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Safety Without Compromise: Restraint & Safety 2021 Conference

News and updates from today's Safety Without Compromise 2021 Conference 

Follow the event on Twitter #restraintandsafety

Minimising the use of restraint and physical interventions

Verity Chester

Network Manager Radiant (Research and Developmental Neuropsychiatry)
Research Associate
Hertfordshire Partnership University NHS Foundation Trust
and Co-Author of Royal College of Psychiatrists Report into Restrictive Interventions in Inpatient Intellectual Disability Services

• minimising the use of restraint and physical interventions
• training and educating frontline staff
• which skills and interventions?
• engaging with people who use services
• demonstrating reduction in restrictive interventions 

Opening today's conference is Verity Chester who is speaking about minimising the use of restraint and physical interventions

She spoke about how numbers are a problem in restrictive interventions as they do not uncover poor/ abusive practise. Therefore data has to be there when looking at RI.

Furthermore numbers do not capture- behavioural incidents, live nature of the environment or the contextual information.

“We need to move from just looking at numbers and look at more robust options”

Verity carried on the conversation by speaking about benchmarking. She said there is a lack of publicly available objective benchmarks which tends to mean that rates are compared to subjective experiences. If a patients characteristics are not taken into account this means that we are not learning from which patient groups are to be at more risk of restrictive interventions.


Medical considerations of managing violent, challenging, disturbed and aggressive behaviour Medical safety: going beyond current thinking

Dr Anthony Bleetman
Consultant in Emergency Medicine & Former Specialist
Committee Member, Violence and Aggression National Quality Standard, NICE
Honorary Clinical Associate Professor
University of Warwick Medical School
Medical Advisor
Ministry of Defence


• explaining why people may present with challenging behaviour
• identifying and dealing with medical emergencies
• assessing medical safety for an organisation – staff fitness to train and be trained
• how we review a syllabus to ensure safety
• improving staff welfare
• how to ensure everyone's safety during the intervention

Started his talk by reminding us how not in the too distant past there very old ways of restraining. Since the 1990s, things started to change, as we started to report incidents to understand the challenges and look at training. Look at safety of staff and service users

Discussed the medical considerations and the aims and highlighted how the “needs for each organisations are different”

To get it right we need a multidisciplinary approach; law, guidelines and ethics, behavioural experts, environmental, medical, occupational health, training delivery.

Tony talked through the process of assessing medical safety for an organisation. This process starts with understanding the organisations structure, size, environment and service users.

Tony finished by summarising that we now understand the needs, vulnerabilities, limitations of our staff and service users, we also understand medical and legal issues better.