Safety recommendation
HSIB recommends that NHS England works with appropriate stakeholders, including experts with appropriate experience, to create guidance on culture change. A quality improvement programme should also be developed to support practitioners in undertaking psychosocial assessments that are in line with guidance from the National Institute for Health and Care Excellence. Person-centred safety planning should be embedded within the process.
Response:
NHS England has begun work with appropriate stakeholders, including experts with appropriate experience, to respond to this safety recommendation.
An engagement event with stakeholders, clinicians, academic experts, people with lived experience and providers was undertaken in February 2023. As part of the wider work of the Quality Transformation Programme, underpinned by £36 million investment over three years, we are currently in the process of co-producing standards for all mental health, learning disability and autism inpatient services to improve the culture of care, an important part of which is embedding the move away from stratification of risk towards psychosocial assessment and person-centred safety planning.
In parallel, we are establishing a quality improvement programme to improve the culture of care. This programme will be available to all providers of NHS-funded mental health, learning disability and autism inpatient services and is designed to provide a clear framework and direct implementation support for organisations to achieve the standards, including those related to psychosocial assessment and person-centred safety planning.
This programme will complement and further support our existing commitments to improve the quality of community care, and the Mental Health Act reform agenda.
As also noted in your Safety Action A/2023/058:
NHS England has written to all mental health trusts in England to highlight the importance of taking a person-centred approach to psychosocial assessments and safety planning. The communication asks trusts to move away from risk assessment tools that stratify an individual’s risk of suicide or self-harm.
Actions planned to deliver safety recommendation response:
- Safety Action A/2023/058 completed on 22 October 2022.
- Stakeholder consultation completed 2 February 2023.
- Co-produce standards to improve culture of care, by Q2 - Q3 23/24. Resources in place: Multidisciplinary design group established, including clinicians, academic, key stakeholders across system and people with lived experience; core team of NHS E staff responsible for drafting, led by staff with lived experience. Other dependencies identified: Multidisciplinary design group established, including clinicians, academic, key stakeholders across system and people with lived experience; core team of NHS E staff responsible for drafting, led by staff with lived experience.
- Co-design quality improvement programme to improve culture of care, by Q3 - Q4 23/24. Resources in place to deliver safety actions: Significant investment over 3 years. Core team of NHS E staff, alongside key stakeholders and people with lived experience, developing and designing the programme to be procured for delivery. Other dependencies identified: Ensuring alignment with existing improvement programmes and clear framework and support for implementation.
Response received on 19 June 2023.