RCN: Restriction and restraint policy needs more evidence

The RCN is calling for evidence to support the Department of Health’s (DH) bid to reduce the use of force and restraint in nursing practice.

In a report published this week, the RCN supports the aims of the DH's Positive and Proactive Care policy document, published in 2014, but the college said this needs to be balanced ‘with the harsh realities of clinical practice’.

RCN's Positive and Proactive Care: Reducing the need for restrictive interventions report cites NHS Protect figures that claim there were nearly 68,000 assaults on staff in 2014/15.

The RCN report, written by the RCN forensic nursing forum, said it is recognised that nurses are struggling in difficult situations. It was written following a series of roadshows organised to inform nurses about the DH report.

Highlighted issues

The college highlights specific concerns regarding the ‘banning’ of face-down (otherwise known as prone) restraint, the process for reviewing incidents and the wholesale implementation of Positive Behavioural Support in mental health services.

It goes on to argue there is a lack of evidence around these policies, and even that evidence contradicts the guidelines laid out in the DH's report, which was published in the wake of the Winterbourne View Hospital scandal and resulting investigation in 2012.

Repeating its call for the regulation of training in the use of restraint, the RCN report notes this remains high on the agenda for the college.

The college originally called for UK accreditation and regulation of training provision regarding physical restraint in 2013. This was debated at RCN congress in the same year and passed by 99.8% of the voting members.

RCN professional lead for mental health Ian Hulatt, who helped produce the report, said: ‘Congress made clear that this needs to be a field where there is accreditation or regulation. There are over 600 providers of this training across the country but the forum felt that it would be progress to have standard guidelines for this.'