I recently had a phone call with someone from a withheld number who didn’t want to tell me their name.
The conversation went as follows:
“Hi Mark
I have just been on a training course where the the trainer was heavily ‘pushing’ and promoting the RRN (Restraint Reduction Network) standards and said that: “all schools in the UK need to comply with the RRN standards” and that “any training done in schools can only be done by a BILD Certified trainer who is registered with BILD and the RRN”.
Surely this can’t be right?
I currently train in schools and the training I deliver is fit for purpose. It has reduced restraints and is being delivered in line with a competent assessment of risk and training needs analysis.
The training is also regularly monitored and reviewed and adapted and changed as and when the need arises and we can evidence the rationale for any changes/amendments.
My fear is that we are coerced (bullied for want of a better word) in having to go down the BILD/RRN route, then we could lose business merely for the sake of our clients (who also don’t want to have to use a trainer certified with BILD and signed up to the RRN standards) just for the sake of having to get a ‘tick in the box’.
I’ve checked against the statute and the statutory guidance and I cannot see that schools are subject to the RRN standards, but I’d appreciate your opinion on this as to why a trainer ‘push’ such incorrect or misleading information at us?“
I did ask this person who they were, but they were reluctant to give me their name, so I said I’d publish my response as a blog post for the sake of accuracy and transparency so that anything I said couldn’t be taken out of context in a telephone conversation.
My response is as follows:
There has been a lot of emphasis by various parties, including some training providers, to encourage organisations to comply with the RRN (Restraint Reduction Network) Standards, when clearly they do not need to do so.
In some cases this is for nothing more than to generate business for themselves at an expense and in some cases at very high (and unnecessary) financial cost for the organisation, which is an unnecessary financial burden, especially during the current recession and increased cost of living crisis, not to mention the deepening mental health recession (see the Financial Times article here – ‘There is a deepening mental health recession‘)
In other cases it may simply be because the person ‘pushing’ organisations to adopt the RRN standards is either misinformed or has not done their own due diligence as to what the statute and statutory guidance actually state and are merely just repeating incorrect information told to them.
Where The Confusion Has Possibly Come From
At the time of publishing this post the following was in public domain:
On the RRN website, when referring to the RRN standards it states: “It is important they are applied consistently to services across education, health and social care, children and adult services across the UK and internationally for all populations, including people with mental health conditions, dementia, learning disabilities and autistic people in order to consistently minimise the risk of physical and psychological harm to all people in all settings in all nations in the British Isles.”
However, The Mental Health Units (Use of Force) Act 2018 statutory guidance – Government response to the consultation, published 07 December 2021, states (see page 6): “Some respondents raised concerns around the type of settings the Act applies to and made suggestions that the Act should apply to Accident and Emergency (A&E) departments and Section 135/136 suites. We understand the concerns raised with the use of force in different settings, however, they remain out of scope of the Act, which only applies to mental health units that provide inpatient treatment.”
On the RRN website it also states that: “Use of Force Act statutory guidance (2021) states “Training providers must be certified as complying with the RRN Training Standards””.
However, what the The Mental Health Units (Use of Force) Act 2018 statutory guidance actually states is (see page 43): “When commissioning a training provider, NHS trusts and commissioned services therefore need to ensure that training is certified (by a UKAS accredited body) as complying with the RRN Training Standards. This will help to ensure training complies with the requirements of section 5 of the act”. Point to note: “Section 5 of The Act” refers to “each mental health unit” in England.
Therefore, the RRN standards only apply to a mental health unit in a NHS hospital in England and as detailed by the very limited categories set out in the statutory guidance.
A final point to note is that the statutory guidance states that: “Certified training that complies with the RRN Training Standards became a requirement of NHS commissioned services for people with learning disabilities, autism or mental health conditions in April 2020”. However, that was as a NHS condition of contract only. Not a statutory legal requirement.
Letter Template For Your Use Reference RRN Standards Compliance
Therefore, with the help of a very eminent lawyer I have put together the following template letter that you are welcome to download and use as a way of demonstrating that you do not need to comply with the RRN standards.
You will of course have to justify via your own training implementation that you do have training in place that is fit for purpose.
The letter (which is also available for you to download and use at the bottom of this email) is as follows:
DISCLAIMER: All of the information provided below has been researched and checked by us. It is accurate at the date of publication. However, it is your responsibility to do your own due diligence and check the following out for yourself to ensure that it is still current and correct should you wish to use all or part of this document. NFPS Ltd accepts no responsibility for any use or publication of this document by any third party.
Perhaps the approach to take if an inspector, trainer or anyone else advises you that you should be complying with the RRN (Restraint Reduction Network) standards is to advise them of the following:
As a [xyz] organisation, we are outside of the scope of the very limited categories set out by the Mental Health Units (Use of Force) Act 2018 Act and the statutory guidance issued by the Secretary of State for Health and Social Care under section 11 of the Health & Social Care Act 2012.
Therefore, we are not legally required to comply with the RRN (Restraint Reduction Network) standards.
For clarification, the categories that must comply with the Mental Health Units (Use of Force) Act 2018 and the statutory guidance are (as taken directly from the statutory guidance) are:
“Mental Health Unit is described as a health service hospital or independent hospital in England (or part thereof) that provides treatment to inpatients for a mental disorder. An independent hospital (or part thereof) will only be a ‘mental health unit’ if its purpose is “to provide treatment to inpatients for mental disorder”, and “at least some of that treatment is provided, or is intended to be provided, for the purposes of the NHS.”
“The types of inpatient service which would be considered within the definition of a mental health unit (this is not an exhaustive list) include:
- acute mental health wards for adults of working age and psychiatric intensive care units
- long stay or rehabilitation mental health wards for working age adults
- forensic inpatient or secure wards (low, medium and high)
- child and adolescent mental health wards
- wards for older people with mental health problems 16
- wards for people with autism or a learning disability
- specialist mental health eating disorder services
- inpatient mother and baby units
- acute hospital wards where patients are “detained under the Mental Health Act 1983 for assessment and treatment of their mental disorder”.
The following services are considered to be outside of the definition of a mental health unit (this is not an exhaustive list) and therefore not covered by the requirements of the act:
- accident and emergency departments of emergency departments
- section 135 and 136 suites that are outside of a mental health unit
- outpatient departments or clinics
- mental health transport vehicles.”
The statutory guidance also states that: “Certified training that complies with the RRN Training Standards became a requirement of NHS commissioned services for people with learning disabilities, autism or mental health conditions in April 2020”.
Outside of the very limited categories where the Act and statutory guidance applies, we have heard that other services are being encouraged to have their training certified by BILD as complying with the RRN training standards. There is no requirement for us to do so.
Also, as a ‘school’ we are not bound by the conditions of the NHS standard contract. However, even if we were, we are aware of the following provision that creates an exception not to adopt the RRN standards:
Section 41 of The NHS Standard Contract 2021/22 Technical Guidance (Mandatory Service Development & Improvement Plans (SDIPs).
Section 41 of the NHS Standard Contract 2021/22 Technical Guidance document covers mandatory Service Development & Improvement Plan’s (SDI’s)
Section 41(6) also makes it very clear that the intention of mandatory SDIPs (Service Development and Improvement Plans) is not to require significant additional investment from commissioners or providers; rather, it is to encourage joint management action to tackle important priorities to the extent possible within available resources.
Therefore, even if we were considering voluntarily having our training certificated by BILD as complying with the RRN Training Standards we are aware of section 41.
The ‘Reasonably Practicable’ Argument (Cost vs Risk)
Our training provision is based on the training control measures identified in a suitable and sufficient risk assessment (as required under Health and Safety legislation).
This means that the training we provide has been justified on a risk vs cost basis.
Therefore, we feel that adoption of the RRN training standards would:
a): Reduce compliance;
b): Be an additional unnecessary expense;
c): Possibly be detrimental to staff and service user safety;
d): Possibly even breach health & safety by making us train outside of our risk assessed training provision;
You can download a copy of the letter here – Letter Re-RRN Compliance (final)
I hope that helps.