A SET of new resources aimed at reducing the use of restrictive practices in healthcare, social care and educational settings has been welcomed by the Minister for Social Care.

The Reducing Restrictive Practices Framework provides advice to those who work with children and adults across relevant settings and services.

The Framework aims to reduce the use of restrictive practices, also known as restraint, used on people of all ages and on those with additional learning needs.

The set of new resources to support the Framework have been developed by the Welsh Government in partnership with the Restraint Reduction Network and Improvement Cymru. The resources are based on the lived experiences of those affected.

They include an animation produced and written by people with a lived experience, an explainer document, and a poster.

The animation depicts the eight types of restrictive practice; physical, chemical, mechanical, enforced isolation, psychological, cultural, surveillance and blanket restrictions.

As well as the animation, the explainer and poster aim to support discussion and increase public knowledge.

Minister for Social Care, Dawn Bowden, has welcomed the new resources which aim to reduce the use of restrictive practices in relevant settings for people of all ages.

Speaking ahead of the launch of the new resources, Minister for Social Care Dawn Bowden said: “We know that restrictive practices can have a negative impact on the people they are used on, as well as those who implement and witness them”.

“We hope this new set of awareness raising resources will reduce the use of restrictive practices in the future, and increase knowledge of the harm they can cause.”

A webinar hosted by the Restraint Reduction Network in partnership with Welsh Government and Improvement Cymru has been planned for 24 July 2024 to officially launch the new resources.

Ben Higgins, Restraint Reduction Network CEO, said: “We are delighted to support the launch of the Welsh Government’s new resources for practitioners working in health, care and educational settings, created as part of the Reducing Restrictive Practices Framework.

“We hope that this coproduced animation increases understanding of restrictive practices – what they are, the harm they cause and how to reduce and prevent them – supporting practitioners to reduce the use of restraint in Wales and make a real difference to people’s lives.”

THE BMA’s deputy chair of Welsh Council issues stark warning about the ‘truly grim’ predicament facing GPs in Wales after years of severe cuts to funding.

Speaking at the BMA’s annual representatives meeting in Belfast, Dr Phil White, who is also a GP in North Wales, accused the Welsh Government of burying their heads in the sand about the crisis facing GPs and the potential impact this will have on an already severely stretched NHS in Wales.

Addressing the BMA’s membership from across the UK he noted the BMA’s strength remarking on its record-high membership figures and the recent progress made by securing ‘three substantial pay offers’ to restore the significant pay loss for doctors working in secondary care in Wales.

Dr White said: “As a union we are stronger than ever, and we will do what it takes to fight for the service we all believe in.”

“Despite this strength and progress made, the predicament facing general practitioners in Wales is truly grim. The service hangs on a precipice, the funding has been slashed and Welsh Government continue to bury their heads in the sand.

“Continuing to ignore the vital role that General Practice plays in the national health service is a grave mistake. My message to Welsh Government is clear. Restore the proportion of the NHS budget which has been cut from General Practice or else it will collapse. If one part of the NHS crumbles, the rest will follow.

“Over the last ten years GPs have been expected to look after 33% more patients while the number of full-time GPs has decreased by 24%, with a fifth of all practices (nearly 100) closing their doors”

He spoke of the risks to patient safety and the personal toll it was taking on GPs with a survey showing that “80% of GPs fear their high workload is detrimental to patient care; morale is low, with many considering their exit.

“Practices are finding ways to stem rising costs – with many reducing existing staff hours or stopping recruitment entirely which all adversely impacts on workload. This is a crisis” he said.

“It is truly shameful, that GP surgeries are expected to run at a deficit, but health boards are simply bailed out by Welsh Government when they overspend” he added.

Referring to BMA Cymru Wales ‘Save our Surgeries’ campaign Dr White said “the public support for an appropriately resourced service is palpable. In a few short weeks, we gathered nearly 22,000 signatures on our Senedd petition, calling on Welsh Government for a rescue package.

Speaking of the bleak picture in Wales with record-high waiting lists rising he added:

“The NHS has been starved for years. Starved of investment, starved of doctors, starved of beds. The impact on patient care is plain to see. Ambulances queuing outside hospitals, patients deteriorating on waiting lists and patients stuck, waiting to be discharged but unable to move on due to a lack of investment in social care.

“The impact on staff is clear too. The rising workload has become unsustainable and understandably, morale is low.

“Three years ago, we publicly called for significant investment in our health service as well as a radical shake-up to create a seamless service. The NHS, social care and community services must work in partnership to effectively meet the needs of patients. Today, I’m restating those calls – the public is behind us – but are the politicians listening?

Dr White ended his speech noting that doctors would continue to campaign for a better service for patients:

“Rest assured, using our collective drive and strength, we will continue to fight for an NHS which has the resources to enable our profession to deliver the care that the people of Wales deserve.”

For years, hospitals and treatment centres focused primarily on medical care. However, the recognition of how the built environment influences patient outcomes has recently been growing. In fact, the environment you’re in plays a much bigger role than you might think. 

Inpatient facilities and treatment centers in London, which have patients for long periods, are moving away from sterile, clinical settings towards spaces that promote well-being and recovery. More and more research highlights the importance of the environment at hospitals and rehabilitation centres that influence your healing journey.

The Science Behind Space

Studies have shown that factors like lighting, noise levels, access to nature and the layout of rooms can impact a patient’s:

1. Pain perception: Dimmable, natural lighting helps regulate sleep patterns and reduce pain perception. 

2. Stress levels: Calming colours, soothing music and access to outdoor spaces contribute to a more relaxed state of mind and improve recovery. 

3. Sleep quality: Controlled noise levels and comfortable room temperature promote restful sleep, which is essential for healing.

4. Mental well-being: Including natural elements, like plants and water features, positively impact a patient’s mood and reduce anxiety.

5. Length of stay: A well-designed environment promotes faster healing and reduces the possibilities of longer hospital stays.

Creating a Calm and Controlled Atmosphere

Hospitals are usually noisy places. Machine beeps, alarms, and staff constant chit-chatting can disturb sleep. Studies have linked excessive noise to slower recovery times, higher stress levels, and increased medication use. Simple design solutions can make a big difference. Incorporating sound-absorbing materials in ceilings, walls, and furniture helps reduce noise pollution. Also, designated quiet zones within the facility give patients much-needed respite.

Design for Dignity and Privacy

Hospitals can feel impersonal and overwhelming. Inpatient facilities are increasingly incorporating design elements that promote a sense of dignity and privacy. Features like individual bathrooms with accessible showers and partitions that create personal space for examinations give a more respectful and comfortable experience. Simple things like adjustable beds and call buttons placed within easy reach encourage patients to take charge of their space and participate more actively in their recovery process.

Design Features for Specific Needs

Healing doesn’t only mean physical well-being. The emotional and psychological aspects also play an important role in the healing process. Design elements that stimulate the senses can be beneficial in this case. For example, calming colour palettes that promote serenity or artwork that expresses positive emotions can be beneficial. Even elements like indoor plants or access to beautiful, scenic outdoor spaces have been shown to reduce anxiety and promote faster healing.

How to Choose a Facility with a Healing Environment

When researching inpatient facilities, don’t just focus on the treatment programs. If available, take virtual tours, ask about the physical layout and amenities, and inquire about the facility’s philosophy on creating a supportive environment. 

Some questions you can consider include:

• Does the facility have natural light and access to outdoor spaces?
• Are rooms private and comfortable?
• Are there designated quiet areas and common areas for socialising?
• What noise-reduction strategies are available?
• How does the staff create a safe and secure environment?

• If you are currently in an inpatient facility and feel the environment could be improved, voice your concerns. Facilities value patient feedback, and your suggestions could positively impact you and future patients. 

Here are some ways to advocate for change:

• Talk to patient support or counsellors within the facility.
• Organise group discussions with fellow patients to raise concerns.
• Write a formal letter to the facility administrator.

The Final Thought

Although the experience of medical professionals plays the most important role, the physical environment of the facility patients stay in during their recovery shouldn’t be an afterthought. Hospitals and rehabs that have thoughtful environments improve patient outcomes. The space where patients spend the most time should promote healing, reduce stress, and encourage faster recovery. From the calming colours to the access to natural light, these features may seem subtle, but they are effective for your healing journey.