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Shared Learning: The Value of NHS Physical Restraint Training

Shared Learning for all Health Boards

Learning and Insight

In all inpatient mental health inspections, we check staff are compliant with restrictive physical restraint training. This is because physical restraint can be harmful to patients or staff if not conducted properly or safely. Training, and refreshers of training, are vital in ensuring patients and staff are protected from injury.

Three of our recent NHS inpatient mental health inspections found very low levels of compliance with this training, as low as 16% in one ward


This poses a significant risk to patients and staff. In addition, we checked recent records of incidents of restraint in these inspections and noted non-compliant staff had been involved in incidents. Again, this poses a significant risk to the patients and staff involved, and we are not assured patients or staff are protected and safeguarded from injury. 

Some of our inspections also noted physical restraint policies were out of date, and some records of incidents involving restraint were difficult to locate, navigate, or contained insufficient detail. Again, this poses a significant risk to patients and staff should someone be injured due to incorrect restraint.

We understand that some face-to-face training has been delayed due to the pandemic. However, it is important health boards ensure staff remain compliant with training to protect patients and staff from the risk of injury.

In summary, we advise health boards should:

  • Retain accurate information on all staff mandatory training compliance
  • Ensure all relevant staff complete full or refresher training as soon as possible
  • Maintain an ongoing programme of refresher training
  • In the absence of all staff being compliant, ensure all shifts have at least one compliant member of staff
  • Ensure policies on the use of physical restraint are up to date
  • Ensure records of incidents of restraint are easy to locate and are sufficiently detailed.