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Reducing restrictive practice in mental health

In July 2019 NHSE/I launched the Patient Safety Strategy which highlighted safety as the biggest concern for mental health services. An aim was set to reduce restrictive practice by a third by April 2020 and an improvement collaborative formed.  Following this, Patient Safety Collaboratives were commissioned to reduce restrictive practice in their regions by 50% by March 2024. These aims focused directly on reducing incidents for patients.

Restrictive practice word cloudAs part of this programme, the Oxford AHSN Workforce Innovation team collaborated with the Oxford Patient Safety team to understand restrictive practice from the staff’s perspective. Themes which emerged included the importance of clear communication and the need to create space for staff to think about how to co-design improvements with patients.

The impacts recorded by staff who have undertaken restrictive practice were captured in the word cloud, left.

Twelve improvement ideas were gleaned as to how restrictive practice could be reduced including:

  • Developing a ward video on restrictive practice through a patient’s experience and capturing how it feels for staff
  • Targeted restraint drills to improve team communication
  • One page profile on the patient’s likes/dislikes and management skills for an escalating scenario
  • Individual care planning with the patient
  • Improved communication between staff.

The Oxford Patient Safety Collaborative is leading on a regional Mental Health Safety Improvement, programme including reducing restrictive practice. Please contact nigel.sims@oxfordahsn.org for further information.

Please contact katie.lean@oxfordahsn.org for further information on the workforce report.