New pilot findings show how Datix Cymru can strengthen oversight of restrictive practice
11 March 2026
Findings from an NHS Wales pilot project have shown how targeted changes to Datix Cymru could improve the recording, monitoring and review of restrictive practice across NHS care settings.
The pilot project was led by NHS Wales Performance and Improvement and the Once for Wales Concerns Management Team in partnership with health boards. It tested a new approach in learning disability and mental health inpatient services as part of adverse incident reporting.
The findings from the data gathered in September-December 2025 demonstrate how more consistent, structured recording can support safer practice, stronger governance and a clearer focus on human rights-based care.
The pilot took place in adult learning disability inpatient units in Hywel Dda, Betsi Cadwaladr, Swansea Bay, and Aneurin Bevan University Health Boards. Following initial success, it was later extended to include eight adult mental health wards in Hywel Dda University Health Board.
Setting the conditions for consistency
Restrictive practices, whether planned or unplanned, can have a significant impact on people’s rights, dignity, and wellbeing. The Welsh Government’s Framework for Reducing Restrictive Practices sets clear expectations that any use of restrictive practice must be lawful, proportionate and used only as a last resort. It also expects organisations to be able to record, monitor, and review their use in a consistent and transparent way.
Before the pilot, health boards described variation in how restrictive practices were recorded on Datix Cymru. In many cases, their use was only identifiable through free-text narrative, making it difficult to analyse patterns or support timely review. The pilot tested a different approach. When reporting an adverse incident, staff were asked whether a restrictive practice had been used. A positive response triggered a series of questions and workflow to capture key details.
What the pilot found
Throughout the testing period, ward staff used the new recording form, capturing restrictive practice in more than 279 adverse incidents.
David O’Brien, Chair of the Restrictive Practice Datix Cymru Project Implementation Group, said:
"Health boards reported that recording was more consistent, and detailed, using prompts for key questions and shaping a workflow that leads to the review of each practice. The predetermined questions for reviewers has complimented existing governance processes. The ability to capture multiple restrictive practices within a single adverse incident has reduced duplication and supported a more accurate understanding of practice at ward, organisational, and national level."
The pilot also demonstrated that the form could be used across the full range of restrictive practice types, providing confidence in its applicability across learning disability and mental health settings.
Learning from learning disability services
In adult learning disability inpatient units, the pilot project prompted important discussion about how different restrictive practices are defined in care settings leading to recommendations for future work.
While there was shared agreement that all restrictive practices should be recorded, services highlighted that not all practices occur in response to an adverse incident. The pilot helped clarify where Datix Cymru is most appropriately used and where alternative recording arrangements are required, supporting clearer and more proportionate governance. Services also reported improved efficiency, with fewer adverse incidents reported as all detail can be captured in one record.
Recording restrictive practice use on Datix Cymru will create a consistent approach across Wales. However, some health boards believe that effective monitoring and review will also require additional information about patient acuity, and care environments before using the data to benchmark. While the new recording form assists review and monitoring, its impact on reducing restrictive practice will need to be evaluated over time.
Additional benefits in mental health wards
Mental health wards involved in the extended pilot identified additional operational benefits.
Administrative teams reported less time spent reviewing narrative reports to extract key information. Ward staff and restrictive practice trainers noted that the structured format supported more consistent recording and improved data quality.
The use of defined fields also enabled the development of real-time dashboards, allowing services to review restrictive practice data as it is recorded, rather than retrospectively.
Next steps
The pilot highlighted that changes to recording must be supported by improved workforce awareness and understanding of restrictive practices. Variation in how restrictive practice is defined and understood will require ongoing training, supervision, cultural change and organisational policies that reflect The Welsh Government Framework.
NHS Wales Performance and Improvement is currently working on how restrictive practice data can be used alongside wider patient safety intelligence to support meaningful learning and improvement over time.
David O’Brien added:
“We’re really pleased with the outcome of this project. It is a great example of improvement across multiple learning disability services having the potential benefit for the wider NHS. We’ve completed an options appraisal which will inform decisions about future rollout. The pilot has demonstrated how our changes can reduce administrative workload, provide a single point of data collection, and support the review of practice.”
Work will continue with health boards, national groups, and the Once for Wales Concerns Team to ensure that future developments support the shared ambition of reducing restrictive practice and strengthening human rights-based care across NHS Wales.