Mental health staff who do not comply with safety checks on tranquillised patients look set for tougher sanctions as bosses said doing the 'nice things' was not good enough.
It was revealed in January that fewer than one fifth of patients at Norfolk and Suffolk NHS Foundation Trust (NSFT) may not have been checked often enough after they were tranquillised.
And although improvements had been made, proof patients had been checked often enough was still only filled out 58pc of the time, the trust's board of directors heard today.
Non-executive director Ian Brookman said: 'We need to do something different rather than carry on doing the same thing, because we're not going to get a different result.
'We've been trying to do the nice, kind things but we are way behind where we should be.'
When rapid tranquilisation is used, the National Institute for Health and Care Excellence (NICE) say patients should be observed once every hour for four hours, and a form must be filled out to prove this was done.
Four months ago the trust's medical director Dr Bohdan Solomka was tasked with ensuring the rate was brought up to 95pc by the end of March next year.
Yesterday non-executive director Adrian Matthews said that because the number of rapid tranquillisations carried out was small, the issue should be 'easy to crack'.
Latest figures from March show patients were tranquillised 51 times.
He said: 'These are professional people who are accepting noncompliance.'
Chairman Gary Page added: 'I'm not hearing any degree of consequences that we will need to get us where we need to be.'
Dr Solomka said staff had been offered extra training and been told of the importance of the checks but admitted there had been no disciplinary procedures for staff who did not comply.
Non-executive director Tim Newcomb asked: 'At what point do we say that's not good enough and some kind of disciplinary happens?'
He added: 'I'm not Attila the Hun but at some point we've got to get to the point where we example set.'
Managing director Julie Cave said: 'We've done lots of training and communication, we've done all the nice stuff, but we have to hold people to account.'
Directors were concerned a lack of staff was contributing to checks not being carried out.
The first check on tranquillised patients must be made within an hour and be carried out by a doctor, while subsequent checks can be done by a nurse.
But because doctors would often have to travel from other sites, the initial checks could not be carried out quick enough.
Non-executive director Marion Saunders said this would continue 'unless we put more doctor cover at night, which is the issue'.
She added: 'This has been going on since I have been with the trust. The one-hour doctor issue is increasingly problematic.'
Ms Saunders has been with NSFT since September 2014.
Operations director for Suffolk Peter Devlin said: 'We might have expectations but [staff shortages] might not allow us to deliver it.'
Governors were told last month NSFT's registered nursing vacancy rate was at 16pc, and its medical staff vacancy rate was 17pc.
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