Norman Lamb MP writes: Ending face down restraint

Department of health, mental health care reportI am sure that many of you will remember the stories about the Winterbourne View scandal a couple of years ago.  Vulnerable residents with autism and learning difficulties were subjected to shocking abuse from those who should have been protecting and caring for them.  The review that was carried out into the scandal highlighted the widespread and inappropriate use of physical restraint, including dangerous face-down restraint, at the hospital.

As a Liberal Democrat I am committed to tackling poor quality care, and ensuring that everyone in our society is treated with the dignity and respect they deserve.  Physical restraint should only ever be used as a last resort, and never to punish or humiliate someone.

The best health and care organisations hardly ever use restraint: evidence shows that with the right positive strategies for managing behaviour the number of situations where restraint becomes necessary can be dramatically reduced.  But there are other organisations where restraint – including dangerous face-down restraint – continues to be used far too often.

Earlier this week, I met Richard, Gary and Sam. They all spoke very powerfully of their experiences of restraint. It was very clear that the trauma of restraint stays with people for a long time. When you hear directly from people who have been scarred by this treatment it makes you very determined to achieve change.

This week, I have published Positive and Proactive Care, a new set of official guidelines aimed at reducing the need for restrictive practices in adult health and care.  We are making clear that face down restraint, or other restraint which blocks breathing or circulation, is not acceptable and should never be used deliberately.

And I believe that we have the chance to succeed. It’s not just a policy document which will gather dust on a shelf. The Government is committing £1.2 million to a two year training programme to help change culture and to enable staff to build a positive environment where the need for restraint is significantly reduced.

I want people across the health and care system to sign up to be champions of change to help make this happen.

And for those organisations which think that they can carry on with business as usual, they need to understand that there will be consequences. When the CQC carries out the new, far more robust, inspections of providers that is currently being developed, they will assess compliance with this guidance. Serious failure to ensure a positive therapeutic environment with resulting harm to service users would amount to a breach of the new fundamental standards of care we are introducing later this year. This could, in future, lead to prosecution. These changes have teeth!

And the new guidelines go further than simply tackling inappropriate physical restraint.  Many people who have come into contact with mental illness will know that the use of drugs to control behaviour can be every bit as demeaning and cruel.  The new approach makes clear that the use of chemical restraint must only ever be a short-term strategy to reduce immediate risk.  Care and support must be grounded upon the principle of recovery, aimed at enabling people to live fulfilled and socially-integrated lives.

In the coming months, I will be monitoring closely the progress that is made in tackling the inappropriate use of restraint.  For people to be subjected to dangerous or harmful restraint is simply not compatible with my vision of a liberal society.  People must receive help, not harm, from our health and care system.  I want to see all mental health patients receiving the best possible care, to create a fairer society in which everyone can get on in life.

* Norman Lamb is MP for North Norfolk and was Liberal Democrat Minister of State at the Department of Health until May 2015. He now chairs the Science and Technology Select Committee

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