Procurement

Service providers should:

  • Increase collaboration between NHS providers on learning, evaluation and procurement of anti-ligature fixtures, fittings and furniture.
  • Encourage agreement of national NHS standards in anti-ligature fixtures, fittings and furniture.
  • Ensure that they follow manufacturer's instructions in maintaining and testing anti-ligature fixtures and fittings.
  • Optimise confidence in using new products through training and measuring effectiveness using key performance indicators.
  • Involve subject matter experts in procurement to enable scrutiny of any proposed product.
  • Involve people who use services in procuring new types of products and technologies

(Although these recommendations were written for NHS trusts, they may also be applicable to independent providers of mental health care.)

Procurement staff should have ligature risks at the forefront of their thoughts when drafting a specification. Regional NHS Procurement hubs can help support trusts by sharing best practice from other regional and national organisations. Additional information can also be found on the online NHS Estates Team Collaboration Hub and in NHS England’s Estates Technical Guidance.

Guiding principles

Key considerations

Are we clear why we require to procure this/these items?

Is the procurement essential – could we look at different ways of working?

  • What is the intended purpose of the equipment/resource? Is this understood across the team?
  • Is this introducing new equipment?
  • How does the selected equipment/resources comply with any national guidance/best practice? Contact your Estates department for the latest guidance.
  • Has this been considered against possible ligature risk? Has it been reappraised against the procurement requirements?
  • If a replacement, was the equipment/resource involved in any ligature events? (consider reviewing incident data to inform your answer)
  • What does the incident records tell you about its use?
  • How has this been considered against the previous questions?
  • How has this been reappraised against the procurement requirements?
  • Could the equipment/resource be used creatively as a component to contribute to a ligature event? E.g. using an item in a different way/context than it is intended. For example, a waste bin could be upturned and used as a stool to potentially reach a ligature anchor point.
  • Service providers could consider asking manfacturers to have their products BRE tested before purchasing products

Have we considered the impact on patient experience in creating a home-like environment? (see the therapeutic environment in the built environment section)

  • Has the range of options been risk assessed and considered in the context of potential ligature harm vs patient experience and therapeutic benefit?
  • Where relevant and possible, have we consulted patients and carers regarding the proposed equipment/resource?