Secure Escort Courses

Safety Training for Mental Health Escort or Paramedic Personnel


Secure Escort

Personal Safety, Conflict or Restraint training specific to your Secure Escort Team needs

  • Communication:  Verbalisation skills for communicating under pressure and de-escalation in high-risk Secure Escorts
  • Duty of Care:  Understanding where the duty begins and ends and who carries responsibility for restraint during Secure Escort.
  • Reasonable Force Rules:  Understanding Reasonable Force for Breakaway Control and Restraint on Secure Escorts
  • Risk Awareness:  What are the risks of physical restraint intervention and how to reduce or avoid them
  • Personal Safety:  Building effective habits and attitudes for enhanced safety on ambulance Secure Escort calls
  • Teamwork:  Working in cooperation with team-mates in high-risk restraint and non-restraint situations
  • Restraint Tactics:   Reliable and Robust methods for last-resort physical intervention resolution of high-risk Secure Escort conflict situations

Personal Safety for Secure Escort Teams

Secure Escort personnel are frequently exposed to the risk of aggression and violence because of the nature of the work. Tasking is often require Secure Escort teams to be the first people on scene at an accident or an incident where the vulnerable people involved may be distressed or agitated because of poor mental health or are suffering from the effects of drugs and alcohol. Developing effective habits and attitudes for maintaining situation awareness and personal safety in such Secure Escort situations is a critical area for staff both new to the job and veterans. Our 9 attitudes methodology provides a framework for developing these skills and our conflict resolution program helps to ensure that Contacts with persons in the community are both non-escalatory and effective.

Secure Escort-specific Breakaway Skills programme

Where Secure Escort personnel are confronted with acts of physical violence, the use of force may become necessary and therefore it is prudent for services to provide training and skills for disengagement and breakaway for personnel.  Our system of self protection offers, in a short period of time, skills which are instinctive, easy to learn, are retained well over time and which are extremely effective in helping Secure Escort staff to prevent themselves being injured in the result of physical attack.  Because the methods we use are based on human survival instincts, they are very court defensible and appropriate for use by healthcare staff.

Control Tactics for Ambulance Service Restraint Scenarios

There are times in some circumstances when, whether with police assistance or when police are attending a call with paramedics, that the use of force to control or restraint a patient becomes necessary.  The situations may arise when Secure Escort personnel are attempting to prevent a great harm from occurring when a patient is refusing treatment or refusing to attend hospital at that time when they are judged not to have capacity to make these decisions, for example.  In these limited scenarios the skilful application of control tactics and restraint procedures, while working as part of the Secure Escort team, can reduce the risk of potential harm to the patient and increase the overall safety of the attending personnel.

Ambulance Service Secure Escort Tasks

Where the Secure Escort service is engaging in a transport task, often it will be necessary for the Secure Escort team to have a full understanding and knowledge of the control and restraint tactics which may be appropriate to safely complete the transport of a patient.  This sometimes will include the use of holding techniques and procedures which reduce the risk of the patient absconding from the care custody custody and control of the health service in which they have been placed.  Secure escort staff may need to have a high level competency in these tactics in order to safely carry out their taskings.

Restraint Devices for Secure Escort – Handcuffs, Soft-Cuffs and Soft Restraint Systems

For some high secure patients it will be necessary for escort staff to safely apply restraint devices. Training should ensure that any application of restraint devices is both safe and appropriate and effective, proportionate to the needs identified in the escorting procedure.  For example, handcuff training should include elements of the proper care of the devices, the mechanical principles which underline their use, the legal rules which accompany their use and tactics for use with both compliant subjects and non-compliant subjects.

Programmes for Ambulance Service Paramedics and Secure Escort Personnel:


      1. Patients in the care of Secure Escorts who become distressed or present with difficult behaviour will need specific and well-considered verbal communications or crisis intervention strategies to avoid, defuse or deescalate behaviour.
      2. Patients who are very distressed, frustrated or highly aroused sometimes take active behaviours which could harm themselves or a member of Secure Escort staff.  Examples include:  lashing out, striking, pushing, pinching, kicking or throwing an object, trying to exit the vehicle, refusing to enter or exit the vehicle, refusing to leave a room.
      3. Patients sometimes resist the reasonable requests of staff to collaborate, co-operate or comply with the Secure Escort staff.  Where a patients resists those requests, it can sometimes lead to elevated risk in the interaction.  In these circumstances, some intervention may be required in order to allow the task to proceed, for example using holding procedures to enable staff to carry out a task.
      4. Patients have medical, physical or behavioural conditions which are complex, in addition to mental ill-health.  For example a significant number of patients for transport have dementia, are elderly or are frail with movement, sensory or cognitive difficulties.  These difficulties in cognition or communication sometimes lead to conflict, aggression and violence.

  • Major Conflict or Violence Flashpoints identified in Secure Escort team analysis:

    • Risk Assessment (on #s of staff) has over- or under-estimated requirements
    • Patient has not been informed they are moving that day
    • Other communication problem on interacting with the patient
    • Patient is in Seclusion on initial contact
    • Patient resists escort on invitation
    • Patient assaults escort on invitation
    • Patient becomes resistive/assaultive during holding/escorting procedure
    • Patient offers resistance near vehicle (will not board)
    • Patient offers resistance in vehicle (tries to exit)
    • Patient offers resistance in vehicle (refuses to exit)
    • Patient needs to be taken to Seclusion on arrival
    • Patient needs to be stabilised on the floor for Rapid Tranquillisation (RT)

  • Key training needs which arise from common scenarios in Secure Escort work.

    FUNDAMENTALS OF BEHAVIOUR FOR PEOPLE WITH SPECIAL NEEDS (Mental Health and Dementia focus):  Where the care staff do not have clinical level of understanding about the special needs of those they may interact with during transfers, it is imperative that the initial and ongoing training in the Prevention and Management of Violence and Aggression should offer a baseline level of advice to staff.   It has been identified that secure escort staff sometimes meet service users with Demential, Learning Disabilities, varied Mental Health conditions, intoxication/drug use and, in the most challenging circumstances, a mixture of these.   Staff need to have a common language for describing the behaviour that they are seeing and experiencing, so that there is a foundation of understanding from which good decision-making can emerge.   Staff should be given an insight into the essential characteristics of the conditions along with conflict non-escalation, de-escalation and crisis management strategies for effective communication with people who display the behaviours in question.

    THE STATUTORY DUTY OF REASONABLE CARE:  Staff need to understand their duty of care in any scenario which may carry a risk of injury.  Section 7 of the Health and Safety at Work Act 1974, which specifically addresses the duty of employees, provides the basis of our advice in this respect.  The Act requires employees to take reasonable care for themselves and for others who may be effected by their acts or omissions.   The training will endeavour to make sure that staff understand the need to balance their own safety (as a primary consideration) with the need to take action which also creates safety for the Patient (the secondary consideration).

    NATIONAL-LEVEL GUIDANCE for PHYSICAL INTERVENTIONS WITH Patients:  Staff will need to have an understanding of the national-level guidance and good practice advice in relation to physical interventions and use of force with Patients. (NICE Guidance NG10) and the Mental Health Code of Practice.

    THE STATUTORY POWER TO USE REASONABLE FORCE:  The legal basis for any physical intervention with a Patient in an occupational setting is currently laid down in the Common Law, the Criminal Law Act 1967, the Mental Health Act and the Mental Capacity Act among other places, which grants staff the power to use ‘such force as is reasonable in the circumstances’ with vulnerable persons, in the pursuit of certain lawful purposes. Staff who carry out physical interventions will need to make robust decisions about the use of force during often rapidly-unfolding or high-stress incidents.  They will also need to articulate their decisions post-incident in written reports and debriefing by their line management and/or any investigating authority.  Clear principles which establish the foundation of the use of Reasonable Force will be explored by the staff, specifically the key components of Necessity and Proportionality as they relate to those decisions.  Key issues will include the ambiguity of circumstances, perception and justification.

    AWARENESS OF RISK IN PHYSICAL INTERVENTIONS: Through long and sometimes tragic experience, there is a considerable body of knowledge and accepted advice in regard to the management of risk in physical interventions.  The most critical risk is that a person subjected to a physical intervention would succumb to a sudden, restraint-related death.  The risk factors which increase the possibility of a sudden, restraint-related fatality are well known and will be explored with staff so that they understand the types of physical intervention which should be AVOIDED whenever possible.    They will also explore the warning signs which would alert them to the possibility that the risk of fatality is presented in a scenario and the alternative measures they should take if such a scenario should present itself.  key issues will include the difference between emergency interventions and planned interventions and the need to be aware of manual handling regulations/advice to avoid musculoskeletal injury where possible.


    THE USE OF RESTRAINT DEVICES AS A LESS-INTRUSIVE RESPONSE  Systems of soft restraint are now in use throughout the UK which offer alternatives to the traditional metal handcuffs and prolonged, intrusive manual restraint by staff.  Soft-restraint systems are a direct replacement for metal handcuffs and have been medically reviewed, legally tested in court as a “less intrusive” method of restraint and offer a risk-reduction strategy for staff, organisations and for the patient.  Where properly incorporated into the system of work for the Secure Escort staff, soft-cuffs have the potential to significantly increase the safety of the staff in some of the most difficult situations they face.

When: Training Programmes specific to your needs can be carried out in durations from 2 to 4 Days based on your identified needs and scheduled for your convenience

Who:  Groups of up to 12 secure escort staff are led by each Dynamis trainer (larger groups by request). Attendees can include Paramedics, Escort Staff, RMN escorts, Supervisors and Operations staff subject to the training needs analysis and learning outcomes of specific courses.

Where:  Training is normally held at your venue where sufficient space is available.

How:  Our trainers deliver this course using a mix of lecture/presentation, Q&A, varied forms of carefully layered physical practice and scenario rehearsal.

Why:  Matched to your needs     Led by Professional Trainers     Legally Audited     Fully Risk-Assessed     Values Dignity and Respect     Safeguards Client rights     Offers Staff Practical Options     Compliant with Government Regulations     Value for Your Investment

Recommended Related Courses: Conflict Management or Personal Safety training, or both depending on your risk level.

Please contact us to gain access to our online Physical Intervention, Control and Restraint, Safe Holding and Conflict Management Training Needs Analysis tools.



This video shows some examples of our mid-tier restraint training.  Less intrusive and more restrictive tactics also form part of our complete repertoire for the full spectrum of risks which exist in healthcare environments.


  • 2018 FEEDBACK SURVEY: The training course from Dynamis fulfilled or exceeded expectations 98.1% 98.1%
  • Our Dynamis instructor had a very good or excellent level of knowledge and competence 97.4% 97.4%
  • The theory and knowledge components helped me professionally 99.6% 99.6%
  • The techniques and tactics were appropriate to real scenarios in our work 97.3% 97.3%
  • Our Dynamis trainer observed good Health and Safety practices 99.4% 99.4%
  • The Dynamis training course was of the right duration to gain the skills and knowledge I needed 89.9% 89.9%

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