THE shocking extent to which mental health patients in East Lancashire have been subjected to ‘dangerous and humiliating’ restraint techniques has been uncovered.

Despite a national drive to stamp out ‘prone restraint’ within mental health care - in which patients are pinned face-down to the floor - the Telegraph has obtained data suggesting a huge increase in use of the controversial technique last year.

A series of Freedom of Information requests to Lancashire Care NHS Foundation Trust revealed 600 cases were reported on its inpatient facilities in Blackburn and Burnley in 2014, up from 383 when figures were first recorded in 2013.

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Meanwhile, a separate file of confidential data, seen by the Lancashire Telegraph as part of an investigation, suggests Lancashire Care is the second highest user of prone restraint in England, and a whistleblower has told of major ‘cultural problems’ with prone restraint and other restrictive practices at the trust, particularly at the two sites in East Lancashire.

The worst figures in the county were reported on the Psychiatric Intensive Care Unit (PICU) at Burnley General Hospital, a six-bed female ward which had 264 prone restraint cases last year.

Female patients are more likely to self-harm, which is thought to result in more restraint cases, but this was still double the number of cases on a similar female ward in Chorley.

The male PICU at the Pendleview Unit in Blackburn had 93 cases last year, which was 10 times the number reported on a similar male ward in Blackpool.

It has also been established that despite official guidance from the Department of Health in April 2014, which said trusts should eliminate prone restraint as a planned or deliberate technique, staff at Lancashire Care were still being trained to use it until December.

Bosses at the trust, led by chief executive Heather Tierney-Moore, said prone restraint, which risks leaving the patient’s airways restricted, has now been removed from the training programme and will stop being used altogether next month.

They said control methods were ‘used only when clinically appropriate and for the safety of patients or staff’, and improved incident reporting was a factor in the rising figures. But the whistleblower said a loss of experienced staff to community services was also a likely factor, while a union official pointed to the trust’s increasing use of agency staff, as they are more likely to resort to ‘quick fix solutions’ when patients become aggressive.

Patient champion Russ McLean said he was ‘appalled’ by the situation, while MPs and a leading mental health charity have expressed serious concerns and called for urgent action to protect patients.

Andrew Stephenson, MP for Pendle, said: “This sounds deeply troubling and clearly needs to be investigated further. It’s important that we support whistleblowers who have genuine concerns about patient safety.”

Jack Straw, MP for Blackburn, said: “This is obviously an issue that the trust needs to deal with urgently. Handling mental health patients can be very difficult but the numbers do suggest there’s a significant problem at Lancashire Care.”

A former employee of the trust, who was afraid to be indentified for fear it could jeopardise their future employment in the NHS, said there were likely to be major problems in eliminating prone restraint in East Lancashire, due to embedded practices and a lack of willingness to change among many managers and staff.

The whistleblower said: “There is a cultural problem at the trust when it comes to control methods and staff have become desensitised to them.

“Patients start to get frustrated and kick against it, which means more violence on the wards, which leads to more restraint. It’s a vicious cycle and we also have some horrible members of staff for which some patients will even assume the restraint position when they see them approaching.

“Especially in East Lancashire, there’s a defensive culture where people are afraid to talk about and challenge these practices. People have tried raise concerns about what’s going on but no one seems to care and the managers seem in denial about the problems.

“There has been a national campaign to get rid of prone restraint since 2013 and official guidance was published last April which backed this up. But things have actually got worse since then.”

The national guidance published last year also said trusts should reduce other restrictive practices, but further data obtained by the Telegraph also suggested significant increases in these other controversial control methods, which should only be used a last resort: n Patients being placed in seclusion rooms, where they are completely isolated for several days, sometimes weeks.

n The use of rapid tranquillisation, which often involves patients being injected with a sedative, or taking it orally.

n Physical restraint in which patients are manually held.

Asked why it had not acted sooner to eradicate prone restraint, and reduce these other practices, the trust said it was working to an agreed two-year programme, and there was an improvement in the prone restraint figures in the second half of 2014, with a monthly average of 45 cases in East Lancashire, compared to 55 in the first half of the year. However, this was still higher than the monthly average of 32 in 2013.

The statement added: “The trust has been developing a two-year programme being rolled out, providing education and support for staff who train others in de-escalation and restraint techniques and a review of the risk assessment process.”

The whistleblower said many of the trust’s nurses had moved into community care, leaving the inpatient wards with inexperienced staff who are more likely to resort to restraint techniques, while Unison official Tim Ellis, who represented trust staff until December, said an increasing reliance on agency staff would also have contributed.

A separate request by the Telegraph showed the use of agency staff on the East Lancashire wards increased by nearly 70 per cent between 2012/13 to 2013/14. This has been partly driven by a national shortage of nurses and a struggle to fill vacant posts. Figures for each calendar year were not available.

The wards provide care for a number of psychiatric conditions, such as bipolar disorder, schizophrenia and psychosis. Calderstones Hospital, in Whalley, was recently slammed by the Care Quality Commission for its over-use of restraint techniques, while this was also cited by inspectors as a key reason for Norfolk and Suffolk’s mental health trust being placed in special measures last month.