Dear North West Anglia 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,

Dave Bracher

RABY, Colette (NORTH WEST ANGLIA NHS FOUNDATION TRUST), North West Anglia NHS Foundation Trust

Dear Dave

 

Reference Number FOI 2019 - 179

 

Thank you for your request for information about a bowel management
patient safety alert at North West Anglia NHS Foundation Trust.

 

We anticipate being able to provide a response within the timescales
allowed under the Act.

 

In the meantime if you have any questions regarding this request please
contact us directly quoting the reference number above.

 

North West Anglia NHS Foundation Trust was formed on 1^st April 2017 and
comprises of Peterborough City Hospital, Hinchingbrooke Hospital and
Stamford & Rutland Hospital.  The Trust also provides community clinics at
Princess of Wales Hospital in Ely, Doddington Hospital and North Cambs
Hospital in Wisbech.  Further information is available via our website
[1]www.nwangliaft.nhs.uk.

 

Any future Freedom of Information requests should be addressed to North
West Anglia NHS Foundation Trust using the email address below.

 

The Freedom of Information Team

Hinchingbrooke Hospital

North West Anglia NHS Foundation Trust

[2][email address]

 

 

 

dangos adrannau a ddyfynnir

RABY, Colette (NORTH WEST ANGLIA NHS FOUNDATION TRUST), North West Anglia NHS Foundation Trust

Ref: FOI/2019/179

 

Dear Dave

 

Thank you for your recent enquiry under the Freedom of Information Act.
Please find your response detailed below.

 

Requesters Question and Trust Response:

 

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

 

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

 

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

 

(a) Yes

 

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

 

(a) Yes

 

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

 

(a) Yes

 

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

 

(a) Yes

 

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

 

(b) No Staff available on one hospital site – training still ongoing on
second hospital site

 

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

 

(a) Yes

 

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

 

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

 

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? 

 

(b) No – Not in a policy but this is accepted practice according to
individual needs       

 

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)

 

Q13.  What are the contact details for the “appropriate clinical
leader”(i.e. name, position, telephone and email)? Not available – Senior
Nurse Role

 

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

 

Not applicable

 

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’?

 

(b) No Our newly registered nurses have not yet come under the plans for
Annexe B

 

Please note that this response has been provided within the 20 working day
timeframe as stipulated in the Act.

 

North West Anglia NHS Foundation Trust was formed on 1^st April 2017 and
comprises of Peterborough City Hospital, Hinchingbrooke Hospital and
Stamford & Rutland Hospital.  The Trust also provides community clinics at
Princess of Wales Hospital in Ely, Doddington Hospital and North Cambs
Hospital in Wisbech.  Further information is available via our website
[1]www.nwangliaft.nhs.uk.

North West Anglia NHS Foundation Trust would like to ensure that the
information provided, following your request for information, was helpful
and appropriate.

We would be grateful if you would take a few minutes to complete the
following survey, your reply will be treated in confidence and be used to
improve the service we provide [2]https://www.surveymonkey.co.uk/r/3W36KZD

 

If you disagree with our decision or are dissatisfied with how we have
dealt with your request in the first instance you may contact me on the
following email address [3][North West Anglia NHS Foundation Trust request email] to request an internal
review.

 

Should you remain dissatisfied with the outcome you have a right under s50
of the Freedom of Information Act to appeal against the decision by
contacting:

 

Information Commissioner

Wycliffe House

Water Lane

Wilmslow

SK9 5AF

 

Phone: 0303 123 1113

Email: [4][email address]

 

Yours sincerely

 

 

FOI Team

Hinchingbrooke Hospital

North West Anglia NHS Foundation Trust

 

[5][email address]

 

 

dangos adrannau a ddyfynnir