Patient Secure Transport Courses

Conflict and Interventions Training for Mental Health Secure Escort or Ambulance Personnel

Secure Escort and Patient Secure Transport

Dynamis training for Secure Transport teams gives you the peace of mind that your teams are able to:

  • Use communication skills to achieve non-escalation and de-escalation when they interact with your patients, your NHS colleagues and your customers so that at each touchpoint, people feel respected and safe.
  • Balance their duty of care to their patient, to themselves and to the community when they are engaged in escorting patients (with care, custody and control of vulnerable persons).
  • Assess and Manage Risk so that the chance of an adverse incident during a secure transport is reduced to the lowest possible level and forseeable difficulties are spotted early and adequately managed.
  • Manage their Personal Safety by deploying effective habits  – staying alert and being decisive – with effective attitudes for enhanced safety on Patient Secure Transport tasks.
  • Working as a team in cooperation with their colleagues in both lower-risk, common situations and in high-risk, physical restraint scenarios.
  • Be ready and able to employ reliable and robust methods for last-resort physical interventions, when words and persuasion alone fail to resolve high-risk Secure Escort conflict situations

Personal Safety for Secure Transport Teams

Secure Escort personnel are frequently exposed to the risk of aggression and violence because of the nature of the work. Taskings often require Secure Escort teams to encounter vulnerable people who may be distressed or agitated because of poor mental health or are suffering from the effects of drugs and alcohol intoxication. 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 vulnerable people 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 protective physical interventions 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 protective instincts, they are very court defensible and appropriate for use by healthcare staff.

Control Tactics for Ambulance Service Violence Management Scenarios

There are times in some circumstances – when words alone fail to create safety – the use of force to control or restraint a patient becomes necessary.  These situations may arise when Secure Transport personnel are attempting to prevent harm from occurring, when a patient is refusing treatment or refusing to attend hospital at a time when they are judged not to have capacity or autonomy to make these decisions, for example.  In these limited scenarios the skilful application of control tactics and physical interventions, 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.

Patient Transport Service Secure Escort Tasks

Where the Patient Secure Transport service is engaging in an escort 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 and control of the team with whom they have been placed.  Secure Transport staff may need to have a high level competency in these tactics in order to safely carry out their taskings.

Restraint Devices for Secure Transport – 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 Secure Transport and Secure Escort Personnel:

      1. These are some of the major Conflict or Violence Flashpoints that we have identified in our analysis of the Secure Escort task with experienced teams around the country:

        • Risk Assessment (on numbers 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)
        • NHS staff ask for assistance: Patient needs to be taken to Seclusion on arrival
        • NHS staff ask for assistance: Patient needs to be stabilised 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.

“Exceeded all  the criteria we needed to achieve, interesting, interactive, informative and enjoyable. A really impressive course in all aspects, my team came away visibly more confident and closer as a team, I am certain the experience will give us the right foundations enabling excellent care to the patients we manage. A sincere thanks.”

“I have been on many training courses and this has to be the best one I have been on and I believe that it was down to the amazing trainer. He understood our needs and situations we could get in to and then used these to practice and learn different techniques. He took his time with each member of staff and treated us as individuals and as a team.”

“Overall the course was well presented. Made a welcoming change to focus on patient role play and de escalation techniques! Really found the hands on part of the course very useful compared to other companies techniques. Very good course.”