Annual Report 2015 applicable house rules. The Commissions will include the findings and recommendations presented in the report in their supervisory activities. Death during detention The Health Care Inspectorate and the Inspectorate VenJ by default have a role to play in the case of a detainee dying while in a detention centre. All reports of a death are assessed jointly by the Inspectorates. A repeat item that arises and requires attention from the reports in the case of death during detention is the exchange of medical information. The professionals do not always share all required medical information. 2. Adult patients in the healthcare system Supervision of the restriction of freedom in the healthcare system took place in 2015, as well. The supervisory activities not only focused on compliance with the relevant legislation, but also, and primarily, on preventing and coercion of physical restraints and seclusion. Various supervisory activities were performed. All instances of compulsory treatment were individually assessed, for instance, while institutions' policies on the application and the prevention of having to use physical restraints and seclusion were also reviewed. Care for the disabled and the elderly The IGZ in 2015 individually reviewed 48 cases in the care for the disabled and the elderly systems. During its inspections, the IGZ met with the client, their legal representative and the treatment team, and inspected the client file. Half of the cases involved the use of bed restraints and physical holding. In addition, the IGZ reviewed the use of seclusion measures and the application of compulsory medication. The IGZ found that both the decision-making process concerning and the performance of compulsory treatment were in proper order for all institutions visited. Both the decision-making and evaluation processes were performed in multidisciplinary consultations. Almost all institutions actively looked for alternatives to using physical restraints and seclusion. The client and/or their representative were properly informed of the reason for the compulsory treatment. However, the involvement of external experts when administering compulsory treatment, the clear registration of the use of these measures and the involvement of the client and/or their representative remain issues requiring improvement. Fewer psychoactive drugs need to be administered and the incidence of locking patients in their rooms needs to go down. In addition, the IGZ reviewed the use of physical restraints and seclusion at the level of the institution. In this connection, too, it was found that institutions observed due care when implementing such measures. The responsibility for the use of the measure was properly divided, the measures used were reported in the client file and most institutions conducted a multidisciplinary consultation prior to deciding to use physical restraints or seclusion. However, the IGZ also identified some shortcomings, especially as concerns the analysis of (problem) behaviour. Because 17 Table of Cont