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What is the Oxford Monitoring System for Self-harm?
The Oxford Monitoring System is a clinical register of information about self-harm. It includes
patients who have presented to the John Radcliffe Hospital following self-harm.
Further information about the Monitoring System can be found here:

What is self-harm?
Self-harm is defined as intentional self-injury or self-poisoning, irrespective of type of motivation or
degree of suicidal intent. This definition, which is used in a similar way in countries in Europe and
elsewhere, includes both ‘suicide attempts’ and acts with other motives or intentions. This reflects
the often mixed nature of intentions.
Self-poisoning is defined as intentionally taking more than the prescribed or recommended dose of
any drug or swallowing other potentially poisonous substances.
Self-injury is defined as any injury that has been non-accidentally self-inflicted (e.g. cutting, jumping
from a height).

How do we get our information?
Most of our information is obtained from a simple data sheet that is completed by a doctor or nurse
after they have seen a patient who has self-harmed in any way. This only happens at the John
Radcliffe Hospital.

For those patients who are not seen by staff from the self-harm service, we have specially trained
data processing staff who are authorised by the NHS to get some basic information from the John
Radcliffe hospital about the presentation.

We have support from the Secretary of State for Health and Social Care to collect this
information without asking individual patients for their explicit consent to do this. This is partly
because of the number of self-harm presentations to hospital in Oxford (up to 2,000 per year) and partly because many patients are not assessed and so there is no opportunity to ask for their consent.

How is the information kept?
All the information we collect is stored securely in accordance with standards set out in the Data Protection Act and by the Health Research Authority. Any information that could potentially identify individuals, such as postcode, is removed from data before being transferred for research purposes.

This means that no patient could be identified by the project data analysts.  We need to have enough identifiable information so that we can link up attendances for self-harm to the correct person. This work is done by NHS staff or NHS approved data processors. Researchers do not have access to identifiable information about patients.

Do I have to agree to my information being used for this research? Can I opt out?
You do not have to do anything as the Secretary of State has agreed that we can collect this information without individual patient consent. 

We also applied to the Secretary of State so that we not have to apply the National Data Opt Out. This is so that we can obtain accurate numbers of self-harm cases in Oxfordshire in order to provide information on trends and rates of self-harm. If we applied the National Data Opt Out we would have no way of knowing how many people had opted out.

However, you can still opt-out of having your information used in our Monitoring projects. If you do not want your information included you can telephone or email our team. We can then ask one of our specially trained, NHS approved data processors to find out which records needed to be deleted. If you agreed, the data processors could also retain a few details to be sure that your information could not accidentally get included at a future data in our

What sort of work has been/is being done with this information?

A list of our current and recent projects can be found here:

Why is this project important?
We have been collecting data on self-harm continuously since 1976 so we have a unique ability to look at self-harm over time. The importance of this project has been recognised both nationally and internationally. The project in Oxford is coordinating the Multi-centre Study of Self-harm in England project. Both projects are continually informing national strategy, especially in relation to the National suicide prevention strategy for England: 2023 to 2028.

What are the benefits of this project?
We have been able to inform national policy that has led to restriction of particular medications that are harmful in overdose. For example, our research led to the decision to reduce the number of tablets in a pack for paracetamol and other analgesics. We have been able to show that this measure has led to fewer deaths from overdoses of these drugs.

Another example is that we were also able to demonstrate how dangerous co-proxamol is in overdose which eventually led the Medicines and Healthcare products Agency to introduce a phased withdrawal of this drug in the United Kingdom. Subsequently, other agencies recommended the phased withdrawal of this medicine across much
of the developed world.

What if I have any questions not covered here?
Please telephone Debbie Casey on 01865 13195 to discuss any aspect of our research or email us at