A TOP doctor said health chiefs should ‘carefully look into’ the use of face-down restraint on East Lancashire’s mental health wards.
Dr Tim Kendall, a professor at University College London and medical director at Sheffield’s mental health trust, says his organisation phased out the dangerous and discredited technique in 2012, after complaints from a group of patients.
The call comes after a Lancashire Telegraph investigation revealed the extent to which prone restraint, where patients are pinned face-down to the floor, and other restrictive practices have been used in Blackburn and Burnley’s mental health unit.
A series of Freedom of Information requests suggested a surge in cases last year, while Lancashire Care NHS Foundation Trust, which runs the units, was second highest user of the technique in England.
Meanwhile, a whistleblower said there are ‘cultural problems’ at the trust, especially on the East Lancashire wards, as data pointed to disproportionate use of prone restraint and other restrictive practices.
Sheffield Health and Social Care NHS Foundation Trust phased out prone restraint in 2012 after complaints from a group of Afro-Caribbean patients.
Its standard control and restraint training programme was scrapped and replaced by a new package called Respect, which did not include prone restraint and focussed more on de-escalation methods and understanding the causes of patients’ challenging behaviour.
Dr Kendall said there were no problems in implementing the changes, which also led to a reduction in other types of restraint techniques, and added: “We discovered the training programme we’d been using was actually making things worse, and we wanted to implement a cultural change in which staff would try to develop relationships with patients from the start of their care.”
Lancashire Care said improved reporting of incidents may have been a factor in the rise in prone restraint in East Lancashire, from 383 in 2013 to 600 in 2014, but staff and union officials pointed to greater use of agency workers and a reduction in experienced nurses.
Dr Kendall said all three of these explanations could be valid and the trust should ‘carefully look into the issue’.
Staff at Lancashire Care were still being trained to use prone restraint until December, but the trust has now ordered it to stop being used by April.
Meanwhile, Blackburn with Darwen Clinical Commissioning Group, which commissions services from Lancashire Care, said: “We have assurances that significant progress to reduce the use of prone restraint has already been made and will continue to monitor this progress to ensure its phased out completely by the end of April 2015.”
It also claimed the trust is ‘leading the way nationally’ with regard to implementing government recommendations which include reducing restrictive practices and banning prone restraint, and recording accurate data.
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