Bowel Management Patient Safety Alert (SPINE 01/19)

The request was successful.

Dear Poole Hospital NHS Foundation Trust,

MY COLLEAGUES AND MYSELF ARE SENDING A DISCRETE AND SEPARATE FOI REQUEST TO EVERY NHS TRUST (BUT ARE ENSURING THAT NO DUPLICATE REQUEST IS MADE TO ANY ONE TRUST).

WE WOULD REQUEST THAT FOI OFFICERS SEND (VIA THE WHATDOTHEYKNOW WEBSITE PORTAL) A SIMILARLY DISCRETE AND SEPARATE RESPONSE FOR EACH INDIVIDUAL TRUST.

I work for the Spinal Injuries Association (SIA), the leading national user-led charity supporting spinal cord injured people and their families. Being a user led organisation SIA understand the challenges of living with a spinal cord injury (SCI). We strive to support all people living with SCI to access the services and support they need to stay healthy and live full, fulfilling and active lives.

Part of my role is to assist the Head of Public Affairs with FOI requests, such as the one that follows. As a request under the Freedom of Information Act, please provide the following information about the recent NHS Improvement (NHSI) Patient Safety Alert “Resources to support safer bowel care for patients at risk of autonomic dysreflexia 25 July 2018”, Alert reference number: NHS/PSA/RE/2018/005

Q1. Does the Trust have a formal written policy for digital rectal examination, digital rectal stimulation and the digital removal of faeces in spinal cord injured and other patients with neurogenic bowel dysfunction?

(a) Yes
(b) No

Q2. Following recommendation of this patient safety alert, did the Trust “review your local clinical policy and guidance relating to bowel assessment and management”?

(a) Yes – produced a new policy
(b) Yes - revised an existing policy
(c) Yes – retained existing policy
(d) No – did not review an existing policy
(e) No – no bowel assessment and management policy in place

Q3. Is your policy based on the policy template that the Spinal Injuries Association circulated to your trust in August 2018?

(a) Yes
(b) No
(c) No bowel assessment and management policy in place

Q4. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention – Digital removal faeces?

(a) Yes
(b) No

Q5. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Digital rectal stimulation?

(a) Yes
(b) No

Q6. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Trans anal irrigation?

(a) Yes
(b) No

Q7. Are staff available seven days a week to undertake these bowel care interventions?

(a) Yes
(b) No

Q8. Has the Trust “reviewed your local education and training provision for interventional bowel management” as recommended in the Patient Safety Alert?

(a) Yes
(b) No

Q9. As requested by the Patient Safety Alert, has the trust developed “an action plan to ensure patients have adequate and timely access to staff who are trained appropriately to carry out these procedures, including in the evening and at weekends”?

(a) Yes
(b) No

Q10. Has the Trust “shared your reviewed local guidance, advice on how to identify staff who can provide Digital Removal of Faeces, and the key messages in this alert with medical, nursing and other relevant clinical staff”?

(a) Yes
(b) No

Q11. Does the Trust have a policy that allows for the personal care assistants/carers of spinal cord injured patients to assist with this element of the patient's care?

(a) Yes
(b) No

Q12. As recommended in the Patient Safety Alert, have you identified “an appropriate clinical leader to co-ordinate implementation of this alert”?

(a) Yes (please answer Q13, but ignore Q14)
(b) No (please answer Q14, but ignore Q13)

Q13. What are the contact details for the “appropriate clinical leader”(ie name, position, telephone and email)?

Q14. Why has your Trust not appointed an “appropriate clinical leader”?

(a) Alert implemented without appointment of a clinical leader
(b) Took no action following Patient Safety Alert, as policy already in place
(c) Took no action. No existing policy in place
(d) Other

Q15. Are your newly registered nurses able to demonstrate the nursing procedures as required in Annexe B, section 6.5 of the Nursing and Midwifery Council’s document ‘Future Nurse: Standards of Proficiency for Registered Nurses’?

(a) Yes
(b) No

Technical Note – Relevant annexe reads:-

“Annexe B
6: Use evidenced based, best practice approaches for meeting needs for care and support with bladder and bowel health
6.5: Administer enema, suppositories and undertake manual evacuation when appropriate.”

If you have any queries or require clarification on any of these questions, please contact the Spinal Injuries Association at [email address]

Yours faithfully,

Andrew Smart

Poole Hospital NHS Foundation Trust

Dear Mr Smart,

Thank you for your request for information made under the Freedom of
Information Act 2000. This request was received by us on 21/02/2019 and
has been logged in our system with the reference number FOI/IG/5677.
Please ensure that you use this reference in any future correspondence
regarding this request.

The Trust has 20 working days from the date of receipt to respond to your
request, however we will endeavour to provide our response as soon as
possible. Should we require an extension to this deadline or any
clarification regarding the context of the request, we will contact you.

Should you have any queries about this acknowledgement or the status of
your request, please contact us using the details provided below. You may
also wish to explore the information which we have published on our
website under our FOI Publication Scheme:
https://www.poole.nhs.uk/about-us/freedo...

Yours sincerely,

The FOI Coordinator
The Information Governance Department
POOLE HOSPITAL NHS FOUNDATION TRUST

Address: Longfleet Road, Poole, BH15 2JB, Dorset
Tel: 01202 442866
Email: [Poole Hospital NHS Foundation Trust request email]
Web: https://www.poole.nhs.uk/about-us/freedo...

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Poole Hospital NHS Foundation Trust

2 Attachments

Dear Mr Smart,

In response to your request received by us on 21/02/2019, please see the
information attached. Any exemptions applied to this request are indicated
as appropriate/applicable.

We trust that this satisfactorily responds to your request however, if you
feel it necessary, you do have the right of appeal against the information
that we have provided. In the first instance, you should direct your
complaint to the Trust's Information Governance Manager using the contact
details provided below. If our internal complaints process does not
resolve your concerns, you may also then submit a complaint to the
Information Commissioner's Office either by post to Wycliffe House, Water
Lane, Wilmslow, Cheshire, SK9 5AF or by telephone on 08456 30 60 60 or
01625 545745. You can also find further information regarding your rights
under the Freedom of Information Act 2000 on the ICO website:
https://ico.org.uk/for-the-public/offici...

Yours sincerely,

The FOI Coordinator
The Information Governance Department
POOLE HOSPITAL NHS FOUNDATION TRUST

Address: Longfleet Road, Poole, BH15 2JB, Dorset
Tel: 01202 442866
Email: [Poole Hospital NHS Foundation Trust request email]
Web: https://www.poole.nhs.uk/about-us/freedo...

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DISCLAIMER: This email and any files transmitted with it are confidential and intended solely for the use of the individual, individuals or entity to whom they are addressed. Any views or opinions expressed are those of the author and do not necessarily represent the views of Poole Hospital NHS Foundation Trust unless otherwise explicitly stated.
This email may contain confidential and/or privileged materials. In the case of confidential and/or privileged materials, any review, retransmission, dissemination or other use of these materials by individuals or entities other than the intended recipient may be the subject of legal action. If you receive an email in error from Poole Hospital NHS Foundation Trust, please contact the sender and delete the material from your computer.