Improvements in Patient Safety by Dr Michael Holland | Our blog

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Improvements in Patient Safety by Dr Michael Holland

As a doctor, my main concern is to ensure that the people who use our services receive the best possible care from our Trust. A big part of that is about making sure that our services are safe and effective.

As a Trust we are deeply committed to improving patient safety. As part of our Aiming High: Changing Lives strategy, there are five quality priorities we have committed to achieving as a Trust. One of these is the reduction of violence and restrictive practice. We can help to improve patient care by reducing the use of restrictive practices to manage challenging behaviour. This includes things like restraint, seclusion and other ways patients’ choices and rights can be limited.

Mental health services are often prone to incidents of violence (physical assaults against staff and/or patients), as well as restrictive practice and trusts across the NHS are working hard to combat this. People come to our services when they are at their most vulnerable so it is really important that we are mindful in the way we engage with service users and do everything we can to make them feel safe.

We have a responsibility to protect our patients’ rights and think about them as individuals.

So I want to take this opportunity to share with you some good news from one of our improvement programmes designed to reduce the use of restrictive practice.

By focusing on understanding the root causes of the problems and reducing the level of violence in our services, focusing on psychological safety and engagement, we can reduce the use of restrictive practice within the Trust.

Having completed a robust trial period we were able to identify a number of very positive changes that had been achieved as a result of this improvement programme. We saw:

  • 18% reduction in violence
  • 43% reduction in restraint
  • 70% reduction in prone restraint and
  • 70% reduction in self harm

I am sure you will agree that these are fantastic results and the way this improvement programme was carried out will help to inform the development of other improvement programmes in the future.

When we think about the changes we want to see, it is important that we understand why we are making changes, that we are realistic about our expectations and that we think about how we can make these change sustainable.

Finally I just want to draw your attention to the fact this Today (Monday 25 July) is National Schizophrenia awareness day.

A big part of the work that we do as a mental health trust is to try and break down the stigma that surrounds mental health conditions.

National Schizophrenia Awareness Day, marked on 25 July every year by the charity Rethink Mental Illness, explores what it means to live with this much misunderstood and often stigmatised mental health condition.

In England, approximately one adult in every 100 will live with a diagnosis of schizophrenia.

For some people, schizophrenia will be a life-long condition that will need day-to-day management. Approximately one in four-to-five people with schizophrenia will recover completely and go on to live independently without further episodes.

You can find out more about schizophrenia on our website Schizophrenia - South London and Maudsley (

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