A Framework for the use of Non-Pharmaceutical Approaches to Reducing Restrictive Practices in Wales

Making decisions about your own care and treatment is a right that everyone has but not everyone is able to use, including people with a learning disability.

If we can understand the reason for a person’s behaviour, we can find a person-centred way of meeting their needs without the overreliance on medication.

Put simply, this approach means we can reduce the use of restrictive practices and improve the quality of life for many people with a learning disability and their families.

Background

Some people with a learning disability use behaviours that cause concern to others. Sometimes these behaviours can cause harm to themselves or others.

This form of behaviour is sometimes referred to by professionals as ‘behaviours that challenge’ or ‘behaviours of concern.’ It can lead to the use of restrictive practices, including the use of medication to manage behaviour.

Pharmaceutical approaches, which are sometimes called ‘chemical restraint,’ can have significant negative effects on a person’s physical health issues, including weight gain, sedation, diabetes, heart problems, and movement disorders. Medications may suppress behaviours without addressing the root causes, such as unmet needs or environmental factors.

Central to reducing the use of chemical restraint is providing alternatives to support people with behaviours of concern and reduce the risk of harm. This framework goes some way to providing details of the non-pharmaceutical interventions used in Wales and understanding their use.

Our purpose

The main purpose of this framework is to improve the quality of life for the many people with a learning disability and families whose needs aren’t being met.

This framework will hopefully encourage prevention over reaction, and highlight  person-centred alternatives.

The aims of this framework are to:

• Highlight the approaches that are being used successfully in Wales and identify best evidence for these, including strengths and limitations.
• Explain the key principles of each approach, such as who they are for and when they might be used.
• Link to current policy and guidance.
• Identify the existing information and resources available for each approach and intervention.
• Include recommendations on how to implement the framework in Wales.

The rationale for this framework will be set out in relation to relevant policies and laws.

Get in touch

If you have any further enquiries or would like to know more about the NHS Wales Executive’s Learning Disability programme, please contact: improvementcymru_ld@wales.nhs.uk