**Implementation**

One OOH practitioner felt that the leaflet would be very difficult to implement in OOH settings. *"so I* work *in out of hours as well and the, it's not something that I routinely translate across into out of hours* . . . *there are certain things that you have to follow when you do out of hours work."* Nurse practitioner 3 *(Environmental context and resources)*

CCG stakeholders reported that high turnover of care staff makes implementation difficult. *"It was a two day course and it's like painting the Forth Bridge, due to the turnover. Somebody said to me, what about the rest of (location) and I said, that's a full time job."* Stakeholder 3 *(Environmental context and resources)*
