Illustrtion of a person stitting looking sad

By Jo Brackley, HOPE(S) Consultant Practitioner

Restrictive practices are common in our services. They are used to manage risks and keep people safe.  They are practices that are used to stop people doing things or make them do things they don’t want to do.  

Over the last year we’ve worked hard to consider our use of these practices to make sure that we don’t use them too much, for too long and only for the right reasons. This is because they can cause further distress, conflict and harm.

There are lots of different kinds of restrictive practice including physical restraint, seclusion, segregation and medication.

The Trust is working hard to reduce our use of all of them while still trying to keep people safe.  

As a Trust, we recognised we had more seclusion rooms than other trusts and we wanted to bring our practice in line with others. As part of this work, a group of wards have come together for the Beyond Seclusion pilot. Their aim is to support each other to build skills, change culture around restrictive practices and potentially close seclusion rooms. This work is linked to the HOPE(S) model we’ve been integrating, looking at reducing the use of segregation. This started with a project on Lotus Ward, part of our Children and Young People’s Services.  

It’s been important to recognise that teams need different things to feel confident in reducing restrictive practice use. Each individual team has been supported to work with patients and staff to gather their views. This has resulted in three out of five seclusion rooms closing, with the other two planned to close imminently.  

“It feels like there is scope to experiment, be honest, get things wrong and ask things after getting valuable, honest experiences from patients.

It holds a real focus to human rights with the essence that we can actually do something about, allowing more inpatients to have them, as opposed to knowing they exist but feeling stuck within the institutions and policies which infringe their rights.

It feels collaborative and it feels like it promotes co-production, which is essential in understanding where we have gone wrong and how we can be better at being safe and less restrictive.” 

(Feedback from the pilot)

This article is part of our 2026 Annual Magazine, all around the theme of 'learning and improving'. You can read the rest of the articles here.