Reflective peer review is effective alongside training because it taps into the feelings
and thinking that can impact on assessment and drive the decision-making process. It provides an opportunity for reflection on alternatives to care using current clinical examples from the practitioner’s workload, as well as exploring staff members’ attitudes to the patient, selfharm and suicide while encouraging reflection on how this may be impacting in a positive or negative way on the care provided. This approach builds on staff members’ existing skills and provides an opportunity for skill acquisition via direct feedback from peers. During the process there is an opportunity to examine and add to the clinical documentation. An audit of case notes after peer review has highlighted an improvement in documentation in relation to rating risk based on historical, clinical, situational and protective factors. Staff have reported an increased understanding of risk assessment and increased confidence; we have
also seen an improvement in recordkeeping requirements. Further work will involve using validated scales to measure confidence and its impact on professional behaviour in terms
of risk-management plans that match clinical and best-practice guidelines.