'Staggering' results at Yorkshire mental health hospital where use of restraint cut by half

A Yorkshire mental health hospital has achieved “staggering” results in cutting the use of tranquilisers and physical restraint by half, thanks to a new programme created by psychiatrists.
Staff on Nostell Ward have reduced the amount they're restraining people by halfStaff on Nostell Ward have reduced the amount they're restraining people by half
Staff on Nostell Ward have reduced the amount they're restraining people by half

Fieldhead Hospital in Wakefield joined the Royal College of Psychiatrists’ improvement programme at the start of the year and since then has seen restrictive practices fall by 56 per cent.

Also in news: Sky to open new creative studio in LeedsThe reductions have been made by changing the rules of areas that were previously restricted - such as the patients’ therapy area - allowing patients more freedom to access to different areas at different times.

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Nostell Ward, which is running the Mental Health Safety Improvement programme, as it is known, has reduced their average monthly use of restrictive practices from 20 at the start of the programme to nine, despite being only halfway through.

Staff reported needing to use less rapid tranquilisation, physical restraint and seclusion, which are measures that are normally taken to keep patients and staff safe in escalating situations.

The programme is a pilot and is using what is called “quality improvement”, which focuses on those closest to the issue – staff, service users and carers - to identify and test new ideas, and uses data to understand which ideas are working.

Nostell Ward created 24/7 access to the drinks trolley and access to the lounge. Staff also ensured patients have open access to the therapy corridor.

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It is the first-time quality improvement has been used nationally in England for mental health.

Also in news: Prof thanks the same hospital team that saved his and his wife’s lives four years apartDr Amar Shah, national lead for the Mental Health Safety Improvement programme, said: “The results achieved by Nostell Ward so early in the programme are staggering and shows what can be done when staff and service users come together to test out their ideas to improve care.

“Quality Improvement gives staff and service users the freedom and opportunity to develop new ideas, test these out and measure progress in real-time.

“While we are only half-way through the programme, we are seeing improvements such as these in many of our participating wards. This is truly inspiring, as restrictive practice is a complex topic where we’ve struggled to see improvement through other approaches.”

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The pilot was announced at the end of 2018, after Dr Paul Lelliott, Deputy Chief Inspector of Hospitals, said there was “understandable public concern” about the use of restrictive measures on patients, especially as hospitals had varying rates.

Kathryn Mason, head of hospital inspection (mental health) at the Care Quality Commission, said: “We have long been concerned about how frequently staff use restraint and seclusion and how this varies from service to service, in response to behaviour that may be challenging.

Also in news: Heartbroken Leeds mum: 'He was brave and he was angry - he didn't want to die'“It is encouraging to see such positive results so early on in the Mental Health Safety Improvement programme and we hope this translates into long-term improvements.

“The reductions have been achieved by involving patients, carers and staff in the programme which highlights the importance of enabling patients to be full partners in decisions about their treatment and care.”

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NHS data shows there were 99,609 recorded cases of restraint in England in 2017-18, including 10,881 instances of people held in the prone position and 52,498 other types of physical restraint.

Patients were kept in seclusion rooms on 8,805 occasions and tranquilised 8,718 times.

The Reducing Restrictive Practices programme, which launched in November 2018 and concludes in March 2020, aims to reduce the use of restrictive practices by one third in 41 wards across 25 mental health trusts.