Skip navigation

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice

Tuesday 22 September 2015
ICO Conference Centre, London

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice

This event has now past, but there may well be news on the event including presentations and quotes from the day at our News pages here, a full list of our forthcoming events is available here.

Follow the conference on Twitter #NHSrestraint

“In April 2014 the government announced a drive to end face-down restraint. The new guidance forms part of a two-year strategy to overhaul the outdated use of restrictive interventions – such as face-down restraint, seclusion and rapid sedation – in all health and care services. The guidance stated that: “Staff must not deliberately restrain people in a way that impacts on their airway, breathing or circulation, such as face down restraint on any surface, not just on the floor.”

NEW: NICE have today released new guidance on safeguarding NHS staff from violent and aggressive patients. 

The guideline recommends that physical restraint should only be used as a last resort, once all other methods of preventing or calming the situation have failed. However, if restraint is the only course of action available, the guideline includes clear recommendations on how it should be done to ensure the safety of both staff and the individual.  Professor Tim Kendall, Director of the National Collaborating Centre for Mental Health, who was also involved in developing the guideline, added: “We now want to see a culture of tolerance towards people with mental health problems, helping health and social care professionals to de-escalate difficult situations and help service users get the support they need when circumstances in the health service can make things worse. “We want to reduce the times when we restrict people who are wound up by mental health problems and placed in restrictive environments. We are recommending that every trust has a restrictive interventions reduction programme. We also want to develop a culture of learning, such that service users and professionals together can review every time we restrain or restrict a person’s freedom; and give as much attention to human rights as we do to safety.” 29th May 2015, NICE

“This guideline recommends that taking service users to the floor during manual restraint should be avoided, but that if it is necessary, the supine (face up) position should be used in preference to the prone (face down) position. The Winterbourne View Hospital: Department of Health review and response reported that restraint was being used to abuse service users. Mind's Mental health crisis care: physical restraint in crisis found that restrictive interventions were being used for too long, often not as a last resort, and sometimes purposely to inflict pain, humiliate or punish. Mind also reported that in 2011/12 the prone position was being used, in some trusts as many as 2 to 3 times a day. This position can, and has, caused death after as little as 10 minutes, by causing a cardiac event. Consistent implementation of these recommendations will save lives, improve safety and minimise distress for all involved.” NICE 2015

Chaired by Eric Baskind, Senior Lecturer in Law and International Expert on Physical Interventions Liverpool John Moore’s University, through expert sessions and case studies this conference will look at the practical implementation of this guidance a year on including in depth interactive sessions focusing on perspectives on the ban, ensuring staff are not put at risk, understanding restraint positions in terms of outcome, safety and efficacy Including alternatives to PRONE/Face Down Restraint, a detailed look at how Sheffield Health and Social Care NHS Foundation Trust have implemented a ban on face down restraint in practice, alternative and emerging models of de-escalation, engaging with service users, ensuring incident investigation and debriefing and finally an extended legal update. 

Future Mental Health events of interest

For mental health practitioners and those working in mental health or with a specialist interest in mental health, psychiatry and psychology.

BASWGood Governance InstituteMental Health PracticeSouth Staffordshire and Shropshire Healthcare NHS Foundation Trust
GGI (Good Governance Institute) accredited conferences CPD Member ASGBI (Association of Surgeons of Great Britain and Ireland) professional partner BADS (British Association of Day Surgery) accredited conferences