Improving safety and outcomes of mental health care
The Mental Health Safety Improvement Programme (MHSIP) aimed to reduce the incidence of restrictive practice in inpatient mental health, learning disability and autism services by 25% by September 2023. Fourteen wards across four organisations participated in the programme from across the South West, supported by Health Innovation South West.
Restraints and seclusion are examples of restrictive practices that can sometimes be used on inpatient mental health, learning disability and autism wards when there is an immediate risk of harm to members of staff, the patient or other service users.
Although restrictive practice is sometimes the only option to keep everyone safe from harm, it can have an adverse impact on the safety of patients and staff. It can hamper recovery and prolong length of stay in hospital. Poor patient experience can lead to subsequent disengagement from services leading to worse outcomes.
Working as part of a Mental Health Collaborative of 5 Health Innovation Networks and 16 NHS Trusts, Health Innovation South West supported Mental Health providers to develop a safety and learning culture, build Quality Improvement capability and test ideas to reduce restrictive practices.
Fourteen wards across four organisations participated in the programme from across the South West.
Ward teams used Quality Improvement methods to help them understand and change their ward systems, working ‘upstream’ to encourage more proactive care and reduce situations when restrictive practices become needed.
Along with Workstream Leads from across the South of England, Health Innovation South West ran the Mental Health Collaborative learning events and coaching sessions, which provided the network for the programme, enabling people in different Trusts to come together to share experience and learning, and strengthen motivation for their improvement work. We also ran groupwork exercises to help staff generate new ideas for change, plan tests of change, and undertake sustainability and planning.
The programme has seen a pattern of strengthened engagement. Some indicators of this are increased attendance at the MH Collaborative events, successful business cases within Trusts to strengthen QI teams, sponsors engaging and helping to launch projects on suitable wards with higher levels of restrictive practice, and the results being achieved by projects in the South West.
The National MHSIP programme is now closed and South West mental health inpatient providers will be continuing their local work to reduce restrictive practices. They will also have the opportunity to join the new Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme from early 2024, which is being launched by NHS England.
Our expertise in Quality Improvement and partnership working in the South West will now be channelled into our broader Peninsula Research and Innovation Partnership Mission on Mental Health, Learning Disabilities and Neuro Diversity working in partnership with our three Integrated Care Systems, two universities and NIHR. Through this partnership and the relationships developed through the Mental Health Safety Improvement Programme, we are in an ideal position to support future improvement opportunities in inpatient care, as well as the broader mental health system.
- The success of the programme was seen through increased engagement in the programme and resulted in positive tests of change which improved outcomes for patients and staff.
- Many wards have reported positive feedback about being involved in this work and it having an impact on their ward.
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I was hugely impacted by being restrained. I can’t really put into large enough words what that re-traumatisation has done to me. If people don’t know me well enough, or know about my history, there is a huge likelihood that I will be restrained. If we give the staff the skills and the tools and the understanding of why sometimes someone might behave in that way, but we do it long before it gets to a crisis point where they have to do that, I think we’re already thinking about prevention.
Patient's experience
