DH launches new controls on patient restraint
New guidance to stop the “outdated” and potentially “dangerous” use of physical restraint on care patients have been launched by the Department of Health.
It means health staff will be urged to avoid the controversial use of deliberate face-down restraint, a method used to pin patients to the ground and physically prevent them from moving.
There are concerns it can result in dangerous compression of the chest and airways and put the patient at risk, the DH said.
Care minister Norman Lamb said the new guidance will stop the inappropriate use of all restrictive interventions, including seclusion and chemical restraint.
It follows a government investigation into the 2011 Winterbourne View Hospital scandal, where staff were found to be using restraint as a way to abuse patients.
A similar study by the charity Mind also found that restrictive interventions were being used for too long, often not as a last resort and even to inflict pain, humiliation or to punish patients.
Mr Lamb said: “No one should ever come to harm in the health or care system. Although it is sometimes necessary to use restraint to stop someone hurting themselves or others, the safety of patients must always come first.
“This new guidance will stop inappropriate use of all types of restraint, reduce this outdated practice and help staff to keep patients safe.”
The guidance has been led by the Royal College of Nursing and developed jointly by health and care professionals and patients.
“Nurses have been at the forefront of developing the new approach”
Dr Peter Carter, chief executive and general secretary of the RCN, said: “Nobody wants to see a repetition of the horrific events of Winterbourne View.
“Nurses have been at the forefront of developing the new approach, which is the result of committed co-operation between professionals, and which makes use of the views of those who have experienced physical intervention.
“This moment is a major step forward in making difficult situations more manageable, and it is at the heart of compassionate care.
“The government’s resolve in bringing about this change is to be applauded and the RCN will be working with them to make this approach a reality for all vulnerable people.”
The DH is providing £1.2m for staff training in the new guidelines, which are called Positive and Proactive Care.
The guidance says there might be a rare occasion when staff need to restrain people, such as stopping someone from harming themselves, but that it must be used only as a last resort and for the shortest time possible.
“Physical restraint can be humiliating, dangerous and even life-threatening”
Paul Farmer, chief executive of Mind, said the guidance marks a “significant step” towards changing attitudes to restraint.
“We know that healthcare staff do a challenging job and sometimes need to make difficult decisions very quickly,” he said.
“This is comprehensive guidance that looks to address the system as a whole, transforming cultures and attitudes so that difficult situations are less likely to arise and so that staff are supported to use alternatives to restraint when faced with challenging behaviour,” he added.
“When someone is in a mental health crisis they need help, not harm. Physical restraint can be humiliating, dangerous and even life-threatening and our own research indicates that some trusts are currently using it too quickly.”