Shared learning database

Lancashire Care NHS Foundation Trust
Published date:
November 2012

A self help leaflet written by a service user and member of staff to help get the two NICE guidelines on self harm into practice.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

Our aim was to have a high quality leaflet that was readily available and widely used.

Our objectives were to develop a meaningful resource to support implementation of the self harm guidelines.

Reasons for implementing your project

Both CG16 and CG133 recommend the provision of verbal and written information. The Trust did not have any that service users felt would meet their needs, and staff did not have anything that was printed and readily available when needed. A resource was needed that was written in a user friendly format, by service users for service users. This leaflet should also have a list of support groups in it and would also act as an educational resource for staff who may not always fully understand the reasons why some people might self injure.

We actually started writing this in response to the 2004 guideline, it was just fortunate timing it was printed in time for the publication of the 2011 guideline!!

How did you implement the project

A Service User representative (Sarah Devlin) currently in treatment, and her Community Psychiatric Nurse (CPN) collaborated on the first drafts. It was then circulated widely to many (many!) stakeholders who contributed to its development. This included the Wound Care Nurse, other service users, the Director of Nursing etc. Once the content was agreed we worked with the communications department to format it and 3000 copies were ordered. The availability of these was advertised and every single copy distributed to community mental health teams and inpatient wards.

The Director of Nursing provided the budget for printing, on the understanding that teams would then pay for any restock. 3000 copies were printed as it was cheaper to buy in bulk, and the communications dept advised it would be cheaper to have them professionally printed, rather that printed out on colour printers in house.

Key findings

The baseline assessment identified that staff wanted this resource, and an audit undertaken 3 years ago found staff were not confident at managing self harm and felt that written information would support them.

The leaflet was distributed to all inpatient mental health wards and community mental health teams in December 2011, alongside the patient version of the NICE CG133 Guideline. We quickly ran out of an initial print stock of 3000 and had to reorder to support the number of requests we had for additional copies.

In February 2012 I emailed those staff that had received the leaflets and put together a very brief summary of responses. These were uniformly positive and the authors were overwhelmed with the comments that came back.

During March 2012 I worked with an identified Administrator in each team and ward to ensure they knew how to ask NICE for more copies of the patient version of the CG133 NICE guideline (and NICE guidelines in general, I have attached the briefing note I put together about this.

In September 2012 and as part of the 'trustwide ward audits' programme, each ward was audited to identify if copies of the leaflet were available. The results for this were a mixed message; only 50% of the wards had a current stock, the remaining 50% had run out and did not have a budget for reordering. It was positive the leaflets were used, but we clearly need to identify a budget to support the stock reordering and reiterate the importance of having a person to be responsible for reordering stock.

Key learning points

The guidelines prompted us to start this work, and I am confident this initiative has helped us not only get the guideline into practice, but also has made a real difference to both the people who self-harm, and the people that care for them.
Key learning points:
- The development of this leaflet took longer than anticipated, mainly due to the many people that wanted to contribute. My tip here is to take time and get any leaflet right before trying to go to print
- The authors of the leaflet felt that they didn't want to produce a leaflet that just sat on a shelf. We built in a robust communications and dissemination strategy and that meant we created such a demand for the leaflet, we literally had a waiting list of people wanting to have copies
- Ensure a restock budget is identified, and make it someone's job to be responsible for reordering
- If a leaflet for service users is required, it is absolutely essential they be involved in the writing of it. This sounds simple, but the majority of the credit for this leaflet should go to Sarah who co-wrote it.

Contact details

Pam Tester
NICE Guidelines Lead
Lancashire Care NHS Foundation Trust

Primary care
Is the example industry-sponsored in any way?