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There were many factors impacting on implementation of the toolkit, including high staff caseloads, technical difficulties and lack of training, but staff and relatives were generally positive about the concept.

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Fiona Lobban 1,*, Duncan Appelbe 2, Victoria Appleton 1, Golnar Aref-Adib 3, Johanna Barraclough 1, Julie Billsborough 4, Naomi R Fisher 1,, Sheena Foster 4, Bethany Gill 1, David Glentworth 5, Chris Harrop 5, Sonia Johnson 3, Steven H Jones 1, Tibor Z Kovacs 5, Elizabeth Lewis 1, Barbara Mezes 1, Charlotte Morton 3, Elizabeth Murray 6, Puffin O’Hanlon 3, Vanessa Pinfold 4, Jo Rycroft-Malone 7, Ronald Siddle 5, Jo Smith 8, Chris J Sutton 9, Pietro Viglienghi 5, Andrew Walker 1, Catherine Wintermeyer 1

1 Division of Health Research, Lancaster University, Lancaster, UK
2 Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
3 Division of Psychiatry, University College London, London, UK
4 McPin Foundation, London, UK
5 Participating NHS trust, , UK
6 Research Department of Primary Care and Population Health, University College London, London, UK
7 School of Health Sciences, Bangor University, Bangor, UK
8 School of Allied Health and Community, University of Worcester, Worcester, UK
9 Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
* Corresponding author Email:

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