Ellern Mede and AndyJohnstonAssociates were jointly recognised in the Reducing Restraint Network’s national leadership awards 2019 for highly innovative healthcare. The commendation was made at a conference in November held in Bristol,UK.

Four quality and safety initiatives involving patient and family engagement, incident reporting, staff training, and a unique ‘NG feeding couch’ combined to earn AndyJohnstonAssociates and Ellern Mede a commendation for their collaborative work in enhancing patient safety and reducing restrictive practices.

AndyJohnstonAssociates, a leading consultancy specialising in achieving improvements in mental health services, launched a comprehensive project over three years, working in partnership with Ellern Mede, a leading provider of CAMHS and Adult Eating Disorder Intensive Care. The project developed 4 quality and safety initiatives targeting improvements to patient safety, engagement informed clinical decision-making. A co-production methodology involved professionals, young people and parents in 1-1, focus groups, observation, and feedback. 

The 4 quality and safety initiatives acclaimed in the Award are:

  • A purpose built Incident Reporting System, EMIM, complete with staff training and external quality control – acknowledged by the CQC as an exemplar system, a system which has undoubtedly positively contributed, through data collection and analysis, to the Ellern Mede restraint reduction strategy. .
  • Patient Inclusion in Least Restrictive Intervention Management Planning (PILRIMP) is a framework for exploring and recording patient’s wishes in advance, identifying choices, triggers, support and Do’s and Don’ts in relation to restrictive interventions. This has been identified by CQC as ‘Outstanding Practice’ and delivers fully on Chapter 9 Mental Health Act CoP 2015 which states services should know patient “wishes expressed in advance”. The use of PILRIMP is referenced in the RRN National Training Standards 2019
  • Eating Disorder Restrictive Intervention Support Training (EDRIST) is the UK’s first purposely designed physical/theoretical intervention programme specific for CAMHS and young adults with eating disorders. It is designed to meet the needs and the challenges of NG feeding and related high intensity resistance, including self-harm using physical intervention whilst being cognisant of the pathology associated with eating disorders. During the 3 years of development the training has been constantly evaluated and improved using stakeholder feedback.
  • The UK’s first evidence-based ‘NG Feeding Couch’ specifically designed for CAMHS/Adult ED NG feeding under restraint, and encouraging de-escalation, has been designed and developed by the AJA Team working with ergonomic and clinical specialists and tested in live training environments. The NG couch is now in commercial development with a well-known specialist mental health furniture manufacturer.

AJA Clinical Director Andy Johnston said: “We are delighted to be recognised for these initiatives. We believe our collaborative leadership in this specialist area has enhanced patient safety, parent confidence and staff competence in their collective experience in reducing Restrictive Interventions.”

Peter Curtis, Managing Director of Ellern Mede, said: “We believe that Patient and Staff experience has been improved by the use of these initiatives and that the goal of consistency for CAMHS services in this area will be well served. Ellern Mede is always looking for ways to improve the patient experience in any way we can, and we have been very happy to have worked closely with AndyJohnstonAssociates in the development of EDRIST and EMIM. We have more developments underway.”

The reason this is so important is that thousands of young people with eating disorders experience inpatient hospitalisation in Child and Adolescent Mental Health Services (CAMHS) every year, many of them life-dependent on naso-gastric feeding, a physical intervention usually requiring ethical restraint of the patient. Since April 2019, it is required that all Tier 4 CAMHS services should be able to administer NG-feeding. National research has showed improvement is needed in this area of CAMHS to reduce risk, ensure least restrictive intervention and to standardise practice.This is also important for young adult patients.

Ellern Mede’s specialist Tier 4 eating disorder CAMHS service has been an NHS Qualified Provider and a leading international independent provider since 2000. The organisation has recently expanded to offer care for young adults up to age 25. It is a leader in recovery rates for people with eating disorders setting very high standards for patient safety, patient engagement and family involvement in therapy.

See more on the awarding organisation at http://www.bild.org.uk/our-services/events/restraint-reduction-network-2019-conference/