68 The implementation of an inter­disciplinary treatment plan would also ensure a better activity programme for the individual patient. The hospital has developed a separate action plan with follow-up points for each recommendation made by the Parliamentary Ombudsman. The action plan is to be followed up with status reports as a regular item at the unit’s management meetings. Following the visit, the hospital – on the ­recommendation of the Parliamentary ­Ombudsman – has extended its use of ­information material. Patients now receive information about their rights in a brochure upon arrival and information is posted on a notice board in the unit. The ­information given to the patients is to be followed up through a user survey, and the information flow will also be a topic during the discharge c ­ onversations with the patients. The use of restraint measures was extensive at Vestfold Hospital compared to national figures. The figures showed an increase in the use of mechanical restraints and short-term physical restraint at the emergency sections last year, despite measures to reduce the use of restraint measures. Several factors were identified in connection with the visit that indicated a real risk of excessive use of coercion. As a result of the recommendations made following the Parliamentary Ombudsman’s visit, the hospital developed guidelines on the use of coercion and improved teaching and training in how the units can prevent the use of coercion. ­Training in record-keeping and registering ­decisions in connection with the use of coercion was also carried out. Spit hoods were removed from the unit ­immediately after the visit, and the hospital went through its procedures for cooperation with police. All of the emergency units at the hospital had separate night shift staff. It seemed that the high focus on security and a somewhat strict framework affected the night shift staff. NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2019 We also found that the night shift staff rarely ­participated in general staff training. Although the hospital found it expedient to continue the ­separate night shift staff arrangement, it was decided that all night staff must participate in selected teaching and one-day meetings. A new rule has also been introduced whereby night shift staff are required to complete one evening shift before they start working night shifts. We found some examples of good practice for segregation, where human contact and joint activities with the staff throughout the day were emphasised. Even so, we noted that the number of segregation decisions had increased and some of these were for long periods. The hospital had updated its procedure for segregation in order to ensure that segregation did not lead to isolation. Bergen Hospital Health Trust, Sandviken Psychiatric Clinic 14–16 August 2018 The NPM’s visit to Sandviken psychiatric clinic under the auspices of Bergen Hospital Health Trust identified several troubling issues, including in ­relation to the use of segregation and isolation. In May 2019, the clinic submitted its follow-up response to the report, and sent supplementary information at the Ombudsman's request in December 2019. All the sections visited at Sandviken had a segregation unit where patients can be kept separated from the other patients. A key finding was that segregation was conducted in premises with undignified conditions. The follow-up plan devised after the Parliamentary Ombudsman's visit stated that the segregation units should be designed to have normal, positive sensory impressions. This entails decoration on the walls, the use of ceiling lights, furniture and the possibility for patients to look out the windows.