Embedding a culture of proactive prevention and person-centred de-escalation techniques for NHS teams is essential to delivering safe, compassionate care.

By reducing reliance on restraint and restrictive practices, trusts can improve outcomes, safeguard wellbeing, and meet both legal and ethical standards, including those set out in the Mental Health Units (Use of Force) Act 2018 and the Restraint Reduction Network (RRN) Training Standards.

At Respect Training, we support staff across the NHS in embedding strategies that focus on prevention first, with the use of force only used as a last resort.

This article is for information purposes only. Competency in de-escalation and safe intervention, and restraint techniques can only be achieved through accredited training.

1. Leadership matters: build commitment to restraint reduction

It’s important for senior leaders to champion and oversee the implementation of de-escalation and restraint reduction training.

Embed restraint reduction, de-escalation, and person-centred principles in recruitment, supervision, and ongoing development of frontline staff, including nurses and healthcare assistants.

2. Embed de-escalation in everyday routines

  • Use daily safety huddles to identify environmental or relational triggers.
  • Introduce person-centred support sheets for wards—documenting likes, dislikes, needs, and identified support strategies.
  • Promote structured responses using the Respect Training 70/20/10 model:
    • Prevention: Environment, sensory planning, predictability 70%
    • De-escalation: Listening, reassurance, choices 20%
    • Intervention: Crisis response, physical intervention 10%.

The emphasis should always be on avoiding escalation through thoughtful, responsive care.

3. Provide consistent, practical de-escalation training

Offer bite-sized reminders on de-escalation techniques for NHS staff, focusing on:

  • Active listening and body language awareness
  • De-escalation, distraction, and offering alternatives
  • Scenario-based choice giving and redirection

Use visual flowcharts and posters across wards to remind staff of safe, person-centred approaches to managing behaviours of concern.

4. Promote positive support over control

  • Support staff to create individualised behaviour plans that focus on strengths and triggers.
  • Share success stories that show how positive, non-restrictive approaches reduce incidents and improve trust and wellbeing.

This aligns with the RRN ethos: dignity, empathy, and prevention over reaction.

5. Reinforce non-restrictive interventions before any physical response

  • Prioritise low-arousal environments, visual timetables, and sensory rooms.
  • Train staff in safe guiding and disengagement techniques only where legally and ethically necessary.

Physical or restrictive intervention should only ever be considered when all other strategies have been exhausted and there is an immediate risk of harm.

6. Implement certified restraint training that meets RRN standards

  • Ensure all restraint-related training is delivered by a BILD ACT and Restraint Reduction Network-certified provider.
  • Incorporate Mental Health Units (Use of Force) Act requirements into training, including record-keeping and patient involvement.
  • Include regular, scenario-based reminders, with an emphasis on when not to intervene physically.

7. Use reflective practice and data to improve safety

  • Track both successful de-escalations and near misses.
  • Run regular debriefs to review incidents, support learning, and emotional processing.
  • Use data dashboards to monitor reduction in seclusion or physical restraint.
  • This creates a learning culture and ensures continuous improvement in how behaviours of concern are managed and supported.

8. Co-produce strategies with people with lived experience

  • Form an “Experts by Experience” panel of service users, carers, and people with a lived experience of restraint.
  • Involve people with lived experience in policy review.
  • Celebrate success through newsletters, case studies, and recognition for teams achieving restraint reduction.
  • Co-production ensures that your approach is grounded in empathy and real-life insight.

The Restraint Reduction Network requires accredited training providers to involve people with lived experience in the development of the training. Making sure you work with an RRN-accredited training provider ensures that “Experts by Experience” are involved from the very beginning.

Invest in accredited training and support

Embedding de-escalation techniques in NHS services is an ongoing commitment. It requires leadership, accredited training, and a whole-systems approach rooted in respect, safety, and dignity.

Respect Training offers RRN-accredited training programmes that empower NHS staff to manage behaviours of concern safely, legally, and ethically.

Please remember: this article provides general guidance only. Competency in de-escalation techniques and crisis intervention can only be developed through formal, accredited training.

To discuss our BILD ACT Certified training for NHS trusts or to book a consultation, get in touch.