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Like-minded organisations in pursuit of restraint-free services

RRN responds to Dispatches exposure of Essex Partnership University NHS Foundation Trust

Just a week after the Panorama exposure of the Edenfield Centre, in which the shocking treatment of patients was reported, we are saddened to witness another example of poor and unacceptable health care in Britain.

The latest Channel 4 Dispatches documentary features the Essex Partnership University Trust and spotlights the continuing safety concerns highlighted for the past 10 years by Melanie Leahy. Since the death of her son many people have died in the setting and yet more experience sub-standard health care, support and treatment.

The findings exposed within the documentary clearly demonstrate the need for a systemic approach to achieving culture change. It was notable that the undercover investigator experienced a stark disconnect between staff training and practices taking place on the ward, demonstrating that training in isolation is not enough to achieve the change that is so desperately needed and that wider culture change that brings together leadership and people with lived experience is crucial.

Unfortunately, what this documentary has exposed is not unique to the Essex Partnership University Trust, nor that of Edenfield which was highlighted in Panorama’s programme last week. Alexis Quinn, Manager of the Restraint Reduction Network, activist and Autism campaigner, said: “Approaches to culture change that disrupt top-down models of health care in which people are powerless to the will of staff working in toxic cultures must be incorporated across the country to challenge the unacceptable practices taking place in too many health and social care settings.

“I have personally been in 12 different hospitals across this country and in each there were elements of inappropriate restrictive practices and unacceptable measures to maintain people’s safety. Training is not a tick box exercise. It should be put into practice and embedded across all organisations and institutions to ensure the rights and dignity of vulnerable people are protected.”

The RRN champions six core strategies to eliminate the unnecessary use of restraint and prevent toxic cultures:

1. Leadership

2. Data collection and analysis

3. Workforce development

4. Using prevention tools and strategies

5. Involving people with lived experience

6. Post incident support and post incident review

It is vital that all six of these strategies are embedded across organisations, utilising practice leadership to help support and embed workforce development and improved practices.

The RRN also supports the three recommendations made following Scotland’s recent independent review on their current mental welfare legislation: give patients who use mental health services a “stronger voice”, reduce restrictive or coercive practices, including the use of restraint and seclusion, and promote the need for positive rights to maximise attainable health and the right to independent living. We believe this should be replicated across the UK.