Quality statement 1: Multi-agency suicide prevention partnerships

Quality statement

Multi-agency suicide prevention partnerships have a strategic suicide prevention group and clear governance and accountability structures.

Rationale

By working together, local organisations can combine their expertise and resources to implement a range of interventions to prevent suicide including addressing risk factors such as self-harm.

Partnerships should have a strategic suicide prevention group to identify priorities and manage the overall strategic direction. Organisations that have a key role in suicide prevention should have senior level representation on the strategic suicide prevention group. Although local structures are likely to vary, the group may coordinate the work of a wider network of representatives from specific services and organisations to implement the local suicide prevention strategy.

To promote understanding, partnerships should involve people with personal experience of a suicide attempt, suicidal thoughts and feelings, or a suicide bereavement. Clear terms of reference and governance and accountability structures will improve effectiveness and sustainability.

Quality measures

Structure

a) Evidence that multi-agency suicide prevention partnerships have a strategic suicide prevention group attended by senior level representatives.

Data source: Local data collection, for example, membership list including job titles and responsibilities and attendance registers.

b) Evidence that multi-agency suicide prevention partnerships have clear governance and accountability structures.

Data source: Local data collection, for example, terms of reference.

c) Evidence that multi-agency suicide prevention partnerships support people with personal experience of a suicide attempt, suicidal thoughts and feelings, or a suicide bereavement, to be involved in the partnership.

Data source: Local data collection, for example, programme of induction and support for people with personal experience who are involved in the partnership.

Outcome

a) Rate of emergency hospital attendance or admission for intentional self-harm.

Data source: Public Health England's Suicide Prevention Profile includes data on the age-standardised rate of emergency hospital admissions for intentional self-harm in local authority areas. NHS Digital's Hospital Episode Statistics includes data on A&E attendances for self-harm.

b) Rate of self-harm in the community.

Data source: Local data collection, for example, community or school surveys. NHS Digital's survey of the mental health of children and young people in England includes questions on self-harm and attempted suicide. Data on episodes of self-harm in primary care are likely to be available from primary care electronic health care record systems.

c) Suicide rate.

Data source: Public Health England's Suicide Prevention Profile includes data on the rate of suicide in local authority areas for different population groups (based on Office for National Statistics source data).

What the quality statement means for different audiences

Lead organisations such as local authorities and residential custodial or detention providers set up a multi-agency suicide prevention partnership with a strategic suicide prevention group that includes senior representatives from key organisations. Lead organisations ensure that representatives on the group can make decisions and commit resources on behalf of their organisation, and have skills and knowledge in line with Health Education England's Self-harm and suicide prevention competence frameworks.

Lead organisations ensure that people with personal experience of a suicide attempt, suicidal thoughts and feelings, or a suicide bereavement who are involved in the partnership can access a programme of induction and support. They identify clear leadership for the partnership and ensure it has clear terms of reference, based on a shared understanding that suicide can be prevented. The terms of reference should:

  • clarify local partnership structures, including working arrangements between the strategic suicide prevention group and any wider network or partnership subgroups

  • identify clear governance and accountability structures, including oversight from local health and care planning groups such as the health and wellbeing board

  • clarify links between suicide prevention partnerships in the local community and those in custodial settings, particularly in relation to managing prisoners and detainees in the community.

Source guidance

Preventing suicide in community and custodial settings (2018) NICE guideline NG105, recommendations 1.1.1, 1.1.2 and 1.1.4

Definitions of terms used in this quality statement

Multi-agency suicide prevention partnership

Suicide prevention requires work across a range of settings targeting a wide variety of audiences. Given this complexity, the combined knowledge, expertise and resources of organisations across the public, private and voluntary sectors is essential. A wide range of representatives working with adults, children and young people may be brought together to contribute to a multi-agency suicide prevention partnership.

[Public Health England's Local suicide prevention planning: a practice resource]

Strategic suicide prevention group

A strategic suicide prevention group in the community could include representatives from the following:

  • clinical commissioning groups

  • local public health services

  • healthcare providers

  • social care services

  • voluntary and other third-sector organisations, including those used by people in high-risk groups

  • emergency services

  • criminal justice services

  • police and custody suites

  • employers

  • education providers

  • people with personal experience of a suicide attempt, suicidal thoughts and feelings, or a suicide bereavement.

A strategic suicide prevention group in a residential custodial or detention setting could include representatives from the following:

  • governors or directors

  • healthcare staff (including physical and mental health)

  • other staff

  • pastoral support services

  • voluntary and other third-sector organisations

  • escort custody services

  • liaison and diversion services

  • emergency services

  • offender management and resettlement services

  • people with personal experience of a suicide attempt, suicidal thoughts and feelings, or a suicide bereavement, to be selected according to local protocols.

[NICE's guideline on preventing suicide in community and custodial settings, recommendations 1.1.3 and 1.1.5 and expert opinion]

Equality and diversity considerations

Multi-agency suicide prevention partnerships should make reasonable adjustments to ensure that people with additional needs such as physical, sensory or learning disabilities, and people who do not speak or read English, or who have reduced communication skills, can participate in the strategic suicide prevention group. People should have access to an interpreter (including British Sign Language) or advocate if needed.