'Potentially deadly' restraints still being used on patients with learning disabilities by Notts healthcare trust

Deadly face-down restraint are still used on learning disability patient.
Deadly face-down restraint are still used on learning disability patient.

Learning disability patients continue to be subjected to potentially deadly face-down restraints at the Nottinghamshire Healthcare NHS Trust, figures reveal.

Charity Mencap, which supports people with learning disabilities, says vulnerable patients locked in "modern day asylums" across England are being put at risk of abuse and neglect.

Staff at the Nottinghamshire Healthcare NHS Foundation Trust reported physically restraining patients with learning disabilities or autism at least 1,240 times in the eight months to June, NHS Digital figures show.

The figures cover the period since the NHS first started producing them last year.

Of these, more than 300 instances were in the prone position, which is where a patient is pinned face-down against the floor or another surface.

Mental health charity Mind says face-down restraint carries a significant risk of death because of the severe impact it can have on a patient's ability to breathe, and has called for the Government to implement a ban on its use.

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Guidance from the National Institute for Health and Care Excellence adds that the practice has been known to kill in as little as 10 minutes.

Across England, medical staff reported using restrictive measures – which can also include drugging and seclusion – almost 23,500 times over the same eight-month period.

This included more than 2,500 instances of physical restraint in the prone position.

Dan Corner, head of policy and public affairs at Mencap, said: "Guidance set out by the Government clearly shows that restrictive interventions should only be used as a last resort.

"However, these figures suggest that it is routine. This is unacceptable and deeply shocking.

"The use of restrictive interventions, including holding people face down on the floor, can exacerbate any challenging behaviour displayed.

"The Government must take urgent action to put a stop to this domestic human rights scandal.”

Physical restraint was the most common type of intervention recorded at the Nottinghamshire Healthcare NHS Foundation Trust.

This was followed by mechanical restraint, which is where devices such as cuffs or belts are used to restrict a patient's movements.

Staff used this method 410 times.

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Ben Higgins, chief executive of the British Institute of Learning Disabilities, said poor quality training could lead to some staff using restrictive interventions as a first rather than last resort.

He said: "While the use of restraint may on rare occasions be necessary to keep people safe, it can also be highly traumatic and must be minimised.

"Too often, training puts too much emphasis on reactive approaches such as physical restraint, and places insufficient emphasis on human rights, meeting needs, prevention, de-escalation and recovery."

A Department of Health and Social Care spokeswoman said it was determined to reduce the number of people with autism and learning disabilities in mental health hospitals, and that restraint should only ever be used as a last resort.

"The Care Quality Commission is undertaking an in-depth review into the use of seclusion, segregation and restraint and we are already taking action on their recommendations," she said.

A spokeswoman for NHS England said: "Local NHS services are working closely with patients, families and local authority partners to get appropriate and high quality care for people with a learning disability as early as possible, investing in community care and avoiding the need for intensive inpatient treatment wherever possible."

Dr Deborah Wildgoose, Executive Director of Nursing at Nottinghamshire Healthcare commented: “Nottinghamshire Healthcare has a positive reporting culture and actively encourages incident reporting at all levels.

"This is to ensure we have an open and transparent approach to care and to ensure we learn from incidents. We are unique in that we provide services for people with a learning disability in the community and in inpatient settings, and also those who require specialist high secure care through the National High Secure Learning Disability Service.

"This is to ensure we have an open and transparent approach to care and to ensure we learn from incidents. We are unique in that we provide services for people with a learning disability in the community and in inpatient settings, and also those who require specialist high secure care through the National High Secure Learning Disability Service.

"We are proud of the services we offer in the least restrictive manner possible and the clinical strategy work we continue to develop with partners, service users and families."