Tidal Thames Water Safety Forum

Drowning Prevention Strategy: Accidental and Self Harm

TIDAL THAMES WATER SAFETY FORUM Drowning Prevention Strategy May 2019 TIDAL THAMES WATER SAFETY FORUM

Foreword 1. Background p2 I am delighted to support the Tidal Foreword p3 Thames Water Safety Forum which brings 1. Background together vital agencies across maritime, 1.1 Membership p4 coastal and emergency services to keep 1.2 Scope p4 the tidal Thames safe for everyone. Our aim is to reduce the number of avoidable 1.3 The London picture p4 deaths from drowning in the tidal 1.4 Rising suicide rates p7 Thames targeting a ‘zero harm’ policy. Stretching 95 miles from Teddington in 1.5 Coping with London’s growth p7 the west to the North Sea in the east, the 1.6 The case for community p9 tidal Thames is the UK’s busiest waterway, used all year round by safety commercial and recreational vessels alike. It is iconic and its bridges are known the world over. 2. Strategic objectives p10

In 2018, 30 people drowned in the river, accounting for 8% of 2.1 Overview p11 drowning-related deaths nationally. Over the year, there were 688 recorded cases of people threatening to enter the Thames to take 2.2 Raising awareness p11 their life. 105 people actually entered the water, triggering 2.3 Tackle river-related suicide p12 interventions by the emergency services. As Minister for suicide and self-harm drownings prevention I see all these incidents as preventable. I am determined that we make our public areas safe and put in place 2.4 Implement a robust, multi- p15 appropriate measures to reduce risk. layered programme to deliver education and water safety to Lasting positive change can only be achieved through clear targeted groups and events leadership and close collaboration between policy makers, authorities and the public. It is imperative we succeed, to reduce 2.5 Continue to maintain and p17 the risks for all the capital’s residents and visitors and make improve the SAR response London the safest global city. to incidents on the river

I thank all of the people involved in the Forum and especially the 2.6 Ensure that safety is an p18 professionals on the frontline who make lifesaving interventions intrinsic part of future on a daily basis and show such dedication to their duty. development

2.7 Establish the p19 as an independently identifiable risk area Jackie Doyle-Price MP 3. Delivering the strategy p20 Parliamentary Under Secretary of State for Mental Health, Inequalities and Suicide Prevention 3.1 Tracking progress and p21 delivery May 2019 4. Strategic summary p22

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1.1: Membership: 1.3: The London Picture The TTWSF involves the full range of regulators, emergency services and England’s longest river, the voluntary groups involved in managing safety on the tidal Thames: Thames is tidal from Teddington in west London out to the Authority (PLA): the statutory harbour authority Thames Estuary. for the tidal Thames; a public trust, established to administer, The tidal Thames is also the preserve and improve the Port of London. UK’s busiest waterway by a significant margin. Flows reach speeds Royal National Institution (RNLI): a charity that saves The Port of London is the UK’s of up to 5mph lives at sea, whose operation extends along the tidal reaches of the second largest hub for the import Thames, with stations providing cover as far upriver as Teddington. and export of commercial freight. Twice daily tide sees the water levels rise and fall by The river’s rich history and iconic up to 7 metres skyline make it a magnet for Service: a 24/7 frontline marine policing response tourists from around the world; unit, based on the river at . recreational use of the river – for sailing, rowing, fishing and accidents affecting the residents, London Fire Brigade : has a water-borne response capability, as walking and other sports are also commuters and tourists in the capital is well as an extensive community outreach programme, part of which growing rapidly. relatively low. focusses on water safety. The Thames is also a challenging river, a But there is no room for complacency; twice daily tide sees the water levels rise projected growth of river usage – both HM Coastguard : Her Majesty’s Coastguard is the part of the and fall by up to 7 metres; flows reach commercial and recreational – pose a MCA responsible for national maritime search and rescue; on the speeds of up to 5mph. parallel increased risk of accidents and Thames this is co-ordinated by London Coastguard. Currently good management and well- deaths due to drowning. London Ambulance Service: the NHS Trust covering maintained riversides mean the risk of fatal an area of about 620 square miles. Its Hazardous Area Response Teams (HART) provide paramedic care in Port of London 2019 environments beyond the capability of standard units. 1.2: Scope INLAND WATERWAY FREIGHT Purpose: To prevent accidental and self-harm drownings in the 4 MILLION TONNES Thames by working in partnership to ensure consistent guidance 400,000 lorries off London’s roads TRADE for safe enjoyment and management of activities in, on and around the water. MILLION TONNES Our Aim: To reduce the number of deaths in and on the tidal Thames food, fuel and manufactured goods; by targeting a strategy of ‘zero harm’. 46,000 jobs, £6.4 billion value added

Developed by representatives of the It has been prepared partially as a emergency services, regulatory bodies and response to the UK National Drowning voluntary organisations involved in Prevention Strategy, which aims to halve managing incidents on the Thames, accidental drowning fatalities in the UK by 363 TRAVEL SPORTING this strategy outlines our priority 2026 and reduce risk amongst the highest 10 m i l l i o n EVENTS actions, governance and how we will risk groups and communities. PASSENGER JOURNEYS £5 million per annum track progress. It will be a framework for TTWSF’s activities up to 2022.

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1.4: Rising suicide rates Suicide is the most frequent cause of Rescue (SAR) missions on the river. drowning in the River Thames, accounting Prevention measures are very limited, for 90% of all deaths. as resources are primarily focussed on Suicide related incidents account for rescue operations. approximately one half of the Search and

800 687 688 700

600 530 500 Came to notice 400 362 Persons in water 300 Deceased

200 118 110 96 105 Suicide related incidents 100 38 29 37 30 account for approximately one 0 half of the Search and Rescue 2015 2016 2017 2018 (SAR) missions on the river 1.5: Coping with London’s growth This strategy coincides with rapid growth ambitious set of goals designed to in London’s population, which is set to maximise the commercial, rise from 8.6 million today to 10 million social and recreational by 2035, and to 11 million by 2050. potential of the tidal river. The growth is forecast to be concentrated The Vision goals for delivery by in the east, much of it likely to be along 2035 include: the river. b Handling 60-80 million The Thames Estuary Growth Commission tonnes of cargo. is leading the development of a plan to b Carrying over 4 million tonnes of deliver the infrastructure that will be goods on the river. required to accommodate this expansion b Doubling the number of people over the next three decades. travelling by river to 20 million. The strategic transport network will b Achieving greater participation in need to be developed. Transport for sport and recreation, on and alongside London has proposed an additional 13 the water. crossings over the Thames, mostly in the east of the capital. It goes without saying that all the goals must be achieved without compromising The 2035 Thames Vision safety. All the contributors are committed In partnership with a broad range of to working together to make sure safety organisations linked to the river, the PLA is central to the Vision’s delivery. has also developed the Thames Vision, an

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1.6: The case for community safety

The TTWSF will take a proactive approach Activities often deemed as relatively safe – to reducing drowning. such as running and walking – may There is significant evidence that actually be where the greatest risk lies. The prevention is the key to reducing the National Water Safety Forum (NWSF) likelihood of incidents, injuries and categorises these groups, including dog fatalities. walkers, as being at the highest risk of drowning. There are three fundamental strands: Simple interventions, such as advising dog walkers to call the emergency services b Prevention – to minimise the rather than follow their pets into the water, likelihood of an incident can make a big difference; whilst the happening. animals are usually able to get safely back b Protection – to minimise the to dry land, it is invariably their owners likelihood of an incident who get into difficulty. happening through the appropriate design of bridges and waterside developments, and the availability of water rescue equipment. b Response – the search and rescue element on the Thames, when an incident occurs. As identified in the Thames Strategic Review, there is limited scope to increase the speed with which SAR units are currently deployed. This means an educational, supervision and influencing approach, targeting users The Water Accident of the river and its banks, is required to achieve the desired reduction in accidents Incident Database shows and lives lost in addition to further improvements to safety on and alongside that nationally half of the river. those who drowned had no The Water Accident Incident Database (WAID) shows that nationally half of those intention of being in the who drowned had no intention of being in water in the first place the water in the first place.

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2.1: Overview 2. Strategic There is no single, miraculous, “cure all” remedy that can prevent any particular objectives type of fatality. The TTWSF intends to utilise the ‘RISE’ (Rescue, Influence, Supervise and Educate) delivery model, developed by the RNLI. It requires all modes of protection to be addressed, without one taking precedence over another. Using this philosophy, we aim to: b Affect change by raising awareness and the public at large. There is strong of self-harm and accidental public awareness around cycle and fire- drownings on the Thames with related deaths in London in particular, but policy makers, regulators and the also across the UK. Far fewer people are general public. aware of the number of fatalities linked to drowning in the Thames. b Support the development and implementation of a programme to A priority for the Forum is to develop a reduce the number of river-related publicity campaign, in conjunction with suicide and self-harm drownings. relevant experts, to reverse this situation and be a catalyst for concerted, co- b Implement a robust and multi- ordinated action. layered programme to deliver Self-harm is a subject many organisations education and water safety to feel is outside their remit; individuals also targeted groups and events. feel they are not empowered to act. This b Continue to maintain and improve must change. the SAR response to incidents on the river. b Ensure that safety is an intrinsic We will: part of all future development. b Raise the profile of the TTWSF b Establish the River Thames as an through positive engagement independent, identifiable risk area. with politicians, public bodies, 2.2: Raising Awareness decision-makers and the public. b Raise awareness of the risks and Achieving these objectives will require all hazards associated with the the organisations involved to work Thames, educating all who live, together. work and visit. Tackling safety on the Thames in London is b Understand and effect key not a new initiative, but we must behaviour changes towards the collaborate even more effectively together Thames. across organisations to gain momentum and save more lives. b Influence and change policy to To be as effective as possible, the Forum support the strategic aims and and its work need to be visible and objectives. accessible to all the organisations involved

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Case study

Wexford MarineWatch Wexford is a town in the South Eastern corner of Ireland sitting at the estuary of the River Slaney. Whilst a beautiful spot with a strong community feel, Wexford has suffered with loss of life through suicide and accidental drowning around the bridge, quay and harbour areas. According to the best available information, on supported extensively through local average between 2000 and 2012 donation and fundraising and critically Wexford saw in excess of 3 deaths per through close collaboration with the 2.3: Tackle river-related suicide and self-harm drownings year in the water around the town. emergency services in the County of In response to this ongoing problem Wexford. Every year the emergency services deal programme for individuals living and and a quick succession of suicide deaths with hundreds of calls relating to people in working near the Thames would be a major The impact has been significant. In the that sent shockwaves through the crisis, threatening to jump into the Thames step forward in expanding the ranks of 6+ years (2012–2018) since community in 2012, the Wexford from bridges spanning the river or the people able to respond in this way. MarineWatch was introduced the MarineWatch was established. number of fatalities has been footpaths adjacent to it. To this end, in consultation with all the Wexford MarineWatch sees patrols of reduced to 2 and the volunteer patrols Those affected do not always follow relevant, qualified experts, we plan to trained volunteers monitoring the have been directly involved in 335 through on their threats, but the statistics facilitate the development of an harbour, bridge and quay areas during incidents and intervened on 157 remain alarming. Of the 688 cases reported appropriate training programme. the key ‘at risk’ times. The volunteers separate occasions where people were in 2018, 105 people entered the water and It would teach participants how to have been trained in skills to intervene indicating their intent to enter the water 30 people died. recognise a person in crisis, based on their with those suffering mental crisis as well for suicide. The vast majority of those affected were behaviour, and how to summon as basic water rescue skills. They are found to have ongoing mental health appropriate help. issues, even if they had not directly stated Pier staff, marine crews, the emergency an intention to complete suicide. services and CCTV operators are among Bridge Watch Intervention training those groups who could be effectively We intend to support the development of Along with the desire to develop a resource of trained volunteers with the There is greater opportunity for last-minute targeted for training of this kind, to a programme that can emulate the capability to directly make an intervention when attempted suicides increase the levels of monitoring and Wexford MarineWatch approach to direct intervention there is scope to add occur in public places. supervision available at key locations. intervention at the ‘precipice’. Members of the public could also be Within the densely populated areas of another ‘layer of vigilance’. With minimal The first response is much more likely to upskilling, existing personnel that come from a passing stranger, rather than educated on how to spot and intervene London, there are significant to help people in crisis, including what opportunities to work with key partners work on or around the river can act as from a family member, professional carer, extra eyes to offer early alert to or member of the emergency services. action to take if a person has already and stakeholders including specialist entered the water. charities, to physically monitor and somebody exhibiting the warning signs This makes it imperative that we equip supervise identified high risk areas, such of mental crisis. people from all walks of life with the skills It is vital to give members of the public the confidence to intervene in such situations as the Thames bridges and piers. The and confidence to intervene when they see focus is to directly engage with a person in crisis in a public place. and reassure them that they will be supported, whatever the outcome. vulnerable individuals before they jump Replicating work successfully delivered by into the river and coach them to a place Network Rail for its partners, a training of safety.

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Case study

Mental health nurses & We will: practitioners on patrol with police b Work with suicide prevention NHS mental health nurses and organisations to develop a practitioners have joined patrols by sensitive and effective approach officers from the various police forces. to tackling the issues of Two permanent teams of mental health accidental and self-harm professionals are embedded within drowning on the Thames. British Transport Police, working across b Promote life-saving England and Wales. Nurses and interventions by training practitoners work directly alongside communities linked to the river police officers to assist in dealing with in the skills necessary to referrals from incidents, and undertake successfully intervene with a proactive patrols. person in crisis; and provide appropriate support to 2.4: Implement a robust, multi-layered programme to deliver individuals when they do. education and water safety to targeted groups and events b Work with the NHS, charities, riverside communities and event The Thames is an integral part of London; b Guidelines for people who spot organisers to expand supervision we want residents and visitors alike to be someone in difficulty in the water. along the Thames. able to enjoy the river and its surroundings, b Self-rescue: what individuals safely. b In partnership with others, should do if they get into difficulty The City of London Police helped develop and deliver a strategy to By making those who live in, work in, or in the water. pioneer the approach. The mental health support the high numbers of visit London aware of the risks that the b Guidance for event organisers. professionals accompany officers to persons in crisis in and around river holds, we can reduce the number of Some national campaigns have incidents as they occur, meaning that the Thames, to establish what drownings that occur each year. already had a very positive impact people showing signs of mental health immediate care, treatment and There is already excellent prevention work and will continue to engage many issues can be assessed on the spot by a appropriate support is available taking place surrounding accidental of our target audience. trained professional and appropriate for those affected. drowning. TTWSF intends to build on this, steps taken immediately, ranging from utilising tools and campaigns already admission to hospital, through to b Change behaviours, in and available to ensure they are effective in RNLI’s Respect the referral to a GP or counsellor in less around the water, of those who tackling the unique complexities of the urgent cases. either witness someone, or Water – Float to Live who are themselves suffering Thames. campaign , concentrated Such knowledge sharing brings benefits mental crisis. We will work with all interested parties to on ‘fighting your instinct, for both the NHS and the police. Medical support further behavioural changes not the water’ to reduce professionals are alerted to incidents through water safety education the impacts of cold water they may otherwise have been unaware programmes. shock. of and officers can be informed if a person is deteriorating, or likely to There are five key areas of water become an increased risk. safety messaging: Royal Life Saving Society’s Don’t Drink Early indications also suggest the b Advice for those who are near, but collaboration leads to improved patient not on the water such as dog and Drown campaign targets summer welfare, more efficient use of NHS walkers and joggers. drinkers, Christmas party goers and students during Fresher’s Week. services and a considerable reduction in b Advice for river users, such as detentions under the Mental Health Act. rowers, sailors, paddle boarders and marine crews.

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Events and water safety awareness There has been a rapid increase in the We will: number of social and sporting events on b Help the public and river users to and around the River Thames annually, save more lives through both planned and unplanned. These campaigns to change behaviour. attract large and diverse crowds, from far and wide. b Deliver a water safety education programme, targeting schools On average there are 400 planned events and community groups. on the tidal Thames each year, ranging from firework displays to rowing regattas b Establish improved procedures and sailing races. for the management of events on There is a need for a smarter and more or near the river, to ensure that robust approach to safety, for both organisers fully factor the safety participants and spectators. of participants and spectators into their plans. We will work collaboratively with event 2.5: Continue to maintain and improve the SAR response to organisers during the planning phase, to incidents on the river identify risks and timely, innovative solutions, improving water safety for both Whilst the greatest gains in tackling the Recent data shows a significant increase in participants and spectators. numbers of fatalities on the river are to be recorded SAR incidents. made through prevention and education, This trend is projected to continue, and will Case study it remains critically important that SAR be accelerated by population growth, capabilities on the Thames are maintained additional riparian development and In recent years the safety of spectators and improved. increased use of the river. watching the Oxbridge University Boat Dedicated Search and Rescue services Advances in technology, staff turnover and Race , held annually on the River Thames were introduced following the lifestyle changes all underline the between Putney and Chiswick, has improved Marchioness disaster of 1989, in which 51 continuing need for SAR procedures to be significantly as a result of closer pre-event people lost their lives. regularly tested and rehearsed. collaboration between the organisers, the SAR services on the tidal Thames PLA, the RNLI and Emergency Services. now comprise: We will: RNLI lifeguards steer crowds on the foreshore b Her Majesty’s Coastguard away from areas at risk from fast-rising tides, b Establish a single database, to Operating Centre; co-located which in previous years have dangerously left provide accurate baseline at the PLA’s Control Room at the some spectators stranded in the river. information, enabling informed Thames Barrier Navigation Centre decisions to be made about in . SAR response. b RNLI vessels. Case study b Eliminate all causes of time b London Fire Brigade water delay, from initial alert of an When England hosted the Rugby World Cup in rescue resources and land incident to deploying an 2015, the RNLI launched patrols close to riverside based appliances. effective response to the scene. pubs in West London, immediately before and b Vessels operated by the b Increase frequency of multi- after every match. Metropolitan Police’s Marine Unit. agency planning exercises. This was a direct response to the increased risk of b PLA vessels. b Improve inter-agency debriefs fans seeking to swim in the river after drinking b Commercial vessels. alcohol, unaware of the risks posed by the life- and reviews when incidents b Leisure craft. threateningly cold temperature of river water and occur. the force of the tides.

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2.6: Ensure that safety is an intrinsic part of future development Case study Case study Improving the safety of existing bridges, Consideration must also be given affecting waterside buildings, footpaths and retrospective improvements recreational areas is essential to reducing to the design of bridges and riverside accidental and self-harm drownings in the edges. tidal Thames. There are a number of locations RNLI data shows that between 2008 and throughout the world where considerable 2014, 68% of suicide attempts occurred improvements have been made to existing from bridges, with 32% occurring from the infrastructure with impressive results in river bank or piers along the Thames. reducing fatalities. High-level suicide prevention barriers Following the installation of barriers on The data underlines the importance of installed on the Prince Edward the Clifton Suspension Bridge in Bristol in 1998, fatalities halved from securing the support of key policy makers, We will: Viaduct in Toronto, Canada developers and riverside land owners to incorporated 450 metres of coloured an average of 8.2 per year (1994-1998) include water safety considerations in the b Educate and influence bridge LED lights, which change to reflect to 4 per year (1999-2003). planning of new developments. owners on the issue of suicide on the fluctuations in air temperature, as At the same time there was no Thames and the work undertaken to evidence of a parallel increase in male The extensive, planned development of well as wind direction and velocity, tackle the issue at similar locations. creating a “living” piece of illuminated suicide attempts from other sites in the Thames, particularly in east London, is the Bristol area. an opportunity to improve waterside b Promote and where appropriate public art. design; it will require close collaboration regulate the placement of public with the Mayor of London, the Greater rescue equipment at high risk 2.7 : Establish the River Thames as an independently London Assembly and riparian boroughs. locations and at new riverside developments and crossings. identifiable risk area We will work closely with planners, designers, architects, developers and b Engage with riverside developers There is currently no specific Thames Risk engineers to ensure river safety is and riparian boroughs to improve Register available to help the relevant We will: integrated into wider decision making and the provision of public life-saving agencies design, plan and deliver their b Engage with the London design out risks associated with new-build equipment along the banks of the prevention and response activities on the Resilience Forum to highlight the infrastucture. Thames and fill in any gaps. tidal Thames. risk of accidental and self-harm Lord Harris’ recent review of the capital’s drowning on the Thames and preparedness to respond to major establish the Thames as a incidents highlighted the criticality of the separate risk area within London. River Thames as a transport hub for London. It urged the London Resilience b Establish a Forum of partners to Forum (LRF) to establish a sub-group to develop a Thames Risk Register. consider resilience on the Thames.

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Improving the safety of existing bridges, b Others are working together to waterside buildings, footpaths and strengthen the voice of recreational areas is essential to reducing stakeholders on key decisions accidental and self-harm drownings in the affecting the Thames, such as river tidal Thames. operators and terminal operators RNLI data shows that between 2008 and working alongside Government 2014, 68% of suicide attempts occurred and national authorities to double from bridges, with 32% occurring from the the underlying intra-port freight river bank or piers along the Thames. carried by water or to improve road and rail access to the port. The data underlines the importance of securing the support of key policy makers, b Some established meetings and developers and riverside land owners to groups may need to consider more 3. Delivering include water safety considerations in the focus of the issue on the Thames, planning of new developments. championing mental health and The extensive, planned development of wellbeing of Londoners. The the strategy the Thames, particularly in east London, is TTWSF will also work closely with an opportunity to improve waterside the GLA and local authorities in design; it will require close collaboration delivering the strategy. with the Mayor of London, the Greater 3.1 Tracking progress and London Assembly and riparian boroughs. delivery Working together over the coming years is Building on the co-design approach to essential to turning this strategy into developing the Vision, delivery will reality. Development of the strategy has continue to be with a broad range of been convened and led by the TTWSF, and organisations and partners. Each of the six delivery falls to this Forum as well as a work streams will be met through a rolling whole host of organisations and groups. series of time-bound priority actions with Delivery will vary according to the priority Key Performance Indicators (KPIs). actions required to deliver the goals: Governance will use existing fora wherever b The TTWSF will be leading some of possible, for example the TTWSF and the priority actions and as Thames and London Waterways Forum, or individual organisations we are convening new groups where necessary. working to ensure we are well- Progress will be reported against actions placed to deliver. through an annual report. b In other cases, different organisations may take the lead such as charities directly involved in suicide prevention.

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4. Strategic summary

Purpose: To prevent accidental and self-harm drownings in the What we intend to do: How we intend to do it:

Thames by working in partnership to ensure consistent guidance Implement a robust, b Help the public and river users to save more lives through for safe enjoyment and management of activities in, on and around multi-layered, campaigns to change behaviour. the water. programme to deliver b Deliver a water safety education programme, targeting education and water schools and community groups. safety to targeted b Establish improved procedures for the management groups and events Our Aim: To reduce the number of deaths in and on the tidal Thames of events on or near the river, to ensure that organisers by targeting a strategy of ‘zero harm’. fully factor the safety of participants and spectators into their plans.

What we intend to do: How we intend to do it: Continue to maintain b Establish a single database, to provide accurate baseline and improve the Search information, enabling informed decisions to be made about Raise the awareness of b Raise the profile of the TTWSF through positive engagement and Rescue response t SAR response. self-harm and with politicians, public bodies, decision-makers and the o accidental drownings public. incidents on the river b Eliminate all causes of time delay, from initial alert of an incident to deploying an effective response to the scene. on the Thames with key b Raise awareness of the risks and hazards associated with the policy makers, Thames educating all who live, work and visit. b Increase frequency of multi-agency planning exercises. stakeholders and b b Understand and affect key behaviour changes towards Improve inter-agency debriefs and reviews when general public the Thames. incidents occur.

b Influence and change policy to support the strategic aims Ensure that safety is an b Educate and influence bridge owners on the issue of suicide and objectives. intrinsic part of all on the Thames and the work undertaken to tackle the issue at future development similar locations. Support the b Work with suicide prevention organisations to develop a b Promote and where appropriate regulate the placement of development and sensitive and effective approach to tackling the issues of public rescue equipment at high risk locations and at new implementation of a accidental and self-harm drowning on the Thames. riverside developments and crossings. program to reduce the b Promote life-saving interventions by training communities b Engage with developers and riparian boroughs to improve number of river related linked to the river in the skills necessary to successfully the provision of public life-saving equipment along the banks suicide and self-harm intervene with a person in crisis; and provide appropriate of the Thames, and fill in any gaps. drownings support to individuals that do. b Work with the NHS, charities, riverside communities and Establish the River b Engage with the London Resilience Forum to highlight the event organisers to expand supervision along the Thames to Thames as an risk of accidental and self-harm drowning on the Thames and support an overall reduction in fatalities. independently establish the Thames as a separate risk area within London. identifiable risk area b In partnership with others, develop and deliver a strategy to b Establish a Forum of partners to develop a Thames Risk support the high numbers of persons in crisis in and around Register. the Thames to establish what immediate care, treatment and appropriate support is available for those affected. b Change behaviours, in and around the water, of those who either witness someone, or who are themselves suffering mental crisis.

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