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Working in healthcare over Christmas and new year? Tell us your stories

This Christmas and new year, millions of healthcare professionals across the world will turn up to work as normal.

While treating people at their most vulnerable can be difficult and sad, working over the festive period can also be uplifting. Hospital wards are decked with tinsel and Christmas trees, choirs sing carols and there’s an abundance of chocolates. Meanwhile, staff might help deliver babies, save someone’s life or simply be there for a person in need.

Are you a healthcare professional who has worked at Christmas and/or new year? We want to hear about it. What have been your memorable moments? What’s the atmosphere like? How did you feel working over the festive season? Have you witnessed or been part of any Christmas or new year miracles? What is different about working at this time?

Please fill in the form below and tell us about your experiences of working at Christmas. A selection of responses will be used in our reporting. You can remain anonymous if you wish.

Urgent talks over future of Four Seasons care homes in UK

The care homes operator Four Seasons Health Care is on course for a stay of execution before a crunch debt deadline, after its major creditor offered to drop demands rejected by directors.

Last-ditch talks aimed at staving off the worst care homes collapse since Southern Cross were continuing on Sunday.

Four Seasons’ largest creditor, US investment firm H/2 Capital Partners, is understood to have made concessions amid pressure from the regulator, the Care Quality Commission, to dispel anxiety around the firm’s future.

Loss-making Four Seasons, owned by multimillionaire Guy Hands’ Guernsey-based private equity group Terra Firma, has said it may not be able to honour a £26m debt interest payment due on Friday, raising the prospect of the company falling into administration.

Terra Firma has offered to resolve the crisis by handing over the keys to Four Seasons to H/2, led by former Lehman Brothers banker Spencer Haber, which owns the majority of Four Seasons’ £525m debt.

H/2 has so far rejected Terra Firma’s proposals and instead offered a “standstill” agreement that would defer the debt deadline, but only if conditions are met that sources close to the negotiations said last week were “unsignable”.

One of these was that any detailed discussion of Four Seasons’ finances should be followed by a “cleansing statement”, where confidential information is released.

This would prevent H/2 finding itself in possession of non-public information, a scenario that would narrow its options by legally precluding it from selling its bonds.

H/2 also wanted Four Seasons’ directors replaced by an entirely independent board, but is understood to be ready to withdraw or water down the demand.

Efforts to find a compromise are understood to have been boosted by the intervention of the CQC, which has the power to stop care homes accepting new residents.

A deal under which debt payments are deferred for up to six months could be announced as soon as Monday. However, Terra Firma has been excluded from the talks, leaving the likelihood of a three-way deal, not to mention a more permanent agreement, in some doubt.

One major bone of contention is the ownership of 24 care homes that are profitable, unlike a sizeable chunk of the 343 homes that make up Four Seasons.

These homes, says Terra Firma, were accidentally added to the assets over which H/2 has security due to a slip of the pen by the law firm Allen & Overy.

Postponing the debt deadline will allow time for the matter to be settled in court, removing one element of uncertainty from near-term talks over the company’s future.

An agreement would also stave off the immediate threat that Four Seasons could be placed into administration, either by its creditors or its directors.

Sources familiar with the talks have suggested that H/2 would have the least to lose from an administration process. The firm owns the majority of Four Seasons’ £525m high-interest bonds, which it bought at a discount for an estimated £260m and which have already yielded £50m in interest.

If administrators are appointed, they would be obliged to secure the best result for creditors, led by H/2. According to some estimates, H/2 could end up sitting on a profit, either on paper or in cash terms, of more than £200m. As one source familiar with the situation put it: “It’s heads they win, tails they win.”

Some observers have warned that an administration could see loss-making homes closed, causing anxiety and disruption for residents and forcing local authorities to fund their continued care.

Labour’s shadow social care minister, Barbara Keeley, called on the government to explain how this would be possible in a worst-case scenario given tight budgets.

She said: “How will councils be able to meet extra demand when they are already struggling under the weight of Tory funding cuts, which will have led to £6.3bn being taken from social care budgets by March 2018?”

“Tory ministers need to come forward with an immediate funding solution, which was called for by the House of Commons recently, and meet the funding gap both for this year and the rest of this parliament.

Administration now looks a more distant prospect but it remains unclear how Terra Firma and H/2 can agree a mutually acceptable permanent solution for the business.

H/2 said it was “working around the clock” to secure a deal and that Four Seasons’ residents and employees were its main priority.

Concern about Four Seasons could reawaken debate about the role of high finance in social care, with the wounds of the 2012 collapse of Southern Cross still fresh.

Four Seasons, which is responsible for the care of 17,000 elderly and vulnerable people, has passed through the hands of a succession of owners, including the Qatar Investment Authority and RBS, all operating a heavily leveraged model.

While Terra Firma cut the group’s debts, the high interest rate on Four Seasons’ remaining bonds – yielding as much as 12.5% – has become unsustainable.

This is partly because spending on social care by austerity-hit local authorities has fallen in real terms, while costs have risen.

Since the Brexit vote, 96% fewer nurses have arrived in the UK from the European Union, forcing Four Seasons to use agency workers who cost up to three times as much.

Urgent talks over future of Four Seasons care homes in UK

The care homes operator Four Seasons Health Care is on course for a stay of execution before a crunch debt deadline, after its major creditor offered to drop demands rejected by directors.

Last-ditch talks aimed at staving off the worst care homes collapse since Southern Cross were continuing on Sunday.

Four Seasons’ largest creditor, US investment firm H/2 Capital Partners, is understood to have made concessions amid pressure from the regulator, the Care Quality Commission, to dispel anxiety around the firm’s future.

Loss-making Four Seasons, owned by multimillionaire Guy Hands’ Guernsey-based private equity group Terra Firma, has said it may not be able to honour a £26m debt interest payment due on Friday, raising the prospect of the company falling into administration.

Terra Firma has offered to resolve the crisis by handing over the keys to Four Seasons to H/2, led by former Lehman Brothers banker Spencer Haber, which owns the majority of Four Seasons’ £525m debt.

H/2 has so far rejected Terra Firma’s proposals and instead offered a “standstill” agreement that would defer the debt deadline, but only if conditions are met that sources close to the negotiations said last week were “unsignable”.

One of these was that any detailed discussion of Four Seasons’ finances should be followed by a “cleansing statement”, where confidential information is released.

This would prevent H/2 finding itself in possession of non-public information, a scenario that would narrow its options by legally precluding it from selling its bonds.

H/2 also wanted Four Seasons’ directors replaced by an entirely independent board, but is understood to be ready to withdraw or water down the demand.

Efforts to find a compromise are understood to have been boosted by the intervention of the CQC, which has the power to stop care homes accepting new residents.

A deal under which debt payments are deferred for up to six months could be announced as soon as Monday. However, Terra Firma has been excluded from the talks, leaving the likelihood of a three-way deal, not to mention a more permanent agreement, in some doubt.

One major bone of contention is the ownership of 24 care homes that are profitable, unlike a sizeable chunk of the 343 homes that make up Four Seasons.

These homes, says Terra Firma, were accidentally added to the assets over which H/2 has security due to a slip of the pen by the law firm Allen & Overy.

Postponing the debt deadline will allow time for the matter to be settled in court, removing one element of uncertainty from near-term talks over the company’s future.

An agreement would also stave off the immediate threat that Four Seasons could be placed into administration, either by its creditors or its directors.

Sources familiar with the talks have suggested that H/2 would have the least to lose from an administration process. The firm owns the majority of Four Seasons’ £525m high-interest bonds, which it bought at a discount for an estimated £260m and which have already yielded £50m in interest.

If administrators are appointed, they would be obliged to secure the best result for creditors, led by H/2. According to some estimates, H/2 could end up sitting on a profit, either on paper or in cash terms, of more than £200m. As one source familiar with the situation put it: “It’s heads they win, tails they win.”

Some observers have warned that an administration could see loss-making homes closed, causing anxiety and disruption for residents and forcing local authorities to fund their continued care.

Labour’s shadow social care minister, Barbara Keeley, called on the government to explain how this would be possible in a worst-case scenario given tight budgets.

She said: “How will councils be able to meet extra demand when they are already struggling under the weight of Tory funding cuts, which will have led to £6.3bn being taken from social care budgets by March 2018?”

“Tory ministers need to come forward with an immediate funding solution, which was called for by the House of Commons recently, and meet the funding gap both for this year and the rest of this parliament.

Administration now looks a more distant prospect but it remains unclear how Terra Firma and H/2 can agree a mutually acceptable permanent solution for the business.

H/2 said it was “working around the clock” to secure a deal and that Four Seasons’ residents and employees were its main priority.

Concern about Four Seasons could reawaken debate about the role of high finance in social care, with the wounds of the 2012 collapse of Southern Cross still fresh.

Four Seasons, which is responsible for the care of 17,000 elderly and vulnerable people, has passed through the hands of a succession of owners, including the Qatar Investment Authority and RBS, all operating a heavily leveraged model.

While Terra Firma cut the group’s debts, the high interest rate on Four Seasons’ remaining bonds – yielding as much as 12.5% – has become unsustainable.

This is partly because spending on social care by austerity-hit local authorities has fallen in real terms, while costs have risen.

Since the Brexit vote, 96% fewer nurses have arrived in the UK from the European Union, forcing Four Seasons to use agency workers who cost up to three times as much.

Urgent talks over future of Four Seasons care homes in UK

The care homes operator Four Seasons Health Care is on course for a stay of execution before a crunch debt deadline, after its major creditor offered to drop demands rejected by directors.

Last-ditch talks aimed at staving off the worst care homes collapse since Southern Cross were continuing on Sunday.

Four Seasons’ largest creditor, US investment firm H/2 Capital Partners, is understood to have made concessions amid pressure from the regulator, the Care Quality Commission, to dispel anxiety around the firm’s future.

Loss-making Four Seasons, owned by multimillionaire Guy Hands’ Guernsey-based private equity group Terra Firma, has said it may not be able to honour a £26m debt interest payment due on Friday, raising the prospect of the company falling into administration.

Terra Firma has offered to resolve the crisis by handing over the keys to Four Seasons to H/2, led by former Lehman Brothers banker Spencer Haber, which owns the majority of Four Seasons’ £525m debt.

H/2 has so far rejected Terra Firma’s proposals and instead offered a “standstill” agreement that would defer the debt deadline, but only if conditions are met that sources close to the negotiations said last week were “unsignable”.

One of these was that any detailed discussion of Four Seasons’ finances should be followed by a “cleansing statement”, where confidential information is released.

This would prevent H/2 finding itself in possession of non-public information, a scenario that would narrow its options by legally precluding it from selling its bonds.

H/2 also wanted Four Seasons’ directors replaced by an entirely independent board, but is understood to be ready to withdraw or water down the demand.

Efforts to find a compromise are understood to have been boosted by the intervention of the CQC, which has the power to stop care homes accepting new residents.

A deal under which debt payments are deferred for up to six months could be announced as soon as Monday. However, Terra Firma has been excluded from the talks, leaving the likelihood of a three-way deal, not to mention a more permanent agreement, in some doubt.

One major bone of contention is the ownership of 24 care homes that are profitable, unlike a sizeable chunk of the 343 homes that make up Four Seasons.

These homes, says Terra Firma, were accidentally added to the assets over which H/2 has security due to a slip of the pen by the law firm Allen & Overy.

Postponing the debt deadline will allow time for the matter to be settled in court, removing one element of uncertainty from near-term talks over the company’s future.

An agreement would also stave off the immediate threat that Four Seasons could be placed into administration, either by its creditors or its directors.

Sources familiar with the talks have suggested that H/2 would have the least to lose from an administration process. The firm owns the majority of Four Seasons’ £525m high-interest bonds, which it bought at a discount for an estimated £260m and which have already yielded £50m in interest.

If administrators are appointed, they would be obliged to secure the best result for creditors, led by H/2. According to some estimates, H/2 could end up sitting on a profit, either on paper or in cash terms, of more than £200m. As one source familiar with the situation put it: “It’s heads they win, tails they win.”

Some observers have warned that an administration could see loss-making homes closed, causing anxiety and disruption for residents and forcing local authorities to fund their continued care.

Labour’s shadow social care minister, Barbara Keeley, called on the government to explain how this would be possible in a worst-case scenario given tight budgets.

She said: “How will councils be able to meet extra demand when they are already struggling under the weight of Tory funding cuts, which will have led to £6.3bn being taken from social care budgets by March 2018?”

“Tory ministers need to come forward with an immediate funding solution, which was called for by the House of Commons recently, and meet the funding gap both for this year and the rest of this parliament.

Administration now looks a more distant prospect but it remains unclear how Terra Firma and H/2 can agree a mutually acceptable permanent solution for the business.

H/2 said it was “working around the clock” to secure a deal and that Four Seasons’ residents and employees were its main priority.

Concern about Four Seasons could reawaken debate about the role of high finance in social care, with the wounds of the 2012 collapse of Southern Cross still fresh.

Four Seasons, which is responsible for the care of 17,000 elderly and vulnerable people, has passed through the hands of a succession of owners, including the Qatar Investment Authority and RBS, all operating a heavily leveraged model.

While Terra Firma cut the group’s debts, the high interest rate on Four Seasons’ remaining bonds – yielding as much as 12.5% – has become unsustainable.

This is partly because spending on social care by austerity-hit local authorities has fallen in real terms, while costs have risen.

Since the Brexit vote, 96% fewer nurses have arrived in the UK from the European Union, forcing Four Seasons to use agency workers who cost up to three times as much.

Urgent talks over future of Four Seasons care homes in UK

The care homes operator Four Seasons Health Care is on course for a stay of execution before a crunch debt deadline, after its major creditor offered to drop demands rejected by directors.

Last-ditch talks aimed at staving off the worst care homes collapse since Southern Cross were continuing on Sunday.

Four Seasons’ largest creditor, US investment firm H/2 Capital Partners, is understood to have made concessions amid pressure from the regulator, the Care Quality Commission, to dispel anxiety around the firm’s future.

Loss-making Four Seasons, owned by multimillionaire Guy Hands’ Guernsey-based private equity group Terra Firma, has said it may not be able to honour a £26m debt interest payment due on Friday, raising the prospect of the company falling into administration.

Terra Firma has offered to resolve the crisis by handing over the keys to Four Seasons to H/2, led by former Lehman Brothers banker Spencer Haber, which owns the majority of Four Seasons’ £525m debt.

H/2 has so far rejected Terra Firma’s proposals and instead offered a “standstill” agreement that would defer the debt deadline, but only if conditions are met that sources close to the negotiations said last week were “unsignable”.

One of these was that any detailed discussion of Four Seasons’ finances should be followed by a “cleansing statement”, where confidential information is released.

This would prevent H/2 finding itself in possession of non-public information, a scenario that would narrow its options by legally precluding it from selling its bonds.

H/2 also wanted Four Seasons’ directors replaced by an entirely independent board, but is understood to be ready to withdraw or water down the demand.

Efforts to find a compromise are understood to have been boosted by the intervention of the CQC, which has the power to stop care homes accepting new residents.

A deal under which debt payments are deferred for up to six months could be announced as soon as Monday. However, Terra Firma has been excluded from the talks, leaving the likelihood of a three-way deal, not to mention a more permanent agreement, in some doubt.

One major bone of contention is the ownership of 24 care homes that are profitable, unlike a sizeable chunk of the 343 homes that make up Four Seasons.

These homes, says Terra Firma, were accidentally added to the assets over which H/2 has security due to a slip of the pen by the law firm Allen & Overy.

Postponing the debt deadline will allow time for the matter to be settled in court, removing one element of uncertainty from near-term talks over the company’s future.

An agreement would also stave off the immediate threat that Four Seasons could be placed into administration, either by its creditors or its directors.

Sources familiar with the talks have suggested that H/2 would have the least to lose from an administration process. The firm owns the majority of Four Seasons’ £525m high-interest bonds, which it bought at a discount for an estimated £260m and which have already yielded £50m in interest.

If administrators are appointed, they would be obliged to secure the best result for creditors, led by H/2. According to some estimates, H/2 could end up sitting on a profit, either on paper or in cash terms, of more than £200m. As one source familiar with the situation put it: “It’s heads they win, tails they win.”

Some observers have warned that an administration could see loss-making homes closed, causing anxiety and disruption for residents and forcing local authorities to fund their continued care.

Labour’s shadow social care minister, Barbara Keeley, called on the government to explain how this would be possible in a worst-case scenario given tight budgets.

She said: “How will councils be able to meet extra demand when they are already struggling under the weight of Tory funding cuts, which will have led to £6.3bn being taken from social care budgets by March 2018?”

“Tory ministers need to come forward with an immediate funding solution, which was called for by the House of Commons recently, and meet the funding gap both for this year and the rest of this parliament.

Administration now looks a more distant prospect but it remains unclear how Terra Firma and H/2 can agree a mutually acceptable permanent solution for the business.

H/2 said it was “working around the clock” to secure a deal and that Four Seasons’ residents and employees were its main priority.

Concern about Four Seasons could reawaken debate about the role of high finance in social care, with the wounds of the 2012 collapse of Southern Cross still fresh.

Four Seasons, which is responsible for the care of 17,000 elderly and vulnerable people, has passed through the hands of a succession of owners, including the Qatar Investment Authority and RBS, all operating a heavily leveraged model.

While Terra Firma cut the group’s debts, the high interest rate on Four Seasons’ remaining bonds – yielding as much as 12.5% – has become unsustainable.

This is partly because spending on social care by austerity-hit local authorities has fallen in real terms, while costs have risen.

Since the Brexit vote, 96% fewer nurses have arrived in the UK from the European Union, forcing Four Seasons to use agency workers who cost up to three times as much.

Urgent talks over future of Four Seasons care homes in UK

The care homes operator Four Seasons Health Care is on course for a stay of execution before a crunch debt deadline, after its major creditor offered to drop demands rejected by directors.

Last-ditch talks aimed at staving off the worst care homes collapse since Southern Cross were still taking place on Sunday.

But Four Seasons’ largest creditor, US investment firm H/2 Capital Partners, is understood to have made concessions amid pressure from the regulator, the Care Quality Commission, to dispel anxiety around the firm’s future.

Loss-making Four Seasons, owned by multi-millionaire Guy Hands’ Guernsey-based private equity group Terra Firma, has said it may not be able to honour a £26m debt interest payment due on Friday, raising the prospect of the company falling into administration.

Terra Firma has offered to resolve the crisis by handing the keys to Four Seasons over to H/2, led by former Lehman Brothers banker Spencer Haber, which owns the majority of Four Seasons’ £525m debt.

H/2 has so far rejected Terra Firma’s proposals and instead offered a “standstill” agreement that would defer the debt deadline, but only if conditions are met that sources close to the negotiations said last week were “unsignable”.

One of these was that any detailed discussion of Four Seasons’ finances should be followed by a “cleansing statement”, where confidential information is released.

This would prevent H/2 finding itself in possession of non-public information, a scenario that would narrow its options by legally precluding it from selling its bonds.

H/2 also wanted Four Seasons’ directors replaced by an entirely independent board, but is understood to be ready to withdraw or water down the demand.

Efforts to find a compromise are understood to have been boosted by the intervention of the CQC, which has the power to stop care homes accepting new residents.

A deal under which debt payments are deferred for up to six months could be announced as soon as Monday. However, Terra Firma has been excluded from the talks, leaving the likelihood of a three-way deal, not to mention a more permanent agreement, in some doubt.

One major bone of contention is the ownership of 24 care homes that are profitable, unlike a sizeable chunk of the 343 homes that make up Four Seasons.

These homes, says Terra Firma, were accidentally added to the assets over which H/2 has security due to a slip of the pen by the law firm Allen & Overy.

Postponing the debt deadline will allow time for the matter to be settled in court, removing one element of uncertainty from near-term talks over the company’s future.

An agreement would also stave off the immediate threat that Four Seasons’ could be placed into administration, either by its creditors or its directors.

Sources familiar with the talks have suggested that H/2 would have the least to lose from an administration process. The firm owns the majority of Four Seasons’ £525m high-interest bonds, which it bought at a discount for an estimated £260m and which have already yielded £50m in interest.

If administrators are appointed, they would be obliged to secure the best result for creditors, led by H/2. According to some estimates, H/2 could end up sitting on a profit, either on paper or in cash terms, of more than £200m. As one source familiar with the situation put it: “It’s heads they win, tails they win.”

Some observers have warned that an administration could see loss-making homes closed, causing anxiety and disruption for residents and forcing local authorities to fund their continued care.

Labour’s shadow social care minister, Barbara Keeley, called on the government to explain how this would be possible in a worst-case scenario given tight budgets.

She said: “How will councils be able to meet extra demand when they are already struggling under the weight of Tory funding cuts, which will have led to £6.3bn being taken from social care budgets by March 2018?”

“Tory ministers need to come forward with an immediate funding solution, which was called for by the House of Commons recently, and meet the funding gap both for this year and the rest of this parliament.

Administration now looks a more distant prospect but it remains unclear how Terra Firma and H/2 can agree a mutually acceptable permanent solution for the business.

H/2 said it was “working around the clock” to secure a deal and that Four Seasons’ residents and employees were its main priority.

Concern about Four Seasons could reawaken debate about the role of high finance in social care, with the wounds of the 2012 collapse of Southern Cross still fresh.

Four Seasons, which is responsible for the care of 17,000 elderly and vulnerable people, has passed through the hands of a succession of owners, including the Qatar Investment Authority and RBS, all operating a heavily leveraged model.

While Terra Firma cut the group’s debts, the high interest rate on Four Seasons’ remaining bonds – yielding as much as 12.5% – has become unsustainable.

This is partly because spending on social care by austerity-hit local authorities has fallen in real terms, while costs have risen.

Since the Brexit vote, 96% fewer nurses have arrived in the UK from the European Union, forcing Four Seasons to use agency workers who cost up to three times as much.

Alarm over restraint of NHS mental health patients

Patients in mental health units were physically restrained by staff more than 80,000 times last year in Britain, including 10,000 who were held face down or given injections to subdue them, new NHS figures show.

Girls and young women under the age of 20 were the most likely to be restrained, each being subjected 30 times a year on average to techniques that can involve a group of staff combining to tackle a patient who is being aggressive or violent.

Black people were three times more likely to be restrained than white people, according to the first comprehensive NHS data on the use in England of such techniques, which have provoked controversy for many years.

Mental health campaigners fear that the use of such force can cause patients physical harm or revive painful memories of the trauma that many have suffered in childhood.

The figures, published by the NHS Digital statistical agency, show that the 80,000 uses of restraint in 2016-17 included patients being subjected to “prone” restraint – being held face down – 10,000 times, and patients being controlled by “non-prone” physical force 43,000 times. Chemical restraint was used on another 8,600 occasions.

The findings have prompted fresh concern among mental health experts that too many patients are still being restrained, despite moves by the government and NHS in recent years to reduce the incidence.

“It is troubling to see how prevalent the most severe, and dangerous, kinds of restraint are in the mental health system,” said Brian Dow, director of external affairs at the charity Rethink Mental Illness. Prone restraint, he warned, “can be terrifying and badly damage someone’s recovery”.

NHS Digital’s figures were published in the recent annual mental health bulletin detailing activity and treatment in NHS mental health units in England. They show that:

■ Black people were more than three times more likely to be restrained than white people.

■ Prone restraint, which guidance says should be used only in life-threatening situations, is used on fewer women than men, but is used on the former more often; women are physically subdued multiple times.

■ Mechanical means of restraint were used 1,200 times, seclusion on 7,700 occasions and segregation 700 times.

Katharine Sacks-Jones, the director of Agenda, an alliance of 70 organisations working with women and girls who are at risk, said: “It’s completely unacceptable that so many women and girls are being restrained over and over again.

“The picture for girls and young women is particularly alarming, with those under 20 subjected to restrictive practices nearly 30 times each on average, the majority of these being incidents of physical and face-down restraint.

“More than half of women who have mental health problems have experienced abuse, so not only is restraint frightening and humiliating, it also risks retraumatising them.”

In its annual report in July, the Care Quality Commission, which regulates NHS care in England, said its inspectors had found unwarranted and wide-ranging variation between units in terms of how often staff used restraint. Wards with low rates had staff who had been trained to handle difficult behaviour and de-escalate challenging situations.

But, the CQC added, mental health wards dealing with acutely unwell patients are high-risk environments where patients can regularly be violent towards staff or fellow patients. The number of times restraint techniques are used has risen from 781 per 100,000 bed days in 2013-14 to 954 per 100,000 bed days last year. However, use of face-down restraint has fallen, from 231 incidents per 100,000 bed days in 2014-15 to 199 incidents per 100,000 bed days in 2015-16.

The Department of Health said that its guidance, issued in 2014, stressed that restraint should be used only if other means of dealing with difficult situations were unlikely to succeed.

“Physical restraint should only be used as a last resort and our guidance to the NHS is clear on this – anything less is unacceptable,” a spokeswoman said. “Every patient with mental health issues deserves to be treated and cared for in a safe environment. We are working actively with the CQC to ensure the use of restraint is minimised.”

The bulletin also reveals that almost one in 20 people in England received NHS help last year for mental health problems.

A total of 2,637,916 people – 4.8% of the population – were in contact with secondary mental health, learning disabilities and autism services at some point. Of these, 556,790 were under 18.

In addition, 101,589 (3.9%) of those 2.6 million patients ended up in hospital receiving treatment.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Alarm over restraint of NHS mental health patients

Patients in mental health units were physically restrained by staff more than 80,000 times last year in Britain, including 10,000 who were held face down or given injections to subdue them, new NHS figures show.

Girls and young women under the age of 20 were the most likely to be restrained, each being subjected 30 times a year on average to techniques that can involve a group of staff combining to tackle a patient who is being aggressive or violent.

Black people were three times more likely to be restrained than white people, according to the first comprehensive NHS data on the use in England of such techniques, which have provoked controversy for many years.

Mental health campaigners fear that the use of such force can cause patients physical harm or revive painful memories of the trauma that many have suffered in childhood.

The figures, published by the NHS Digital statistical agency, show that the 80,000 uses of restraint in 2016-17 included patients being subjected to “prone” restraint – being held face down – 10,000 times, and patients being controlled by “non-prone” physical force 43,000 times. Chemical restraint was used on another 8,600 occasions.

The findings have prompted fresh concern among mental health experts that too many patients are still being restrained, despite moves by the government and NHS in recent years to reduce the incidence.

“It is troubling to see how prevalent the most severe, and dangerous, kinds of restraint are in the mental health system,” said Brian Dow, director of external affairs at the charity Rethink Mental Illness. Prone restraint, he warned, “can be terrifying and badly damage someone’s recovery”.

NHS Digital’s figures were published in the recent annual mental health bulletin detailing activity and treatment in NHS mental health units in England. They show that:

■ Black people were more than three times more likely to be restrained than white people.

■ Prone restraint, which guidance says should be used only in life-threatening situations, is used on fewer women than men, but is used on the former more often; women are physically subdued multiple times.

■ Mechanical means of restraint were used 1,200 times, seclusion on 7,700 occasions and segregation 700 times.

Katharine Sacks-Jones, the director of Agenda, an alliance of 70 organisations working with women and girls who are at risk, said: “It’s completely unacceptable that so many women and girls are being restrained over and over again.

“The picture for girls and young women is particularly alarming, with those under 20 subjected to restrictive practices nearly 30 times each on average, the majority of these being incidents of physical and face-down restraint.

“More than half of women who have mental health problems have experienced abuse, so not only is restraint frightening and humiliating, it also risks retraumatising them.”

In its annual report in July, the Care Quality Commission, which regulates NHS care in England, said its inspectors had found unwarranted and wide-ranging variation between units in terms of how often staff used restraint. Wards with low rates had staff who had been trained to handle difficult behaviour and de-escalate challenging situations.

But, the CQC added, mental health wards dealing with acutely unwell patients are high-risk environments where patients can regularly be violent towards staff or fellow patients. The number of times restraint techniques are used has risen from 781 per 100,000 bed days in 2013-14 to 954 per 100,000 bed days last year. However, use of face-down restraint has fallen, from 231 incidents per 100,000 bed days in 2014-15 to 199 incidents per 100,000 bed days in 2015-16.

The Department of Health said that its guidance, issued in 2014, stressed that restraint should be used only if other means of dealing with difficult situations were unlikely to succeed.

“Physical restraint should only be used as a last resort and our guidance to the NHS is clear on this – anything less is unacceptable,” a spokeswoman said. “Every patient with mental health issues deserves to be treated and cared for in a safe environment. We are working actively with the CQC to ensure the use of restraint is minimised.”

The bulletin also reveals that almost one in 20 people in England received NHS help last year for mental health problems.

A total of 2,637,916 people – 4.8% of the population – were in contact with secondary mental health, learning disabilities and autism services at some point. Of these, 556,790 were under 18.

In addition, 101,589 (3.9%) of those 2.6 million patients ended up in hospital receiving treatment.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Alarm over restraint of NHS mental health patients

Patients in mental health units were physically restrained by staff more than 80,000 times last year in Britain, including 10,000 who were held face down or given injections to subdue them, new NHS figures show.

Girls and young women under the age of 20 were the most likely to be restrained, each being subjected 30 times a year on average to techniques that can involve a group of staff combining to tackle a patient who is being aggressive or violent.

Black people were three times more likely to be restrained than white people, according to the first comprehensive NHS data on the use in England of such techniques, which have provoked controversy for many years.

Mental health campaigners fear that the use of such force can cause patients physical harm or revive painful memories of the trauma that many have suffered in childhood.

The figures, published by the NHS Digital statistical agency, show that the 80,000 uses of restraint in 2016-17 included patients being subjected to “prone” restraint – being held face down – 10,000 times, and patients being controlled by “non-prone” physical force 43,000 times. Chemical restraint was used on another 8,600 occasions.

The findings have prompted fresh concern among mental health experts that too many patients are still being restrained, despite moves by the government and NHS in recent years to reduce the incidence.

“It is troubling to see how prevalent the most severe, and dangerous, kinds of restraint are in the mental health system,” said Brian Dow, director of external affairs at the charity Rethink Mental Illness. Prone restraint, he warned, “can be terrifying and badly damage someone’s recovery”.

NHS Digital’s figures were published in the recent annual mental health bulletin detailing activity and treatment in NHS mental health units in England. They show that:

■ Black people were more than three times more likely to be restrained than white people.

■ Prone restraint, which guidance says should be used only in life-threatening situations, is used on fewer women than men, but is used on the former more often; women are physically subdued multiple times.

■ Mechanical means of restraint were used 1,200 times, seclusion on 7,700 occasions and segregation 700 times.

Katharine Sacks-Jones, the director of Agenda, an alliance of 70 organisations working with women and girls who are at risk, said: “It’s completely unacceptable that so many women and girls are being restrained over and over again.

“The picture for girls and young women is particularly alarming, with those under 20 subjected to restrictive practices nearly 30 times each on average, the majority of these being incidents of physical and face-down restraint.

“More than half of women who have mental health problems have experienced abuse, so not only is restraint frightening and humiliating, it also risks retraumatising them.”

In its annual report in July, the Care Quality Commission, which regulates NHS care in England, said its inspectors had found unwarranted and wide-ranging variation between units in terms of how often staff used restraint. Wards with low rates had staff who had been trained to handle difficult behaviour and de-escalate challenging situations.

But, the CQC added, mental health wards dealing with acutely unwell patients are high-risk environments where patients can regularly be violent towards staff or fellow patients. The number of times restraint techniques are used has risen from 781 per 100,000 bed days in 2013-14 to 954 per 100,000 bed days last year. However, use of face-down restraint has fallen, from 231 incidents per 100,000 bed days in 2014-15 to 199 incidents per 100,000 bed days in 2015-16.

The Department of Health said that its guidance, issued in 2014, stressed that restraint should be used only if other means of dealing with difficult situations were unlikely to succeed.

“Physical restraint should only be used as a last resort and our guidance to the NHS is clear on this – anything less is unacceptable,” a spokeswoman said. “Every patient with mental health issues deserves to be treated and cared for in a safe environment. We are working actively with the CQC to ensure the use of restraint is minimised.”

The bulletin also reveals that almost one in 20 people in England received NHS help last year for mental health problems.

A total of 2,637,916 people – 4.8% of the population – were in contact with secondary mental health, learning disabilities and autism services at some point. Of these, 556,790 were under 18.

In addition, 101,589 (3.9%) of those 2.6 million patients ended up in hospital receiving treatment.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Alarm over restraint of NHS mental health patients

Patients in mental health units were physically restrained by staff more than 80,000 times last year in Britain, including 10,000 who were held face down or given injections to subdue them, new NHS figures show.

Girls and young women under the age of 20 were the most likely to be restrained, each being subjected 30 times a year on average to techniques that can involve a group of staff combining to tackle a patient who is being aggressive or violent.

Black people were three times more likely to be restrained than white people, according to the first comprehensive NHS data on the use in England of such techniques, which have provoked controversy for many years.

Mental health campaigners fear that the use of such force can cause patients physical harm or revive painful memories of the trauma that many have suffered in childhood.

The figures, published by the NHS Digital statistical agency, show that the 80,000 uses of restraint in 2016-17 included patients being subjected to “prone” restraint – being held face down – 10,000 times, and patients being controlled by “non-prone” physical force 43,000 times. Chemical restraint was used on another 8,600 occasions.

The findings have prompted fresh concern among mental health experts that too many patients are still being restrained, despite moves by the government and NHS in recent years to reduce the incidence.

“It is troubling to see how prevalent the most severe, and dangerous, kinds of restraint are in the mental health system,” said Brian Dow, director of external affairs at the charity Rethink Mental Illness. Prone restraint, he warned, “can be terrifying and badly damage someone’s recovery”.

NHS Digital’s figures were published in the recent annual mental health bulletin detailing activity and treatment in NHS mental health units in England. They show that:

■ Black people were more than three times more likely to be restrained than white people.

■ Prone restraint, which guidance says should be used only in life-threatening situations, is used on fewer women than men, but is used on the former more often; women are physically subdued multiple times.

■ Mechanical means of restraint were used 1,200 times, seclusion on 7,700 occasions and segregation 700 times.

Katharine Sacks-Jones, the director of Agenda, an alliance of 70 organisations working with women and girls who are at risk, said: “It’s completely unacceptable that so many women and girls are being restrained over and over again.

“The picture for girls and young women is particularly alarming, with those under 20 subjected to restrictive practices nearly 30 times each on average, the majority of these being incidents of physical and face-down restraint.

“More than half of women who have mental health problems have experienced abuse, so not only is restraint frightening and humiliating, it also risks retraumatising them.”

In its annual report in July, the Care Quality Commission, which regulates NHS care in England, said its inspectors had found unwarranted and wide-ranging variation between units in terms of how often staff used restraint. Wards with low rates had staff who had been trained to handle difficult behaviour and de-escalate challenging situations.

But, the CQC added, mental health wards dealing with acutely unwell patients are high-risk environments where patients can regularly be violent towards staff or fellow patients. The number of times restraint techniques are used has risen from 781 per 100,000 bed days in 2013-14 to 954 per 100,000 bed days last year. However, use of face-down restraint has fallen, from 231 incidents per 100,000 bed days in 2014-15 to 199 incidents per 100,000 bed days in 2015-16.

The Department of Health said that its guidance, issued in 2014, stressed that restraint should be used only if other means of dealing with difficult situations were unlikely to succeed.

“Physical restraint should only be used as a last resort and our guidance to the NHS is clear on this – anything less is unacceptable,” a spokeswoman said. “Every patient with mental health issues deserves to be treated and cared for in a safe environment. We are working actively with the CQC to ensure the use of restraint is minimised.”

The bulletin also reveals that almost one in 20 people in England received NHS help last year for mental health problems.

A total of 2,637,916 people – 4.8% of the population – were in contact with secondary mental health, learning disabilities and autism services at some point. Of these, 556,790 were under 18.

In addition, 101,589 (3.9%) of those 2.6 million patients ended up in hospital receiving treatment.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.