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

Bowel Management Patient Safety Alert (SPINE 01/19)

We're waiting for Andrew Smart to read a recent response and update the status.

Dear Dudley and Walsall Mental Health Partnership 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

Foi (DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST),

Hi Paul,

Please see below draft response to Mr Smart - FOI cam in yesterday.

Dear Mr Smart

FREEDOM OF INFORMATION ACT 2000 - Dudley & Walsall Mental Health Partnership NHS Trust

Thank you for your request for information under the requirements of the Freedom of Information Act 2000 which we received on 20 February 2019.

I am able to respond now and can confirm that the Trust holds the requested information. Please find our response to your following request in blue.

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.”

A As we are a mental health trust, we do not treat bowel conditions. Therefore your request is not applicable to this Trust.

Your request has now been closed. If you have any queries related to the responses provided please in the first instance contact me.
If you are dissatisfied with the handling of your request please contact the Information Governance Manager on 01384 3245111 or email [email address]

If you remain dissatisfied, then you are entitled to approach the Information Commissioner and request an assessment of the manner in which the Trust has handled your request.

The Information Commissioner is an independent officer, appointed by the Crown and reports directly to Parliament. The Commissioner can request all the documentation relating to your request to decide whether the Trust’s decision was fair and meets the requirements of the Freedom of Information Act 2000 and can be contacted via www.ico.org.uk

You can also refer to the Information Commissioner at:

Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
www.informationcommissioner.gov.uk

Kind Regards

Mr Chris McGann
Corporate Governance Officer
Dudley and Walsall Mental Health Partnership
Trust Headquarters
2nd Floor
Trafalgar House
47-49 King Street
Dudley
DY2 8PS
[email address]

dangos adrannau a ddyfynnir

Foi (DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST),

Dear Mr Smart

FREEDOM OF INFORMATION ACT 2000 - Dudley & Walsall Mental Health Partnership NHS Trust

Thank you for your request for information under the requirements of the Freedom of Information Act 2000 which we received on 20 February 2019.

I am able to respond now and can confirm that the Trust holds the requested information. Please find our response to your following request in blue.

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.”

A As we are a mental health trust, we do not treat bowel conditions. Therefore your request is not applicable to this Trust.

Your request has now been closed. If you have any queries related to the responses provided please in the first instance contact me.
If you are dissatisfied with the handling of your request please contact the Information Governance Manager on 01384 3245111 or email [email address]

If you remain dissatisfied, then you are entitled to approach the Information Commissioner and request an assessment of the manner in which the Trust has handled your request.

The Information Commissioner is an independent officer, appointed by the Crown and reports directly to Parliament. The Commissioner can request all the documentation relating to your request to decide whether the Trust’s decision was fair and meets the requirements of the Freedom of Information Act 2000 and can be contacted via www.ico.org.uk

You can also refer to the Information Commissioner at:

Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
www.informationcommissioner.gov.uk

Kind Regards

Mr Chris McGann
Corporate Governance Officer
Dudley and Walsall Mental Health Partnership Trust Headquarters 2nd Floor Trafalgar House
47-49 King Street
Dudley
DY2 8PS
[email address]

dangos adrannau a ddyfynnir

Dear Foi (DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP 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,

Andrew Smart

Foi (DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST),

Dear Mr Smart

FREEDOM OF INFORMATION ACT 2000 - Dudley & Walsall Mental Health Partnership NHS Trust

Thank you for your request for information under the requirements of the Freedom of Information Act 2000 which we received on 2nd May 2019. You requested the following information:

Please explain precisely why you believe that a spinal cord injured person could never require services from your trust in their lifetime.

In relation to the previous request the response provided was correct. Please note that the Trust provides Mental Health Services, although we are aware that a patient may also have physical health conditions these would be managed and treated by the relevant Acute Trust or General Practitioner. Each patients physical care needs would be assessed on an individual basis within the Trust.

Your request has now been closed. If you have any queries related to the responses provided please in the first instance contact me.

If you are dissatisfied with the handling of your request please contact the Information Governance Manager on 01384 3245111 or [email address]. If you remain dissatisfied, then you are entitled to approach the Information Commissioner and request an assessment of the manner in which the Trust has handled your request. The Information Commissioner is an independent officer, appointed by the Crown and reports directly to Parliament. The Commissioner can request all the documentation relating to your request to decide whether the Trust’s decision was fair and meets the requirements of the Freedom of Information Act 2000 and can be contacted via www.ico.org.uk

You can also refer to the Information Commissioner at:

Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
www.informationcommissioner.gov.uk

Kind Regards

Information Governance and FOI Lead

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 ywAndrew Smart mewngofnodwch a gadael i bawb wybod.