Key points to note from the Best Practice Guidance for Suicide Prevention Services (HSE, 2019)
In 2019, the HSE released the Best Practice Guidance for Suicide Prevention Services which aims to support organisations to deliver high-quality, evidence-based suicide prevention services. Implementing this guidance is an important step in assuring quality in the provision of suicide prevention services.
The Best Practice Guidance for Suicide Prevention Services (HSE, 2019) is relatively new to the sector. This coupled with the impact of the COVID-19 pandemic on service provision over the last two years has resulted in a limited opportunity for services to consider their implementation.
Now is the time for services to be proactive and look at implementing this guidance. In this blog, we discuss the key points to note from the Guidance and offer services advice on the initial steps required to implement the Best Practice Guidance for Suicide Prevention Services (HSE, 2019).
Who is the guidance for?
The HSE state this guidance is designed to be used by organisations providing suicide prevention services, including services providing:
- Health promotion
- Early intervention and prevention
- Targeted suicide-prevention for high-risk individuals
- Crisis support and on-going intervention for people experiencing suicidal thoughts and behaviour
- Suicide prevention for communities or groups at risk of suicide
- Support for individuals or groups affected by suicide
- Suicide prevention interventions aimed at the whole of the population
Structure of the HSE Best Practice Guidance for Suicide Prevention Services
The document identifies five key themes for quality and safety in suicide prevention services, these are:
- Recovery oriented care and support
- Effective care and support
- Safe care and support
- Leadership, governance and management
Each theme identified in the document has a one or more aims and related indicators. Under each indicator there is a set of features which describe what best practice in this area looks like. Below are a number of examples of the types of aims and indicators outlined in the guidance.
Theme 1: Recovery Oriented Care and Support
Recovery-oriented suicide prevention services are person-centred and promote kindness, consideration and respect for people’s rights, dignity, privacy and autonomy. They empower people to be involved in shaping the services they are using, to making informed choices and to promote their own wellbeing and recovery.
This theme has eight aims and each of these aims has one or more indicators. An example of aims and indicators are below.
- Aim 1: Collaborative and person-centred planning and delivery: The planning, design and delivery of the suicide prevention service is informed by lived experience, identified needs and preferences.
- Indicator 1.1: People using the service are supported to co-produce and/or collaborate in the governance of the suicide prevention service.
- Indicator 1.2: The suicide prevention service establishes mechanisms for engaging people who use the service, and/or relevant named supporters, in strategic and operational planning, design and implementation.
- Indicator 1.3: People who use the service and, where relevant, named supporters, co-produce in the planning of their care and support, including but not limited to, areas of consent, capacity, choice, rights and responsibilities.
- Aim 7: Handling complaints (and compliments): Complaints (and compliments) by people who use the service are responded to promptly, openly and effectively, with clear communication and support provided throughout this process.
- Indicator 7.1: Processes are in place to support the recognition, reporting and management of complaints and compliments.
Theme 2: Effective Care and Support
Delivering an effective suicide prevention service means that the person using the service receive the best achievable outcome within the context of the service provided and the resources available to it.
This theme has six aims and six corresponding indicators. An example of these are listed below.
- Aim 1: Evidence-based policies and practice: The suicide prevention service reflects national and international evidence of what is known to achieve the best outcomes for the person using the service.
- Indicator 1.1: The suicide prevention service is based on current best practice and supported by evidence-based policies, procedures and guidelines and the knowledge and experiences of staff, volunteers and the person using the service.
- Aim 6: Monitoring and evaluation: The effectiveness of suicide prevention initiatives and outcomes is systematically monitored, evaluated and continuously improved.
- Indicator 6.1: There is a structured approach to quality improvement that involves co-production and/or collaboration between the person using the service, named supporters, staff and volunteers.
Theme 3: Safe Care and Support
Safe care and support means that people using a suicide prevention service are protected from potential harm, both in their personal circumstances and whilst seeking support from the service. A high-quality, safe service learns from all relevant information, including when things go wrong.
This theme as five aims and five corresponding indicators. An example of these are listed below.
- Aim 2: Safety monitoring and improvement: The suicide prevention service gathers, monitors and learns from information relevant to the provision of safe services and actively promotes learning, both internally and externally.
- Indicator 2.1: The suicide prevention service has a system in place to monitor and report on the quality and safety of care and support provided, which supports improvement and learning.
- Aim 3: Managing safety incidents: The suicide prevention service effectively identifies, manages, responds to and reports on safety incidents.
- Indicator 3.1: There are systems in place to identify, record, review report and learn from adverse incidents.
Theme 4: Leadership, Governance and Management
Leaders have a key role to play in strengthening and encouraging a culture of quality and safety within their service. A well-managed and well-governed suicide prevention service ensures that the service effectively plans, organises and delivers safe, person-centred and recovery-oriented care, in compliance with legislation, standards, guidance and recommendations from relevant statutory bodies.
This theme has five aims and a number of corresponding indicators for each aim. An example is listed below:
- Aim 1: Accountability: The suicide prevention service has clear accountability arrangements in place to achieve the delivery of high-quality, safe and reliable services.
- Indicator 1.1: The suicide prevention service identifies clear lines of accountability, responsibility and authority to oversee the management of quality and safety.
- Indicator 1.2: The suicide prevention service complies with all relevant legal and regulatory requirements, including the HSE’s requirements under a Grant Aid Agreement or a Service Agreement (S.39 of the Health Act, 2004).
- Aim 2: Governance and policies: The suicide prevention service has formalised governance arrangements for assuring the planning and delivery of high-quality, recovery-oriented, safe and reliable services.
- Indicator 2.1: There are governance and management arrangements for assuring quality, risk-management and safety.
- Indicator 2.2: An integrated system is in place to govern the development, dissemination, approval, implementation, monitoring and review of policies, protocols, procedures and guidelines in accordance with regulations and best-practice requirements.
- Aim 4: Monitoring arrangements: The suicide prevention service has systematic monitoring arrangements for identifying and acting on opportunities to continually improve the quality, safety and reliability of its services.
- Indicator 4.1: The suicide prevention service has introduced systematic monitoring arrangements for identifying internal and external opportunities to improve quality and safety.
Theme 5: Workforce
The workforce in a suicide prevention service is one of its most important resources. It is important that the workforce has the right mix of skills to deliver high-quality, safe and reliable care and support, and that the workforce is planned, structured and managed effectively.
This theme has four aims and a number of corresponding indicators, an example listed below:
- Aim 1: Workforce and skills management: The suicide prevention service plans, organises and manages its workforce to achieve its objectives for high-quality, recovery-oriented, safe and reliable services.
- Indicator 1.1: There is an appropriate number of staff and volunteers, with the required skill mix.
- Aim 3: Skills development: The suicide prevention service ensures that its workforce has the competencies and capabilities required to deliver a high-quality, recovery-oriented, safe and reliable service.
- Indicator 3.1: Staff and volunteers are supported in maintaining and developing their competencies.
- Indicator 3.2: Regular formal and informal supervision is available to staff and volunteers to ensure they perform their job/role to the best of their ability.
What to do next?
As part of the guidance, the HSE request that suicide prevention services self-assess their service against the guidance to track progress and identify examples of how they have implemented the guidance. They recommend doing this over a 12-month period.
A good place to start, even prior to the self-assessment, is to first benchmark your service against the guidance. This can be done by completing a Gap Analysis of your service against the Best Practice Guidance for Suicide Prevention Services (HSE, 2019).
Conducting a Gap Analysis against the guidance will help you understand your current position, how your service’s processes currently stack up against what is required for best practice, and it will give you a detailed understanding on whether your processes are comprehensive, if they are effective and if they are person centred.
Once you know the gap between current practice and required practice, a plan for compliance can be developed.
How can HCI help?
HCI has been working with health and social care organisations for over 17 years, supporting them in building Quality and Safety Management Systems that fulfil regulatory requirements and drive improvement in their services.
We have recently supported Suicide Prevention Service by conducting a Gap Analysis against the Best Practice Guidance for Suicide Prevention Services (HSE, 2019). We use our knowledge and understanding of regulatory inspections to develop a comprehensive report that will detail areas of good practice and areas of non-compliance against the best practice guidance. This report can be used to support the development of a Quality Improvement Plan that will support you in implementing a best practice, comprehensive Quality and Safety Management System.