot training • Self harm clinic • Carers information • DNA/‘left without being seen’ • Funding for SHRegister – BHP business case