Quality statement 1: Multi-agency suicide prevention partnerships | Suicide prevention | Quality standards

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

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

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

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by partnership organisations, for example, membership lists, including job titles and responsibilities, and attendance registers.

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

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by partnership organisations, 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: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by partnership organisations, for example, programmes 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: The Office for Health Improvement and Disparities' Suicide Prevention Profile includes data on the age-standardised rate of emergency hospital admissions for intentional self-harm in England. NHS Digital's Hospital Episode Statistics includes data on A&E attendances for self-injurious behaviour.

b) Rate of self-harm in the community.

Data source: Local data collection, for example, community or school surveys. Data on episodes of self-harm in primary care are likely to be available from primary care electronic healthcare record systems.

c) Suicide rate.

Data source: The Office for Health Improvement and Disparities' Suicide Prevention Profile includes data on the rate of suicide in clinical commissioning groups and sustainability and transformation partnerships 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. NICE guideline NG105 (2018), 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. [Adapted from Public Health England's Local suicide prevention planning: a practice resource, section 2]

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. For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.