Quality standard
Quality statement 5: Safe physical environments
Quality statement 5: Safe physical environments
Quality statement
People who have self‑harmed are cared for in a safe physical environment while in the healthcare setting.
Rationale
Caring for people who have self‑harmed in a safe physical environment within the healthcare setting can reduce distress, help them to feel supported and maintain physical safety in the healthcare setting.
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
Evidence of local arrangements to undertake assessments of the safety of the environment in healthcare settings.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations.
Outcome
Number of episodes of self‑harm occurring in healthcare settings.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. The NHS National Reporting and Learning System contains national and local figures on patient safety incidents, including self‑harm.
What the quality statement means for different audiences
Service providers ensure that they undertake assessments of the safety of the environment to ensure that healthcare settings are safe for people who have self‑harmed.
Healthcare professionals ensure that people who have self‑harmed are cared for in a safe physical environment while in the healthcare setting.
Commissioners ensure that they commission services that provide safe physical environments in healthcare settings for people who have self‑harmed.
People who have self‑harmed are cared for in a safe physical environment.
Source guidance
Self-harm: assessment, management and preventing recurrence. NICE guideline NG225 (2022), recommendations 1.7.16, 1.12.6 and 1.12.7
Definitions of terms used in this quality statement
People who have self‑harmed
People who have carried out intentional self‑poisoning or injury, irrespective of the apparent purpose of the act. [Adapted from NICE's guideline on self-harm, terms used in this guideline; self-harm]
Safe physical environment
People who have self‑harmed should be offered an environment that is safe and balances respect for the person's autonomy against the need for restrictions.
Consideration should be given to removing items that may be used to self-harm. The person who has self-harmed should be involved in this decision.
A safe physical environment refers to primary care settings, ambulance services, emergency departments, minor injury units and inpatient settings where people who have self‑harmed are being cared for. [Adapted from NICE's guideline on self-harm, section 1.7 and recommendations 1.12.6 and 1.12.7]