• New clinical model reduces use of restraint by over 20 per cent in medium secure unit
  • West London Mental Health Trust introduced the new model when it opened new building at Three Bridge secure unit
  • Modeal has reduced physical restraint by 21 per cent and medication led restraint by 60 per cent

A mental health trust has reduced patient restraint by a fifth in one year under a new clinical pathway at its purpose built medium secure unit.

West London Mental Health Trust opened Thames Lodge at its Three Bridges secure unit in February 2016.

The whole unit houses 114 male medium secure mental health patients from across eight London boroughs.

As well as opening the new unit, the trust introduced a new clinical model, which it says has reduced the overall use of restraint by 21 per cent - falling from 298 cases in 2015 to 233 in 2016.

The number of physical restraints at the unit fell by 21 per cent from 265 in 2014 to 209 in 2016, while from 2015 to 2016 the use of medication led restraint fell 60 per cent to just 24 instances.

Male medium secure clinical lead Satinder Sahota said the new clinical model has moved away from patients being moved through the system based on the decisions of clinicians. Now, when a patient is admitted to the unit, the doctors, nurses and patient agree on a set of outcomes as part of a personalised recovery plan.

These give clear goals for patients to achieve before they can move from assessment wards to rehabilitation wards and finally to discharge.

Each stage of the plan is split into four sections based on the patient’s mental health, risk, behaviour and discharge planning. Once a patient achieves all the goals of one stage they can progress to the next.

Dr Sahota told HSJ that the model has helped improve patient safety and the patient experience on the seven wards.

He added: “What we are seeing after 12 months, patient safety and the patient experience is a lot better than it was.

“It’s taking a little of the clinical decision making away from clinicians and putting it into the hands of teams and patients, giving them a much clearer idea of what they have to do to move on and progress along the pathway.

“It’s taking away the idiosyncrasies and uncertainty for the patients and taking away some of the not knowing what’s expected of them at a much earlier stage.

“The model has allowed us to eliminate a lot of restrictive practices; all of these are moving in a positive direction.”