Investigations into abuses at Winterbourne View Hospital and Mind’s Mental Health Crisis in Care: physical restraint in crisis showed that restrictive interventions have not always been used only as a last resort in health and care.
They have even been used to inflict pain, humiliate or punish.
Restrictive interventions are often a major contribution to delaying recovery, and have been linked with causing serious trauma, both physical and psychological, to people who use services and staff. These interventions have been used too much, for too long and we must change this.
There is overwhelming support for the need to act. Over 95% of respondents were supportive in consultation. The Royal College of Nursing Congress voted by 99% in favour of new guidelines.
Whilst I appreciate there may be times when restrictive interventions may be required to protect staff or other people who use services, or the individuals themselves, there is a clear and overwhelming case for change.
This is about ensuring service user and staff safety, dignity and respect. This is absolutely not about blaming staff.
Whilst at Winterbourne there was clearly abuse and this must not be allowed to happen, we know that many staff have just been doing what they have been trained to do and have been struggling in difficult situations and often with very little support.
We need to equip these individuals with the skills to do things differently. The guidance makes clear that restrictive interventions may be required in life threatening situations to protect both people who use services and staff or as part of an agreed care plan.
Together Positive and Proactive Care and A Positive and Proactive workforce provide a framework to radically transform culture, leadership and professional practice to deliver care and support which keeps people safe, and promotes recovery.
I want to thank the Royal College of Nursing for leading the multi-professional consortium who led on developing the Department of Health’s guidance, and Skills for Care and Skills for Health in developing the complementary guidance to support the commissioning of learning and development.
This was a great example of organisations working together to deliver high quality products that affect all of us.
This guidance is only one part of the story.
The department is launching a new, wider 2 year initiative Positive and Safe to deliver this transformation across all health and adult social care.
We will identify levers to bring these changes about including improving reporting, training and governance. We will also develop accompanying guidance in relation to children, young people and those in transition in healthcare settings.
I look forward to working with colleagues to co-produce this programme.
Through Positive and Safe we have the potential to make whole scale system-wide changes, ensuring we have a modern, compassionate and therapeutic health and care service fit for the 21st century.