Developing and implementing a restraint reduction plan

Stephen DavisonWith the 2015 Restraint Reduction Conference just over a week away, Stephen Davidson, Restrictive Intervention Lead from Tees, Esk and Wear Valleys NHS Trust gives us an overview of his Workshop, which will share the experiences and cultural and organisational changes made within the Trust as it developed and implemented its restraint reduction plan.


Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) provides a range of mental health, learning disability and eating disorders services for the 1.6 million people living in County Durham, the Tees Valley and North Yorkshire.

TEWV has over 6,000 staff working out of 180 different sites, and an annual income of £291m. We deliver our services by working in partnership with seven local authorities and clinical commissioning groups, a wide range of voluntary organisations, as well as service users, their carers and the public. The services cover a wide group of specialities with 53 community based services and nearly 1000 inpatient beds, covering a broad geographical area of around 3,600 square miles, which includes coastal, rural and industrial areas.

TEWV were identified in 2014 nationally as high users of restrictive interventions. Over the last two years the organisation has set clear aims to reduce the use of restrictive interventions as part of the Positive and Safe campaign.

In January 2015 the Trust agreed its restraint reduction policy and plans to create a restraint-free culture over the next two years. The plan consists of seven key points:

  • Person-Centred Behaviour Support. Effective use of behaviour support plans based on person centred values and a focus on preventative approaches to behaviour management
  • Safewards. Trialling the approach in key service, learning lessons and considering implementation across all 84 inpatient services
  • Debrief. Building upon national guidance, development of a standardised practical approach to debrief, that is inclusive for all and allows lessons to be learned
  • Reporting and recording. Developing new ways to record the use a restrictive interventions clearly and effectively, supporting staff teams to use this information to improve the services we provide and to help create a no restraint culture within the trust
  • Safe use of Medication. Changing the ways we use this intervention, looking at alternatives, working in coproduction and prioritising the use of behaviour support techniques
  • Seclusion. Understanding our use as an organisation, making it safe and as part of an overall person centred behavioural approach
  • Training. Changing the ethos of training to focus upon the person centred elements of behaviour support, building upon patient interaction and communication and also considering how we can learn lessons for the future in order to support our workforce, service users, their families and carers during these times

Conference attendees are invited to come along to our workshop to hear about how we have implemented our plan, the lessons we have learnt from its implementation and how, as an organisation, we see it shaping and influencing the future of our services.

The Developing a Restraint Reduction Plan Workshop is scheduled to take place on the morning of Thursday 12 November.