Call for changes on use of restraint on North East care patients

MENTAL health trusts in the North East are using physical restraint on patients in their care more than anywhere else in the country, a new report reveals.

MENTAL health trusts in the North East are using physical restraint on patients in their care more than anywhere else in the country, a new report reveals.

Data secured by health charity Mind under the Freedom of Information Act reveals that 6,009 patients in the region were restrained in 2011 to 2012.

Northumberland, Tyne and Wear NHS Foundation Trust had the highest number of “face down” restraint incidents in England at 923, while the average for England is just 65. Its total incidents of physical restraint was 2,660.

Meanwhile, Tees, Esk and Wear Valleys NHS Foundation Trust reported the highest number of total physical restraint incidents in the country at 3,346. The average for England is 455.

Health bosses in the North East say that the use of physical restraint in any mental health setting is always used as the last resort after all other options have been exhausted.

They insist that the vast majority of situations are successfully resolved safely through effective staff engagement, communication and de-escalation skills.

But mental health charity Mind is now calling on the Government and NHS England to put an end to face down restraint of people with mental health problems in healthcare settings and provide accredited training in managing violence for frontline healthcare staff.

Paul Farmer, chief executive of Mind, said: “Physical restraint can be humiliating, dangerous and even life-threatening and the huge variation in its use indicates that some trusts are using it too quickly. Face down restraint, when a person is pinned face down on the floor, is particularly dangerous, as well as extremely frightening to the person being restrained.

“It has no place in modern healthcare and its use must be ended. Our research shows that some trusts have a shameful over-reliance on physical restraint and use face down physical restraint too readily in their response to managing a crisis situation.

“We know that healthcare staff do a challenging job and sometimes need to make difficult decisions very quickly, but physical restraint should only be used as the last resort, when there’s no other way of stopping someone from doing themselves or others immediate harm.”

Nationally, there is a significant variation among health trusts using face down physical restraint as some record no incidents in the 12 month period, while Northumberland, Tyne and Wear NHS Foundation Trust recorded almost 1,000.

A spokesperson for the trust said: “Most restraints do not involve the use of the prone (face down) position. The use of any restraint is assessed on an individual case-by-case basis with the safest and most proportionate response used.

“Restraint techniques include the standing, sitting, supine (face up) and prone position, with the prone position used only as an absolute last resort and for the shortest possible time. Most incidents are resolved within minutes.

“As one of the largest mental health and disability trusts in the country, covering two large cities in the North East, we recognise we are one of the highest reporters among those organisations who responded to Mind’s Freedom of Information request.

“Our recorded statistics are comparable to other mental health trusts of similar size and who also provide a similar range of regional and national specialist services.”

A spokesperson for Tees, Esk and Wear Valleys NHS Foundation Trust, said: “The number of incidents may seem high. However, we are one of the largest mental health and learning disability trusts in the country, with over 1,000 beds and a high proportion of specialist units caring for people with extremely challenging behaviour.

“Our staff are fully trained in using a range of techniques to manage people with challenging behaviour and they adopt an individualised approach for each patient.” NHS England said it has set up a Mental Health Expert Safety Group chaired by Paul Farmer, from the charity Mind.

Mike Durkin, NHS England director of patient safety said: “This group will help us to continue to examine safety issues relating not only to mental health services but also whenever a vulnerable patient requires support regardless of the care setting.”


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