NHS Lanarkshire,

Headquarters,

Kirklands,

Fallside Road,

Bothwell

G71 8BB.

Continued


Date3 September2013

ReferenceFOI/LCB

Enquiries toLinda Brownlie

Telephone01698 858110

Continued


Dear Sir/Madam

Further to your enquiry of 5 August 2013under the Freedom of Information Act, please find our response below. In your request you asked for the following information in relation to the NHS policy on physical restraint and rapid tranquilisation of psychiatric inpatients:-

  1. What type of physical restraints are approved?
  2. Is prone (face down) restraint used in NHS Lanarkshire Psychiatric Institutions?
  3. How many separate incidents of physical restraint have taken place in NHS Lanarkshire Psychiatric Institutions in the years 2010, 2011 and 2012?
  4. How many separate incidents of rapid tranquilisation have taken place in NHS Lanarkshire Psychiatric Institutions in the years 2010, 2011 and 2012
  5. Has NHS Lanarkshire implemented the Scottish Patient Safety Mental Health Programme on Restraint, Seclusion and Emergency Sedation Action Package?
  6. If no to (5) when and how are carers, guardians, and or the named person notified that such a method has been used?
  7. Provide copies of all internal and external correspondence relating to physical restraint and rapid tranquilisation, whether paper or Internet based

Response

Physical Restraints

Prevention and management of violence and aggression (PaMOVA) training is provided by the NHS Lanarkshire occupational health, safety and return to work service. All PaMOVA tutors are registered with/accredited by the General Services Association (GSA).

The approved physical restraint techniques practised within NHS Lanarkshire are as per agreed core curriculum of physical intervention skills approved by the GSA. These include face up, face down and seated restraints.

Prone (face down) restraint is used within the NHS Lanarkshire mental health and learning disability service.

Incidents of Restraint

I regret to advise that I am unable to provide you with the number of incidents of physical restraint or rapid tranquillisation within the mental health and learning disability service. This information is not centrally recorded.

To find this information would require a review of case notes within each individual patient record to ascertain if restraint had been used over the period you request. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

Scottish Patient Safety Mental Health Programme

NHS Lanarkshire is involved in the national Scottish Patient Safety Programme which includes seclusion and restraint. The focus is very much on prevention and improving practice. NHS Lanarkshire is also represented on the national group working with the Scottish Patient Safety Programme looking specifically at restraint.

Following the work with the Scottish Patient Safety Programme, NHS Lanarkshire has introduced a debrief process following any episode of restraint.

Correspondence

The following documentation is used for guidance:-

Prevention and Management of Violence and Aggression to Staff Policy (attached)

Mental Welfare Commission Rights Risk and Limits to Freedom (attached)

Mental Welfare Commission Zero Tolerance (attached)

NHS Lanarkshire Rapid Tranquillisation policy (attached)

Regarding the future of restraint, past errors and practice now unacceptable, the guidance of the GSA continues to be followed and all techniques taught are part of the agreed GSA core curriculum. Their techniques are reviewed on an ongoing basis and the tutors are advised of any changes through annual tutor updates as and when required. There is also a tutor forum which facilitates the sharing of information and best practice.

The attached information represents documentation and information that has been located centrally. To locate all internal and external correspondence relating to physical restraint and rapid tranquillisation would require a manual search through our records and gathering this information would be prohibitive in both terms of time and cost. This, as you possibly know, constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002. I do hope, however, that what has been provided is of assistance to you.

I hope this is to your satisfaction. If you have any further queries on this please do not hesitate to contact me.

If you are not satisfied with this response to your original request we can advise you that you do have a right to a review under section 20 of the Freedom of Information (Scotland) Act. For this review you should write to Rosemary Lyness, Director of Nursing, Midwifery and AHPs, NHS Lanarkshire, Kirklands, Fallside Road, Bothwell G71 8BB or by email to thin 40 working days of 3 September2013.

If, following the outcome of a request for review, you are still dissatisfied I can advise you that you have the right to make application for a decision by the Scottish Information Commissioner under Section 47(1) of the Freedom of Information (Scotland) Act 2002. The Commissioner can be contacted at Kinburn Castle, Doubledykes Road, St Andrews, Fife KY16 9DS or by telephone on 01334 464610, by fax on 01334 464611, and by E-mail at

Yours sincerely

Linda Brownlie

Freedom of Information Officer

NHS Lanarkshire