Nottinghamshire Healthcare NHS Foundation Trust

Our work in suicide prevention

Nottinghamshire Healthcare NHS Foundation Trust (Nottinghamshire Healthcare) is committed to working “Towards Zero Suicide”. This approach aims to improve the care and safety of people accessing our services, and support suicide prevention work within local communities.

Towards Zero Suicide is our commitment to suicide prevention and providing compassionate, person-centred care which is based on evidence, clinical knowledge and collaborative decision making. Our Zero Suicide ambition means that we have a commitment to suicide prevention and promoting a culture that focuses on learning, improvement, personalisation and safety, rather than blame and “defensive” practice.

Our work in suicide prevention

We have developed a framework for working “Towards Zero Suicide,” centred on four key areas: Community and Partnerships, Clinical Practice and Pathways, Just Culture, and Clinical Competence. Each of these focus areas drives our current priorities and actions within the Trust.

Under Community and Partnerships, we prioritise building and promoting networks both within and beyond the Trust, demonstrated through active participation in local, regional, and national groups and initiatives. We also closely monitor self-harm and suicide data, leveraging tools such as incident reporting, mortality surveillance, and real-time surveillance of suspected suicides in collaboration with Public Health partners.

In Clinical Practice and Pathways, our efforts focus on promoting best practices in suicide prevention, particularly in risk assessment, effective care, and safety planning, achieved through Quality Improvement initiatives and staff engagement. We are implementing a strategic approach to suicide prevention in inpatient areas and developing resources and communication tools to share knowledge, understanding, and lived experience across the Trust.

The principles of Just Culture are embedded into our practices to support learning from incidents, foster a culture of safety, and encourage staff to speak up. This approach emphasises restorative practices to create an environment of accountability and improvement.

Lastly, in Clinical Competence, we are reviewing staff support and needs related to suicide prevention, promoting a skilled and compassionate workforce through supervision and clear access to support and advice. We are also revising our Suicide and Self-Harm Prevention training, working collaboratively with individuals who have lived experience to design and implement a new training model.

Our current challenges

The implementation of the Towards Zero Suicide ambition and strategy presents a significant challenge for a large Trust like ours, with its diverse range of services and areas. This work must align with broader efforts to shape a culture of compassionate leadership across the organisation. A key step in this journey has been completing a consultation process on “Building Our Purpose, Values, and Behaviours Together,” which lays the foundation for our cultural transformation.

Several ongoing initiatives complement this work. We are committed to ensuring our staff Health and Wellbeing service is fit for purpose, providing robust support for our workforce. Additionally, we are refining HR policies and processes to adopt a more Just Culture approach. This shift focuses on creating a learning culture rather than a blame culture, offering support to staff involved in incidents, allegations, or formal procedures.

Another key element is the adoption of the “Breaking the Rules for Better Care” methodology, developed by the Institute for Health Improvement. This approach prioritises rapid identification and decision-making to enhance care delivery, as successfully implemented by other Trusts across the UK. To drive engagement and progress, we are hosting Trustwide events centred on these initiatives, fostering collaboration and embedding these principles into our organisational practices.