1. Self harm: Salena Williams UHBristol June 2015

2. Who’s involved? David Gunnell UoB Blanka Robertson BCC/Public Health Lisa Foote SISH Dominique Thompson GP Kyla Thomas Public Health Jonathon Benger UHB/UWE Jacky Keane NBT Jon Hayhurst CCG NHS England Claire Thompson CCG Rowena Green UHB

3. Progress to Date The Self Harm Register – extended to all Bristol hospitals PPI involvement ED improvements – from posters to education to PSP’s ED resource z card and website development New 7 day 14 hour service to ED GP training 3 research publications recruited over 100 patients to NIHR funded research projects

4. The SHR: 40 item dataset all self harm attendance Postcode and GP area Day of the week Hour of the day Precipitating factors Gender, age What taken Risk assessment Psychosocial assessment? Outcome – GP, CMHT, in-patient repetition

5. Numbers of patients Incidence stable at BRI with ~1500 attendances annually

6. Key Indicators Table 11. STITCH group's key indicators over time based on all episodes of self-harm at the BRI, 2011-2014 2011201220132014 No. of attendances 1,4941,4021,5381,539 Use of TCA's in overdose3.98%3.80%2.70%5.15% Psychosocial assessment 57.09%56.11%58.84%58.30% Medical admission64.66%63.27%64.76%65.24% ITU admission2.28%3.49%2.22%3.92% Mean LOS (days)* 3.063.632.372.14 *Excludes outliers: 10. LOS – Length of Stay

7. Challenge

8. Intervening GP prescribing of drugs lethal in overdose SHRegister: identify admissions to ITU GP pilot to Student Health Centre: blister pack/1 weeks supply Meet GP forums across Bristol Government/NHS England pressure

9. Success

10. research plans Evaluate the impact of the new investment in self-harm services on patient outcomes and costs Develop patient-centred outcomes for self-harm Maximise patient involvement with self- harm service research RCTs of interventions to improve self-harm outcomes

11. Future Plans 2015/16 Ambulance crews pilot training Self harm clinic Carers information DNA/‘left without being seen’ Funding for SHRegister – BHP business case