Royal College of Psychiatrists praises dramatic cut in use of ‘restrictive practice’


The Royal College has issued a press release today (Tuesday 17 September, 2019)  highlighting the 56% reduction in the use of physical restraint, seclusion and rapid tranquilisation on our Nostell ward at Fieldhead Hospital. It comes nine months after we joined an 18 month improvement programme led by the Royal College of Psychiatrists.

Nostell ward provides inpatient care for people who are in crisis who cannot live safely in their home environment. The ward caters for people with a wide variety of mental health problems, who are acutely unwell and who need to be admitted to hospital.  

Nostell ward is part of our new £17m Unity Centre which features state-of-the-art therapeutic areas, en-suite bathrooms and vastly improved relaxation areas to help people in our care on their journey to recovery.

After 9 months of the 18-month Reducing Restrictive Practice programme, staff on Nostell ward reduced their use of ‘restrictive practices’ by 56%. The reductions have been achieved using innovative methods of care, including changing access rules to areas that were previously restricted by time or location, such as the patient’s therapy area. The national 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.

Nostell Ward has reduced the average monthly use of restrictive practices from 20 at the start of the programme to nine.  The programme is using a new way of improving patient care. It focuses on involving 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. It is the first-time quality improvement has been used nationally in England for mental health, with almost half of England’s mental health trusts taking part.

Dr Amar Shah, The Royal College’s 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.” 

Our Medical Director, Dr Subha Thiyagesh, said: “It’s fantastic that the Royal College of Psychiatrists is celebrating the hard work of staff and people in our care on Nostell ward. This is a huge achievement of which all involved can be very proud. We are driving up quality across all areas of the Trust and were very pleased that the Care Quality Commission recently rated us as ‘good’, recognising the improvements we have and the strength and quality of the services we provide. Inspectors also noted that acute wards for adults of working age and psychiatric care units have improved. As a learning organisation we are delighted to be working with the Royal College as part of the reducing restrictive practice programme and will continue to engage with local, regional and national partners as we constantly strive to improve and offer outstanding care.”


Royal College of Psychiatrists praises dramatic cut in use of ‘restrictive practice’

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