Nid ydym yn gwybod a yw'r ymateb mwyaf diweddar i'r cais hwn yn cynnwys gwybodaeth neuai peidio - os chi ywTim Nicholson mewngofnodwch a gadael i bawb wybod.

Bowel Management Patient Safety Alert (SPINE 01/19)

We're waiting for Tim Nicholson to read a recent response and update the status.

Dear Weston Area Health 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,

Tim Nicholson

FOI, Waht (WESTON AREA HEALTH NHS TRUST), Weston Area Health NHS Trust

Dear Tim

Please find below the response to your recent Freedom of Information enquiry from Weston Area Health NHS Trust.

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?

Weston General Hospital is not a trauma centre nor do we operate on spinal patients. The hospital does not admit spinal patients to the Trust, these patients would be transferred to a tertiary centre for management.

I trust that your request has been satisfactorily answered, but I should advise you that you have the right to complain about this response by reference to the complaints procedure of the Weston Area Health NHS Trust, in which case you should write to me at this email address.

If you remain dissatisfied with the decision of the Trust following your complaint, you may write to the Information Commissioner, whose address is:

Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Yours sincerely,

Jo Ward

on behalf of Gillian Hoskins
Trust Board Secretary &
Freedom to Speak Up Guardian

[email address]

Telephone: 01934 647002

www.waht.nhs.uk

dangos adrannau a ddyfynnir

FOI, Waht (WESTON AREA HEALTH NHS TRUST), Weston Area Health NHS Trust

Dear Tim

Please find below the response to your recent Freedom of Information enquiry from Weston Area Health NHS Trust.

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?

Weston General Hospital is not a trauma centre nor do we operate on spinal patients. The hospital does not admit spinal patients to the Trust, these patients would be transferred to a tertiary centre for management.

I trust that your request has been satisfactorily answered, but I should advise you that you have the right to complain about this response by reference to the complaints procedure of the Weston Area Health NHS Trust, in which case you should write to me at this email address.

If you remain dissatisfied with the decision of the Trust following your complaint, you may write to the Information Commissioner, whose address is:

Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Yours sincerely,

Jo Ward

on behalf of Gillian Hoskins
Trust Board Secretary &
Freedom to Speak Up Guardian

[email address]

Telephone: 01934 647002

www.waht.nhs.uk

dangos adrannau a ddyfynnir

FOI, Waht (WESTON AREA HEALTH NHS TRUST), Weston Area Health NHS Trust

Dear Tim

Please find below the response to your recent Freedom of Information enquiry from Weston Area Health NHS Trust.

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?

Weston General Hospital is not a trauma centre nor do we operate on spinal patients. The hospital does not admit spinal patients to the Trust, these patients would be transferred to a tertiary centre for management.

I trust that your request has been satisfactorily answered, but I should advise you that you have the right to complain about this response by reference to the complaints procedure of the Weston Area Health NHS Trust, in which case you should write to me at this email address.

If you remain dissatisfied with the decision of the Trust following your complaint, you may write to the Information Commissioner, whose address is:

Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Yours sincerely,

Jo Ward

on behalf of Gillian Hoskins
Trust Board Secretary &
Freedom to Speak Up Guardian

[email address]

Telephone: 01934 647002

www.waht.nhs.uk

dangos adrannau a ddyfynnir

Dear FOI, Waht (WESTON AREA HEALTH NHS TRUST),

Spinal cord injured people may need in-patient or community care at any time in their lives.
Indeed, such care may be required many, many years after their original injury (and rehabilitation). Also, the primary reason why care is required might well be unrelated directly to the spinal cord injury.
For example, a spinal cord injured person may: have serious mental health issues which require in-patient treatment; be admitted to hospital following an accident or severe infection; or require ongoing care in the community.
Despite the above, you have advised that our bowel management freedom of information request is not applicable to your trust.
Please explain precisely why you believe that a spinal cord injured person could never require services from your trust in their lifetime.
It would be greatly appreciated if you could copy your WhatDoTheyKnow response to [email address]

Yours sincerely,

Tim Nicholson

FOI, Waht (WESTON AREA HEALTH NHS TRUST), Weston Area Health NHS Trust

Dear Tim

Thank you for your e-mail, and please find below the response to your concerns.

As it is so very rare that staff here at Weston will encounter this group of patients it was felt we would be unable to maintain competencies for their specialist care.

The Critical Care Matron at the Trust is currently working with the Senior community team including the Director of Nursing and Therapies and is in consultation with BBNSSG Continence Partnership Group who work under the Adult Bowel Care NSCP Policy to agree a support from them when we admit a spinal injury patient from the community. This will ensure the right skilled professional people are manging any interventions required for spinal injury patients during their acute stay. Protocol and guidance notes are being produced by the Trust for future reference.

I trust that your request has now been satisfactorily answered, but I should advise you that you have the right to complain about this response by reference to the complaints procedure of the Weston Area Health NHS Trust, in which case you should write to me at this email address.

If you remain dissatisfied with the decision of the Trust following your complaint, you may write to the Information Commissioner, whose address is:

Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Yours sincerely,

Jo Ward

on behalf of Gillian Hoskins
Trust Board Secretary &
Freedom to Speak Up Guardian

Telephone: 01934 647002

www.waht.nhs.uk

dangos adrannau a ddyfynnir

Nid ydym yn gwybod a yw'r ymateb mwyaf diweddar i'r cais hwn yn cynnwys gwybodaeth neuai peidio - os chi ywTim Nicholson mewngofnodwch a gadael i bawb wybod.