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Reducing Restrictive Practice & Interventions

Friday 3 February 2017
De Vere West One Conference Centre, London

Reducing Restrictive Practice & Interventions

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.

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"Latest guidance from the Department of Health, Positive and Proactive Care, places an increasing focus on the use of preventive approaches and de-escalation for managing behaviour that services may find challenging.  All restrictive interventions should be for the shortest time possible and use the least restrictive means to meet the immediate need based on the fundamental principles in Positive and Proactive Care. This is supported by the 2015 Mental Health Act Code of Practice which states that -unless there are cogent reasons for doing so, there must be no planned or intentional restraint of a person in a prone position”. NICE guideline NG10: Violence and aggression also recommends avoiding prone restraint, and only using it for the shortest possible time if needed. We recognise that the use of mechanical restraint may be considered to be the least restrictive intervention in some specific cases, and may present less risk to the individual than the alternative of prolonged manual restraint or transfer to a more restrictive setting. This could provide a valid reason for using mechanical restraint in an emergency or 'unplanned" interventions, as well as planned interventions. However, providers should clearly document that any mechanical and physical interventions were considered by a group wider than just the service to assess whether this was the least restrictive option which was in the best interests of the person, and that there were no less restrictive alternatives which were appropriate and proportionate to the risks posed. In line with Positive and Proactive Care, providers should have a policy on the use of restraint and a restrictive intervention reduction programme, for which the board is accountable. Use of all restraint, including any use of mechanical restraint, should always be in line with this policy, and any staff should be appropriately trained. All cases of mechanical restraint should be reported to the trust board.” Care Quality Commission April 2016

"The CQC is committed to using its regulatory powers to ensure that mental health services minimise the use of restraint and other restrictive interventions” Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (Mental Health), Care Quality Commission

This conference focuses on developing positive and proactive care, reducing the need and use of restrictive interventions in health and mental health services. The conference will cover all forms of restraint practice and how they can be reduced in your service. Through national and legal updates, extended sessions and case studies the conference will provide a practical guide to developing and implementing a restrictive intervention reduction programme in practice.

"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 persons freedom; and give as much attention to human rights as we do to safety.” Professor Tim Kendall, National Clinical Director for Mental Health

"Face-down physical restraint is still being used in mental health wards in England, despite the government and the NHS saying it should stop." BBC News September 2016

"We are going in the right direction, but there's a lot of other things that we need to do. When you go to an inpatient unit, you are commonly being restricted. And that's bound to produce a reaction in people, and it's important for all of us to make sure that doesn't end in restraint. For those trusts not changing things in a positive way, or worse [where] still things are not improving, they really need to take note of this.These are real human rights and ethical issues that they should be thinking about." Prof Tim Kendall National Clinical Director for Mental Health NHS England September 2016

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