Overview
During the past year, Lorraine Randlesome, a Senior Clinical Advisor from IC24’s Norfolk and Waveney NHS 111 Contact Centre, has implemented training across all our contact centres to support NHS 111 clinicians with suicide-related calls. Providing confidence and guidance to help clinicians with these difficult calls.

Supporting clinical advisors with advanced suicide training support
Many of us are all too familiar with the alarming statistics around suicide. The loss of a life is a highly significant event and those occurring in a professional context are no different. Even before the pandemic, Lorraine was aware that mental health calls were the most challenging for clinical advisors.

“It’ll be no surprise to many that suicide-related calls are the most distressing for clinical advisors. Before the pandemic began, I’d identified that my fellow colleagues would struggle the most with suicide NHS 111 calls and gauging whether there was immediate suicidal intent. Although there’s always NHS Pathways support, most clinicians do fear saying the wrong thing – as they’re human beings and truly care for a patient’s welfare.”

A couple of years prior, Lorraine took part in some mental health and suicide support training with an out of hours GP, and after submitting a proposal to IC24’s Learning and Development department, she engaged Dr Anna Crozier to work on a range of sessions to support clinical advisors at IC24’s three contact centres.   

Providing confidence and reassurance to help colleagues
“It was no small feat to start the project, especially due to the large range of stakeholders involved; but I knew how important the work would be. The Learning and Development department were crucial to the project, as well as our NHS Pathways Manager.”

After Lorraine engaged numerous stakeholders within IC24 and ran regular meetings to project manage the proposed work, the first sessions went ahead virtually in February and March 2021. The sessions provided clinical advisors with an aide-mémoire, full of top tips on assessing suicidal intent, compiled together with high-level risk assessments to measure the biggest predictors of immediate intent. As well as giving them the tools and an increased sense of confidence when dealing with calls of this difficult nature.

“Whilst suicide can never be accurately predicted, there’s certain questions and probes that can help clinicians to build a clearer image of a situation. These sessions were perfect for helping clinicians to feel more confident with these types of conversations, as effective physician-patient communication is a crucial part of the role. Even questions like ‘What has stopped you so far from ending your life?’ can be telling in a highly critical situation, as assessing a patient’s protective factors like children or pets gives you a better viewpoint for escalation. Understanding the psychology behind these questions was invaluable.”

“Since the sessions took place, we’ve been working hard to review and amend the existing ‘Management of Suicidal Callers SOP (Standard Operating Procedures)’. The proposed changes to the SOP have been agreed recently and will be implemented shortly into all our contact centres.”

Changing perceptions and gaining feedback
With the first sessions becoming a unanimous success, Lorraine has already put plans in place for further clinician drop-in sessions with Dr Anna Crozier.

“From the feedback we’ve received so far, clinicians found the training to be very helpful, and would like this to be a continued and ongoing project. I’ve been so pleased with the response, as it’s invoked a sense of hunger for further training in this arena. It’s been great to get clinicians’ insights into the course, and we’re building those insights into the next sessions i.e. use of case studies to move the training forward. The sessions have truly been a learning lesson for all parties involved. Even Dr Crozier has had a change of perception. It’s really opened her eyes to how NHS 111 are the true gatekeepers, as you wouldn’t get many calls of that nature in out of hours work. She’s commended us on how well we deal with these calls.”

A sincere well done to Lorraine for this important work. Stay tuned for the next instalment of the ‘IC24 Star of the Month’. You can find out more about our brilliant people by searching #MadeToBeBrave on Facebook, LinkedIn, Twitter, and Instagram.