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mental health & dementia
News archive - January 2014
The risks of anti-ligature
Mental health trusts lack the knowledge and support they need to ensure patient environments are truly ligature free, according to a leading manufacturer of global shading and privacy systems.
Greg Myatt, international project consultant at Yewdale, oversees the design and specification of the Kestrel fail-safe anti-ligature blind and curtain track systems and said there was a pressing need to educate estates and facilities managers who are confused by the term ‘anti-ligature’.
“One thing we are seeing is that NHS managers and healthcare architects seem scared by potential risk-related incidents so they are over specifying,” he said. “A lot of projects within the sector are quite frustrating because of this approach.
“Some trusts are looking to put anti-ligature fixtures and fittings into A&E departments. Yes you might get a patient coming in who is mentally ill, but you are also getting a lot of patients with broken legs etc. One example is where someone comes in with their family or friends. They sit down next to the bed within the cubicle area and the curtain is draped across the back of the chair where it has been pulled open by a staff member. They move the chair in towards the bed, which brings the curtain with it and, in turn, pulls the anti-ligature fixture away, as it is designed to for mental health areas. This then hits the person causing potential shock and/or injury and then they proceed to sue the trust.”
Lack of understanding
“It seems hospitals and other providers are panicking and my advice would be to make sure you are getting the right product for the right environment and that is not always an anti-ligature product.”
A lack of understanding about the true meaning of ‘anti-ligature’ is also affecting specification.
“Anti-ligature as a term means it is impossible to attach a ligature to a particular product and to then transfer body weight onto that product without it failing,” said Myatt.
“Most estates and facilities managers have little understanding of what it really means. They need not only to understand the meaning, but to read up on how the different technologies work.”
And the lack of standards and guidance is not helping this situation.
“We actually sat down with a group of NHS managers from various trusts and said we wanted to produce an HTM to stipulate what we should be making our products compliant with. But, because it’s an area that is not fully understood, they wouldn’t commit themselves to writing an anti-ligature legal document and we were just told that our products ‘must comply’, which makes it very unclear and hence other non-anti-ligature products get installed.”
This ‘grey area’ is proving dangerous as some products on the market are not truly fail-safe or anti-ligature, according to Myatt.
“An anti-ligature system that relies on friction to trigger it cannot be truly anti-ligature if you look at how the technology works,” he said.
“Those that rely on friction can be breached, for example in the case of some curtain tracks, you can distribute the weight between the fittings so they can take nearly double the intended weight before coming apart, or patients can also jam paper into couplings to make a tight fit that will stop the system from breaking away at the required load rating.
“Mental health patients have a lot of time on their hands and will find ways to get around a wide variety of safeguards.”
Yewdale is the manufacture of Kestrel, the only truly anti-ligature fail-safe system on the market. Rather than friction, it relies on a carefully-designed and patented magnetic technology to prevent ligatures from being attached to it.
Myatt said: “Anti ligature is a minefield and one that should not be taken out of context. So many areas need to be looked at. We have to go around NHS trusts and prove that some products are not truly anti-ligature and this is why we need to educate their in-house teams more so as to prevent incorrect systems being installed and wasting the NHS a lot of money when they find that they have had a non-anti-ligature system installed and will need to replace it.
“With magnetic systems, because they are made from a natural product, nothing can jam, break or wear out, and even if a magnet was to become weak over an extended period of time, this would only result in the product breaking away when less weight is applied.”
He concluded: “While it is slow progress advising all the mental health trusts so that they understand exactly what anti-ligature is, it is important that they carry out proper risk assessments so as they know exactly what the risks are and can ensure that they specify and procure products that meet these requirements in terms of anti-ligature fixtures and fittings.”
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