Implementation Project
This project will oversee the Mersey Care implementation of recently updated NHSE guidance in risk formulation, management and safety planning (Staying Safe from Suicide, 2025).
The Safety Assessment Framework is relevant for all mental health practitioners. This includes those working in all disciplines, within all divisions, working in both community and inpatient settings, and supporting patients of all ages.
For the most part, Mersey Care is already compliant with these guidelines, and the project should be seen as an update rather than a full redesign.
However, we must make sure that the key changes in the Safety Assessment Framework are implemented - see below.
Key changes in the Safety Assessment Framework:
- Change the language we use from “risk assessments” to “safety assessment”
- Stop the use of all risk stratification (i.e. categorising risk as high, medium and low). Instead, patient risk should be defined and managed in the context of relational, therapeutic engagement, which is known to improve outcomes without relying on risk prediction labels
- Review and agree standardisation of documentation used in the organisation to complete “safety assessments”.
This guidance supports the National Suicide Prevention Strategy (2023) and aligns with the Culture of care standards for mental health inpatient services (2024) and is underpinned by research.
Phase 1 (Autumn 2025) will:
(a) Phase out the use of risk stratification language (high, medium and low) within the context of mental health safety assessments. Minor changes will be implemented within clinical record templates.
(b) Ensure that the rationale and implication of NHSE guidance is recognised and understood by clinical colleagues across the Trust. This will include provision of interim training materials as aligned with the existing eRisk competency.
Phase 2 (Winter – Spring 2025/26) will deliver wider improvements:
(a) Full refresh of the functionality of digital assessment tools in clinical records, with an aim of reducing repetitiveness of documentation and improving language to be formulation driven and person centered.
(b) Full refresh of the safety assessment framework training packages (currently eRisk) for all Mental Health practitioners.
No immediate changes are scheduled for either training or clinical system forms, and all changes will be communicated in advance. However, there are some things we need you to do in preparation.
Step one: Read the guidance
For now, we’d simply like you to be aware of the NHSE guidance, and to reflect on how this compares to current practice within your own service. Many teams will already be working in this way due to risk training that has been delivered over recent years.
Step two: discuss with your teams
Please start to discuss in your multidisciplinary team meetings
Step three: feedback
We would like you to share any initial feedback, queries or hopes about the project with the steering group, by using this online form.
This will help us understand how to target our communication and we will use responses to populate an FAQs section on this page.
This page will be updated with further opportunities to get involved in the design and delivery of improvements, look out for news in staff newsletters as more information is added.
We will be engaging with our patients and carers to gain their feedback, using CIVICA and will look for support to develop and deliver the training.
If you have groups of patients and/or carers you would like us to engage with, please let us know using the online form above.
- NHSE guidance - NHS England » Staying safe from suicide: Best practice guidance for safety assessment, formulation and management
- NICE guidelines NG225 - Recommendations | Self-harm: assessment, management and preventing recurrence | Guidance | NICE
- Case study webinars from other NHS trusts - NCISH | Local approaches to personalised risk assessment
FAQ
No. The NHSE guidance is about staying safe from suicide and recommendations such as the removal of risk stratification are specifically aimed at suicide safety assessment. However, a holistic and person-centred safety assessment, formulation and plan should incorporate wider social and psychological risk factors, including signposting to other mental health risk assessment tools where appropriate. This is currently the case in Mersey Care, as reflected in both clinical practice and in eRisk training. For this reason, the project is being referred to more generally as the Safety Assessment Framework.
No. Physical health risk assessments (such as falls, pressure ulcers etc.) will not be changing in content. However, Phase 2 of the project will explore more joined-up signposting between physical and mental health safety assessments and resources, in line with the Trust's objective to deliver whole person, joined up care.