NHS Protect launches new guidance on challenging behaviour

Friday, 06 December, 2013

‘Meeting needs and reducing distress: Guidance for the prevention and management of clinically related challenging behaviour in NHS settings’

New NHS guidance on how to prevent and manage challenging behaviour related to a patient’s clinical condition is launched today, Thursday 5 December 2013.

The guidance is for the use of clinical and non-clinical NHS staff and managers and may also be of interest to patients and service users, carers and families.

Clinically related challenging behaviour by patients and service users makes it difficult for staff to deliver good care safely. It takes many forms, from mildly uncooperative to highly disruptive and potentially dangerous behaviours. Such behaviour is often related to a clinical condition or treatment and is a sign of distress and unmet needs rather than any intent to be challenging.

The guidance was developed by an expert group of leading doctors, nurses and training and security specialists, led by NHS Protect. It is supported and endorsed by a number of other leading organisations, including NHS England and the Royal College of Nursing.

It will help staff prevent and manage clinically related challenging behaviour by minimising a patient’s distress, meeting their needs and delivering high quality personalised care, in an environment that is safe for staff, patients and visitors. It underscores the importance of staff employing good communication skills and being compassionate to build trust with patients and service users and better understand what leads to distress. This will ensure that appropriate care can be designed to prevent challenging behaviour.

Practical strategies are provided for staff to dynamically assess the situation when things go wrong, minimise the risks and respond to an individual’s anxiety and distress calmly, by non-confrontation and de-escalation.

Senior managers have a key role to play in making taff should have access to bespoke training to ensure their own safety and that of the people they care for. The guidance provides examples of how challenging behaviour awareness training can be incorporated in existing conflict resolution training or dementia or learning disability awareness training.

The full package includes:

 

  • Guidance document – outlining practical approaches for clinical and non-clinical staff and organisational responsibilities to deliver high quality, personalised care that meets all the needs of patients and minimises their distress.

 

  • Dedicated website – easy, single point of access to the guidance, as well as case studies, learning outcomes, clinical guidelines, tools and templates available at www.nhsprotect.nhs.uk/reducingdistress

 

  • Scenario-based videos – outlining prevention and management strategies that can be incorporated into staff inductions and challenging behaviour awareness training or used as a separate learning resource for staff

 

Andrew Masterman, Policy Lead, Violence Strategy, NHS Protect:

“The aim of this important new guidance is to assist staff in preventing clinically related challenging behaviour by anticipating an individual’s needs, reducing their distress and delivering the highest quality care. It provides a practical approach on how to prevent challenging behaviour and where it occurs to manage it safely. It also provides staff with a consistent approach, so that anyone can adopt it in any NHS setting.  That is its real strength.”

Dr Mike Durkin, Director of Patient Safety, NHS England:

“The challenge of keeping patients safe at times when they are outwardly exhibiting challenging behaviour has been increasingly recognised over the last few years. ‘Meeting needs and reducing distress’ provides a welcome focus on an area of healthcare that can cause high levels of anxiety for patients, their families and healthcare professionals. “This is part of a wide and far-reaching programme of work being developed on the avoidance and safe management of restraint, to ensure every step is taken to keep risk to a minimum and that safety is paramount.”

More endorsements from stakeholder organisations are available at: http://www.nhsprotect.nhs.uk/background/endorsements

 

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