Dear Pennine Care 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

PENNINECARE, Foi (PENNINE CARE NHS FOUNDATION TRUST), Pennine Care NHS Foundation Trust

 

 

Dear Mr Smart,

 

FOI ref: 2019/0354

 

Thank you for your request for information dated 21^st February 2019.

 

We will consider your request under the Freedom of Information Act 2000.
You should receive a response within 20 working days - in this case by
21^st March 2019.  Please be aware, the information you have requested may
not be disclosed to you if it is exempt.

 

We will inform you if:

•               we are unable to achieve the 20 working day deadline. We
aim to give you a revised due date as soon as possible.

•               we are unable to give you the information as responding to
your request exceeds the ‘appropriate limit’. This would apply if it would
take us longer than 18 hours to retrieve, collate and provide the
information you request.

•               your request (in full or in part) needs be transferred to
another public authority to obtain the information you have requested

 

If you have any questions about this request, please contact me quoting
the reference number above.

 

 

 

Yours sincerely,

 

Julie Higginbottom

Information Governance Administrator

 

Pennine Care NHS Foundation Trust

225 Old Street

Ashton-under-Lyne OL6 7SR

 

 

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dangos adrannau a ddyfynnir

PENNINECARE, Foi (PENNINE CARE NHS FOUNDATION TRUST), Pennine Care NHS Foundation Trust

Dear Mr Smart,

 

FOI ref: 2019/0354

 

Further to your email below, I can now respond to your request dated 21^st
February 2019.

 

Following receipt of your request, searches were conducted within Pennine
Care NHS Foundation Trust (the Trust) to locate the requested information
and I can confirm that the information requested is held by the Trust.

 

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

 

Responses are provided from:

Bury Adult Community Nursing Service & Continence and Stoma Service .

Oldham Adult Community Nursing Service.

Trafford Community District Nursing Service.

 

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”?

 

(c)  Yes – retained existing policy

 

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

 

Oldham Adult Nursing Service response - (a) Yes

Bury Adult Nursing Service & Continence and Stoma Service response – (c)
No bowel assessment and management policy in place

Trafford Community District Nursing Service – (b) No.

 

 

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?

 

Oldham Adult Nursing Service response - (a) Yes

Bury Adult Nursing Service & Continence and Stoma Service response – (a)
Yes (taught and prescribed by Continence Advisory Service only)

Trafford Community District Nursing Service – (b) No.

 

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

 

(a) Yes

 

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”?

 

Oldham Adult Nursing Service response - (a) Yes

Bury Adult Nursing Service & Continence and Stoma Service response – (a)
Yes (this would be in discharge planning prior to discharge into
community).

Trafford Community District Nursing Service – (a) Yes (these procedures
are performed by the District Nursing service who operate 24/7).

 

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       

 

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

 

Oldham Adult Nursing Service response - (a) Yes (please answer Q13, but
ignore Q14)

Bury Adult Nursing Service & Continence and Stoma Service response – (b)
No (please answer Q14, but ignore Q13)

Trafford Community District Nursing Service – (a) Yes (please answer Q13,
but ignore Q14)

 

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

 

Oldham Adult Nursing Service response:-

Sara Handley*

Practice Development Lead - Adult Nursing Services/Staff Governor

RN, BSc, CSP/CPT-DN, PGCT, NMP, QN

Contact Tel: 0161-716-3000

 

Trafford Community District Nursing Service response:-

Lisa Spencer*

Senior Practitioner Bladder & Bowel Team

Delamere Clinic

 

 

 

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

 

Bury Adult Nursing Service & Continence and Stoma Service response:-

(a)  Alert implemented without appointment of a clinical leader

 

 

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’?

 

Oldham Adult Nursing Service response - (a) Yes

Bury Adult Nursing Service & Continence and Stoma Service response – (a)
Yes (as part of induction to clinical practice competencies and
supervision as required).

Trafford Community District Nursing Service – (a) Yes

 

 

*Please be aware, the personal information disclosed within this response
has been provided for the purposes of the Freedom of Information Act
(2000), including transparency and accountability.  The provision of this
information by the Trust should not be interpreted as consent for the
purposes of either direct or unsolicited marketing. 

 

 

Complaint Rights

 

Your attention is drawn to the details below, which outline your right of
complaint.

 

Should you have any further queries concerning this matter, please email,
write or contact the team on telephone number 0161 716 3147 quoting the
reference number above.

 

Yours sincerely

 

Julie Higginbottom

Information Governance Administrator

 

Pennine Care NHS Foundation Trust

225 Old Street

Ashton-under-Lyne OL6 7SR

 

 

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SATISFACTION SURVEY

 

To help us monitor and improve our services, please complete our anonymous
satisfaction survey that can be found at the following address –

[1]https://www.surveymonkey.co.uk/r/pcftfoi...

 

COMPLAINT RIGHTS

 

Are you unhappy with how your request has been handled or do you think the
decision is incorrect?

 

You have the right to request the Trust review their decision.  However,
please be advised, as per the Freedom of Information Code of Practice
(2018), the Trust is not obliged to undertake a formal internal review on
any complaints received  40 working days after the date of response.  If a
request for internal review is received after 40 working days, the Trust
may not accept your request for formal review, but will take steps to
assist you. 

 

Prior to lodging a formal complaint you are welcome and encouraged to
discuss the decision with the case officer that dealt with your request.

 

Ask to have the decision looked at again –

 

The quickest and easiest way to have the decision looked at again is to
telephone the case officer.

 

That person will be able to discuss the decision, explain any issues and
assist with any problems.

 

Complaint

 

If you are dissatisfied with the handling procedures or the decision of
Pennine Care NHS Foundation Trust made under the Freedom of Information
Act 2000 regarding access to information, you can lodge a complaint with
Pennine Care NHS Foundation Trust to have the decision reviewed.

 

Complaints should be made in writing and addressed:

The Information Governance Manager

Pennine Care NHS Foundation Trust

225 Old Street

Ashton-under-Lyne OL6 7SR

 

If email is preferred, complaints may be sent to
[2][Pennine Care NHS Foundation Trust request email].

 

The Information Commissioner

 

After lodging a complaint with Pennine Care NHS Foundation Trust if you
are still dissatisfied with the decision you can make an application to
the Information Commissioner for a decision on whether the request for
information has been dealt with in accordance with the requirements of the
Act.

 

For information on how to make an application to the Information
Commissioner please visit their website at [3]www.ico.org.uk . 
Alternatively, phone or write to:

 

Information Commissioner's Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Phone:  01625 545 700

 

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dangos adrannau a ddyfynnir