Bowel Management Patient Safety Alert (SPINE 01/19)

The request was successful.

Dear St Helens and Knowsley Hospitals NHS 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

FOIrequests, Mersey and West Lancashire Teaching Hospitals NHS Trust

5 Attachments

Good Afternoon

I wish to acknowledge receipt of your FOI request 101250219 made to St
Helens & Knowsley Teaching Hospital NHS Trust Warrington Road, Prescot
Merseyside

The Trust will endeavour to respond to your request within the 20 working
day time frame set out in the Freedom of information Act.

If you need to contact the Trust about your request you should write to
the above address or call on 0151 676 5697 or direct any e-mails to
[1][Mersey and West Lancashire Teaching Hospitals NHS Trust request
email]. Please quote the above reference number in all communications

Sharon Muldoon

Freedom of Information Officer

Pavilion

Alexandra Business Park

Tel 0151 676 5698

W:  [2]www.his.sthk.nhs.uk

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FOIrequests, Mersey and West Lancashire Teaching Hospitals NHS Trust

6 Attachments

Hi,

Please find the attached information from St Helens & Knowsley Teaching
Hospitals NHS Trust, Warrington Road, Prescot, Merseyside in response to
your Freedom of Information request ref 101250219 regarding Bowel
Management Patient Safety Alert (SPINE 01/19)

If you are unhappy with the way that the Trust has handled your request
you should contact the Complaints Department at Whiston Hospital at the
above address.

If any of the information that you requested has been subject to an
exemption you can ask for an internal review of that decision by
contacting the Complaints Department.

Following an internal appeal by the Trust you also have recourse to the
Information Commissioner (IC) for a review of the Trusts response. Contact
the IC as below:-

Information Commissioners Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Further information can be obtained from his website [1]www.ico.gov.uk

Or by contacting the helpdesk on: 01625545745

We are committed to improving our service can you please help us to do so
by completing a short questionnaire which can be found by clicking [2]here

W:  [3]www.his.sthk.nhs.uk

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Business Park, St Helens, WA10 3TP

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DISCLAIMER: This email may contain confidential and/or proprietary information some or all
of which may be legally privileged. It is for the intended recipient only. If any addressing or
transmission error has misdirected this email, please notify the author by replying to this e
mail and destroy any copies. If you are not the intended recipient you must not use, disclose,
distribute, copy, print, or rely on this email.

The information contained in this email may be subject to public disclosure under the
Freedom of Information Act 2000. Unless the information is legally exempt from disclosure,
the confidentiality of this email AND YOUR REPLY cannot be guaranteed.

References

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