The value of graduates in the nursing workforce has been recognised in the move to all-graduate preparation of pre-registration nurses in England ( Nursing and Midwifery Council, 2010 ). Increasingly, after registration continuing professional development programmes for nurses are being offered at Master's level. However, there is limited evidence of the relationship between postgraduate study and improved patient outcomes. Evidence that does exist suggests that nurses who engage in postgraduate study are more likely to have improved critical thinking and decision-making skills, demonstrate leadership qualities to empower them to challenge poor practice, and have the skills needed for advanced clinical practice roles. This article explores these issues and makes recommendations for further work in this area.

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Background Very little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England. Methods We included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients’ characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD). Results 387 children aged 5–12 years presented to the study hospitals in 2000–2016, 39% of whom were 5–11 years. Boys outnumbered girls 2:1 at 5–10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year. Conclusions Gender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5–10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention.

This article discusses the experience of one university in the development, implementation and evaluation of a modular programme of study for practitioners working with people with long-term conditions. It addresses the complexity of developing a curriculum in response to Department of Health initiatives, at times pre-empting central guidance. It highlights the importance of partnership working underpinning every aspect of programme development. The article provides some context for the policy initiative, discusses some of the challenges in programme design, content and the requirement for work-based learning. The assessment, learning and teaching strategies are described, highlighting some of the benefits of portfolios as a means of evidencing and enhancing learning. Evaluation and progress of the programme to date is shared, highlighting some future challenges. This includes ensuring that the programme continues to complement other courses and that modules meet future challenges, including the Nursing and Midwifery Council requirements for advanced practice.