Clinically Related Challenging Behaviour Training in Healthcare Settings

Workplace violence risks for staff and service users in healthcare settings are often related to a patient’s or service user's situation, which may be unpredictable due to an acute medical condition or mental health issue, such as dementia.

Most effective in reducing risk and the number and severity of incidents is a considered approach to conflict resolution that develops awareness and safer working practices whilst contributing to positive relationships, rather than confrontation.

Managing Challenging and Risk Behaviours

NHS conflict resolution training (CRT) has traditionally focused on general conflicts involving visitors and patients. CRT is very important but also limited, in 2013 research concluded "79% of reported physical assaults against NHS staff in England in 2012-13 were due to medical factors (medical illness, mental ill health, severe learning disability or treatment administered)". 

The NHS Protect Guidance ‘Meeting Needs and Reducing Distress’ addresses this gap in training and encourages Trusts to offer an ‘Enhanced CRT’ training programme that covers clinically related challenging behaviours.

In settings experiencing higher levels of challenging behaviour and risk, this training should include practical skills for avoiding injuries to patients and staff when going about tasks and procedures, and may extend to clinical holds.

The integrated solution

To meet the wider needs of NHS staff Maybo has created a series of healthcare programmes that provide safer, everyday practical skills for managing both conflict and clinically related challenging behaviour. These core programmes can be tailored to the needs of staff through the inclusion of elective modules covering:

Heightened Observation (Patients at risk), Mental Health Crisis Skills, Learning Disability & Autism Awareness, Dementia Awareness, Supporting Children & Young People, Counter Terror Awareness, Post Incident Support & De-briefing

This tailored approach ensures staff receive the level of training they need in their role to be able to recognise, prevent and manage challenging behaviour, calm and defuse conflict situations and more effectively manage both clinical and malicious assault risks.

Level 1 - Conflict Resolution Training (CRT)

Delivers the NHS Protect minimum requirement for NHS Staff in a highly engaging way with superb resources and highly relevant and practical scenarios for each setting. Maybo’s Enhanced CRT also includes awareness of clinically related challenging behaviours.

Level 2 - Enhanced CRT

This course covers and refreshes the L1 CRT syllabus and builds understanding of clinically related challenging behaviours and safer nursing approaches that reduce anxiety and risk of harm to patients and staff.

Staff will learn:

  • Positive strategies to reduce and manage challenging behaviours and recognise vulnerable patients
  • Safer working practices on day to day tasks
  • How to reduce risks of injury when in close proximity to unpredictable patients
  • To guide and re-direct patients who may be confused
  • Disengage (breakaway) in a safer, low arousal way
  • Manage low level turbulence by a patient on bed/trolley.

Level 3 – Clinical Holding

This course builds on the L2 Training Syllabus and teaches safer methods for clinical holding and containment of patients when lawful and necessary.

Staff will learn to:

  • Recognise and reduce the risks surrounding holding
  • Work within legal, professional and ethical guidance
  • Contain a patient to prevent harm and permit critical authorised care and treatment
  • Apply restrictive holds when standing, seated on chairs, beds and in wheelchairs or supine on a bed/trolley

Level 4 – Incident Response

Aimed at the people who perform the incident response function which can include security officers and porters, clinical team members, on call duty manager and doctor.

Staff cover the relevant levels above subject to their role, plus learn how to:

  • Work as a team to ensure a professional response to an incident, with clear roles and communications
  • Contain and de-escalate, demonstrating a duty of care during and following the incident and accountability
  • Recognise and support highly vulnerable individuals
  • Implement Trust protocols in both emergency and planned crisis situations
  • Safer for staff and patients

Maybo’s considered approach to conflict management develops awareness and safer working practices and contributes to positive relationships, rather than confrontation. Maybo’s physical skills are proven to be gentle and low arousal, yet robust and safer for use with adults, children and older people when required as a last resort.

Benefits that make a real difference to your organisation, your patients and your staff

Your organisation benefits from training that provides evidence to support compliance with:

Your patients benefit from being cared for by staff who will be better able to:

  • Identify and respond early to patient’s physical and emotional needs
  • Recognise and respond professionally to challenging and risky behaviour
  • Reduce injury risks
  • Reduce the need for restraint and safeguarding incidents
  • Deliver more rounded patient centred care

Staff will benefit from being able to:

  • Recognise underlying causes of behaviour and how to respond to these
  • Adopt safer working practices that reduce risks of injury
  • Work better as a team in difficult scenarios

Flexible Delivery

To maximise the learning opportunity for your staff within your available budget you can choose direct delivery – a Maybo trainer delivering directly to your staff, or trainer training – your staff are developed and trained to deliver our programmes.

Both options can be blended with e-learning to give you the best fit in terms of staff development and value.


Please get in touch to learn more about our enhanced CRT training.