Quality standard
About this quality standard
NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements. NICE quality standards draw on existing NICE or NICE-accredited guidance that provides an underpinning, comprehensive set of recommendations, and are designed to support the measurement of improvement.
Expected levels of achievement for quality measures are not specified. Quality standards are intended to drive up the quality of care, and so achievement levels of 100% should be aspired to (or 0% if the quality statement states that something should not be done). However, this may not always be appropriate in practice. Taking account of safety, shared decision-making, choice and professional judgement, desired levels of achievement should be defined locally.
Information about how NICE quality standards are developed is available from the NICE website.
See our webpage on quality standard advisory committees for details of standing committee 3 members who advised on this quality standard. Information about the topic experts invited to join the standing members is available from the webpage for this quality standard.
This quality standard has been included in the NICE Pathway on violence and aggression, which brings together everything we have said on a topic in an interactive flowchart.
NICE has produced a quality standard service improvement template to help providers make an initial assessment of their service compared with a selection of quality statements. This tool is updated monthly to include new quality standards.
NICE produces guidance, standards and information on commissioning and providing high-quality healthcare, social care, and public health services. We have agreements to provide certain NICE services to Wales, Scotland and Northern Ireland. Decisions on how NICE guidance and other products apply in those countries are made by ministers in the Welsh government, Scottish government, and Northern Ireland Executive. NICE guidance or other products may include references to organisations or people responsible for commissioning or providing care that may be relevant only to England.
Improving outcomes
This quality standard is expected to contribute to improvements in the following outcomes:
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rates of manual restraint
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rates of rapid tranquillisation
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rates of injury among service users
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rates of injury among members of staff
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experience of service users and carers
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prioritisation of de-escalation by service providers.
It is also expected to support delivery of the Department of Health's outcome frameworks:
Resource impact
NICE quality standards should be achievable by local services. The potential resource impact is considered by the quality standards advisory committee, drawing on resource impact work for the source guidance. Organisations are encouraged to use the costing statement for the source guidance to help estimate local costs.
Diversity, equality and language
During the development of this quality standard, equality issues were considered and equality assessments for this quality standard are available. Any specific issues identified during development of the quality statements are highlighted in each statement.
For all statements, good communication between health and social care practitioners and people with mental health problems and their carers (if appropriate) is essential. Treatment, care and information should be culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. People with mental health problems and their carers (if appropriate) should have access to an interpreter or advocate if needed. Carers should be involved in decision‑making for people with a mental health problem who lack mental capacity, in accordance with the Mental Capacity Act 2005.
Commissioners and providers should aim to achieve the quality standard in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations. Nothing in this quality standard should be interpreted in a way that would be inconsistent with compliance with those duties.