CMDU performance

The request was partially successful.

Louise Bicknell

Dear Chelsea and Westminster Hospital NHS Foundation Trust,

I have been advised to contact you for this information having originally requested it from the North West London University Healthcare NHS Trust. They advise that to contact the North West London Health and Care Partnership (STP) which will have the information I must submit my request to you. Details of this are below

For this Covid Medicines Delivery Unit “CMDU”

For each of the following periods:

10 December 2021 to 9 February 2022,
10 February 2022 to 16 March 2022,
17 March 2022 to 30 June 2022,
divided into weeks if data is held at this level:

What hours did it/does the CMDU it operate?
How many staff are on duty exclusively to perform the work of the CMDU?
How many staff perform this work plus other duties?
What staff coverage is there per operating hour per day?
Does this differ at weekends/bank holidays
What key performance indicators did/do the CMDU staff work to during each period?
- When were each of these documented and agreed?
How many complaints have been received about the ability to contact the CMDU?
How many complaints have been received about other aspects of the work of the CMDU - please provide a break down ?
Please detail how the CMDU receives information from the logging of a positive lateral flow test from a clinically extremely vulnerable patient?
- Is this an instant notification or is a download peformed at set periods in the day – please detail providing a sample of the data
How many calls have been received by the CMDU following a positive lateral flow or PCR test asking for help from this CMDU?
How many calls had to be facilitated by GPs to ensure access to the CMDU

For each of the above periods (A, B and C) divided into weeks (Monday - Sunday, referred to as “calendar weeks” “CW”)

12.1 How many computer referrals/calls were returned by a CMDU qualified operative to provide a telephone assessment within a 4 hour window?
12.2 How many computer referrals/calls were returned to provide a telephone assessment within an 8 hour window?
12.3 How many computer referrals/calls were returned to provide a telephone assessment within a 24 hour window?
12.4 How many computer referrals/calls were returned to provide a telephone assessment after 48 hours but within 72 hours?
12.5 How many computer referrals/calls were returned to provide a telephone assessment after 72 hours?
12.6 How many people within each CW were advised no treatment was necessary
12.7 How many people within each CW were prescribed treatment by:
12.8 i. Sotrovimab
ii. Paxlovid
iii. Remdesivir
iv. Molnpiravir
12.9 On how many occasions within each CW was the first choice of medication not available?
12.10 On how many occasions within each CW was the second choice of medication not available?
12.11 For each of the above people who were prescribed treatments, what was the time between the first call being received from the patient and the treatment actually being provided?
12.12 For each of the above people how many people were subsequently admitted to hospital for treatment for COVID-19?
12.13 How many people subsequently died?
12.14 For each that died please provide causes of death noted on the death certificate and the date of death

Current position

What is the contingency plan to increase staffing in the CMDU in the event of an increase in COVID cases in the population?
What documentation sets this answer out? Please provide.
Please provide any relevant documents, including those detailing the work, roles and responsibilities of CMDU staff including job descriptions.
Is there a dedicated telephone line solely for the purpose of the CMDU work?
If so please provide the details of this telephone number.
Please also provide copies all other internal reporting (documents/data) that the CMDU (or its supervisory body) provides within its hospital authority as well as that which is then provided to the DHSC.

Yours faithfully,

Louise Bicknell

FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Dear Sir/Madam,

Thank you for your Freedom of Information request. Please note that in September 2015 Chelsea and Westminster Hospital NHS Foundation Trust merged with West Middlesex University Hospital so our response will include information for both trusts. There is no need to send in a separate request.
This request is being handled under the Freedom of Information Act 2000. We are permitted up to 20 working days (commencing the first working day after receipt of a request) in which to either answer your request or explain why we are unable to answer it. For more information on Freedom of Information, please see our website at:
http://www.chelwest.nhs.uk/about-us/orga...
We will answer your request as quickly as we can.
If you have any questions about your request please ensure you include our ref number above and send to [email address]

Information Governance Team

show quoted sections

FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Dear Requester
 
FOI 2022 424                                                            
  
Thank you for your information request received by us on   11 July  2022.
This request has been handled under the Freedom of Information Act 2000.
Please note that Chelsea and Westminster Hospital NHS Foundation Trust
merged with West Middlesex University Hospital in September 2015, for this
reason our response covers both sites
 
This response is for the first 10 questions only
 
What hours did it/does the CMDU it operate?
 
Around 10 hrs per day
 
How many staff are on duty exclusively to perform the work of the CMDU?
 
Has depended on workload but between 5 and 12
 
How many staff perform this work plus other duties?
 
Zero
 
What staff coverage is there per operating hour per day?
 
Has depended on workload but usually all staff are working the full shift
 
Does this differ at weekends/bank holidays
 
No except for Christmas day when it was reduced to 3 staff
 
What key performance indicators did/do the CMDU staff work to during each
period?
 
No specific KPIs but just to get through the whole list
 
When were each of these documented and agreed? n/a
 
How many complaints have been received about the ability to contact the
CMDU?
 
Unknown but less than 5
 
How many complaints have been received about other aspects of the work of
the CMDU - please provide a break down ?
 
Please detail how the CMDU receives information from the logging of a
positive lateral flow test from a clinically extremely vulnerable patient?
 
National Portal, referrals from GP, specialist services and 111
 
- Is this an instant notification or is a download performed at set
periods in the day – please detail providing a sample of the data
 
Continuously reviewed but initially national database was refreshed 2 or 3
times per day.
 
How many calls have been received by the CMDU following a positive lateral
flow or PCR test asking for help from this CMDU?
 
Precise figure unknown but many thousands
 
How many calls had to be facilitated by GPs to ensure access to the CMDU
 
Unknown
 
 
If you are not satisfied with how your request has been handled then
please either
1.      Respond to this email and we will review our answers and get back
to you or
2.      Write directly to:
The Chief Executive
Chelsea and Westminster Hospital NHS Foundation Trust
369 Fulham Road
London
SW10 9NH
 
If, after we have addressed your complaint, you remain dissatisfied with
how we have responded, you are entitled to appeal to the Information
Commissioner at:
The Information Commissioner's Office, Wycliffe House, Water Lane,
Wilmslow, Cheshire, SK9 5AF.
 
Phone 0303 123 1113
Website: [1]www.ico.org.uk
There is no charge for making an appeal.
Re-use of information and copyright
You are free to re-use the information contained in our response under the
terms of the Open Government Licence
[2]http://www.nationalarchives.gov.uk/doc/o...
You must take into account the exemptions and any other conditions such as
the non-endorsement condition below
This licence does not grant you any right to use the Information in a way
that suggests any official status or that Chelsea and Westminster Hospital
NHS Foundation Trust, the Information Provider and/or Licensor endorse you
or your use of the Information
Further information can be found at:
[3]http://www.opsi.gov.uk/advice/psi-regula...
Yours sincerely
The Information Governance team
Chelsea and Westminster Hospital NHS Foundation Trust
Email: [email address]
 
 
 
 
 
 
 
 

show quoted sections

Dear FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

Thank you for your response. I am somewhat surprised by how limited it is, so am seeking some clarification on some of the answers as I am sure there is more information in the background.

I had asked that the answers be split by the following time periods (10 December 21 - 9 February 22, 10 February 22 - 16 March 22 & 17March 22 - 30 June 22) to get an idea of how this process had bedded in, however at this stage think it is better to focus on the answers you have provided that need clarification

You say that the number of staff who work exclusively on the CMDU work depends on workload.
How is this assessed on a daily basis to ensure that the right number of staff are allocated to this work, what is the process followed and where is this documented?
You say that the download form the National Portal is “continuously reviewed but initially was refreshed 2 or 3 times per day”. How are resources and workload therefore assessed intraday to meet increased demand?

You say that there are no key performance indicators and that staff “just get through the whole list”.
How is this process of getting through the whole list monitored and overseen?
Does the process involve, for example, logging into each report and updating the status on a computer system?
If you cannot get through to someone, how do you ensue that they are called back later?
How does management ensure that items on the list are not just ticked as called when this is not happening?
Do you have any documentation to back up this process?

I understand that you receive the positive lateral flow test detail from the “National Portal”.
Please advise the name of this National Portal.
When you receive direct calls, which you indicate you have received many thousands of, how are these added to the list to be completed?
Are they included into the National Portal or documented elsewhere so that workload can be assessed and recorded?

Does the work of the CMDU involve accessing the Adastra system? If so what is the work around if this is not working?

What other systems are used by the CMDU in its work?

Please additionally advise whether, when setting up the CMDU, documented processes for performing the work of the until were agreed (at a national or local level), including decision trees to assess what treatment to provide to each different patient. If so please provide a copy of these.

Yours sincerely,

Louise Bicknell

Dear FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

I refer to my follow up requesting clarification. I have yet to receive an acknowledgement, although the system shows it was received. Please advise, if I fail to hear form you I will submit a further FOI on these points

Thank you in advance
Yours sincerely,

Louise Bicknell

FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Dear Louise

Sorry for not acknowledging sooner

I am passing your follow up questions to the team responsible and will respond as soon as I hear back

Regards

Jeff Pearce
FOI Officer

show quoted sections

Louise Bicknell left an annotation ()

Referred to the information commissioner for review given the failure to answer on 17/9/22

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

1 Attachment

Dear Requester

 

FOI 2022 427 and 486  

ICO- 192401-B3X9                                                        

  

Thank you for your information request originally received by the Trust
received by us on   11 July  2022.

 

The Trust responded on 8 August and on 17 August you expressed
dissatisfaction with the response and asked the follow-up questions below
presented in bold..

 

On 28 September the Trust received a complaint via the ICO that you had
not had a response to these follow-up questions.

 

Please accept the Trust’s apologies for this and I hope we can rectify
this now. A copy of this response has been sent to the case officer at the
ICO too.

 

Please note that Chelsea and Westminster Hospital NHS Foundation Trust
merged with West Middlesex University Hospital in September 2015, for this
reason our response covers both sites

 

I had asked that the answers be split by the following time periods (10
December 21 - 9 February 22, 10 February 22 - 16 March 22 & 17March 22 -
30 June 22) to get an idea of how this process had bedded in, however at
this stage think it is better to focus on the answers you have provided
that need clarification

 

You say that the number of staff who work exclusively on the CMDU work
depends on workload.

How is this assessed on a daily basis to ensure that the right number of
staff are allocated to this work, what is the process followed and where
is this documented?

 

You say that the download form the National Portal is “continuously
reviewed but initially was refreshed 2 or 3 times per day”.  How are
resources and workload therefore assessed intraday to meet increased
demand?

 

You say that there are no key performance indicators and that staff “just
get through the whole list”.

How is this process of getting through the whole list monitored and
overseen?

 

Does the process involve, for example, logging into each report and
updating the status on a computer system?

 

If you cannot get through to someone, how do you ensue that they are
called back later?

 

How does management ensure that items on the list are not just ticked as
called when this is not happening?

 

Do you have any documentation to back up this process?

 

I understand that you receive the positive lateral flow test detail from
the “National Portal”.

 

Please advise the name of this National Portal.

 

When you receive direct calls, which you indicate you have received many
thousands of, how are these added to the list to be completed?

 

Are they included into the National Portal or documented elsewhere so that
workload can be assessed and recorded?

 

Does the work of the CMDU involve accessing the Adastra system?  If so
what is the work around if this is not working?

 

What other systems are used by the CMDU in its work?

 

Please additionally advise whether, when setting up the CMDU, documented
processes for performing the work of the until were agreed (at a national
or local level), including decision trees to assess what treatment to
provide to each different patient.  If so please provide a copy of these.

 

Please see the Trust’s response in tabular form attached.

 

If you are not satisfied with how your request has been handled then
please either

1.      Respond to this email and we will review our answers and get back
to you or

2.      Write directly to:

The Chief Executive

Chelsea and Westminster Hospital NHS Foundation Trust

369 Fulham Road

London

SW10 9NH

 

If, after we have addressed your complaint, you remain dissatisfied with
how we have responded, you are entitled to appeal to the Information
Commissioner at:

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

 

Phone 0303 123 1113

Website: [1]www.ico.org.uk

There is no charge for making an appeal.

Re-use of information and copyright

You are free to re-use the information contained in our response under the
terms of the Open Government Licence
[2]http://www.nationalarchives.gov.uk/doc/o...

You must take into account the exemptions and any other conditions such as
the non-endorsement condition below

This licence does not grant you any right to use the Information in a way
that suggests any official status or that Chelsea and Westminster Hospital
NHS Foundation Trust, the Information Provider and/or Licensor endorse you
or your use of the Information

Further information can be found at:

[3]http://www.opsi.gov.uk/advice/psi-regula...

Yours sincerely

The Information Governance team

Chelsea and Westminster Hospital NHS Foundation Trust

Email: [4][email address]

 

 

 

 

 

 

show quoted sections

Dear PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

Thank you for your response

Unfortunately while the links to documents work from “the what do they know” website, the document links you pasted is showing pdf/word symbols in response to three questions do not open. These are the “CMDU Standard Operating Procedures”, the “CMDU Clinician’s SOP” and the “COVID 19 Antiinfectives Management”. Please can you post the complete documents on to the site (if large you can post them separately to the site)

I did have a couple of follow on questions as follows:

You refer to weekly national meetings taking place to inform service delivery in response to question 2. Can you provide details of these and any related papers?

Can you supply any data to show whether the CMDU is meeting the key timeframes set out in the CAS alert?

If you would prefer me to submit a further freedom of information request on the above points I am happy to do so. If i do not receive a response by next Monday I will follow up in that way

Many thanks again

Yours sincerely,

Louise Bicknell

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Dear Louise

I have forwarded your comments to the teams responsible and will look at the issue of the links too

Would you be prepared to use an email address outside of wdtk? I could send you the documents there perhaps

Regards

Jeff Pearce
FOI Officer

show quoted sections

Dear PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

Many thanks forget prompt response

Happy to do so Jeff. Can you give me a telephone number to call so I can provide this to you please?

Yours sincerely,

Louise Bicknell

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Thanks

The team are sending me the docs

I don’t have a work phone as I work from home but let's see what arrives first

Jeff

show quoted sections

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

2 Attachments

Dear Louise

Here are 2 of the 3 documents - let me know if you can open them please in wdtk

I am awaiting the pdf document and the other answers to your follow up questions

Regards

Jeff Pearce
FOI Officer

show quoted sections

Dear PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

Thanks

Yes I can access these and print them which is perfect. Look forward to receiving the rest

Best wishes

Yours sincerely,

Louise Bicknell

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

1 Attachment

Dear Louise

Here is the pdf document

I will be in touch when I hear back about your other questions

Regards

Jeff Pearce
FOI Officer

show quoted sections

Dear PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),
Thanks

Very interesting. I look forward to the answers to the other questions

Best wishes
Yours sincerely,

Louise Bicknell

Dear PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST),

Hello there, is there any update on this please on the outstanding questions?

Many thanks

Yours sincerely,

Louise Bicknell

PEARCE, Jeffrey (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

Dear Louise

I believe this is being looked at but I am temporarily off FOIs so please could you send any reminders to

[email address]

From now on

Regards

Jeff Pearce
FOI Officer

show quoted sections

FOI (CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST), Chelsea and Westminster Hospital NHS Foundation Trust

 

Dear Louise

 

I hope this finds you well.

 

Your two follow up questions from FOI 2022 427 and our responses are
listed below.

 

1.       You refer to weekly national meetings taking place to inform
service delivery in response to question 2.  Can you provide details of
these and any related papers?

 

We do not attend the national meeting but get feedback at our 2 weekly
Regional (London) meeting. There are no formal papers from this meeting as
we are not the owner of these meetings or  controller of the information
discussed. We would suggest that you refer this query  to NHSEI ((NHS
England and NHS Improvement)

Darren Woolridge ([1][email address]) circulates the papers for
the meeting so may be able to suggest the correct form of wording and to
whom the FOI enquiry should be addressed.

 

2.       Can you supply any data to show whether the CMDU is meeting the
key timeframes set out in the CAS alert?

 

The data exists in crude format as part of Hospital and patient records
(medical records from the National Portal, NHS Mail, and the eReferral
System).  To accurately answer the query, we would need to access and
review individual patient records via the differing referral routes. Even
if it only took two minutes to access each patients record the time limit
of 18 hours would be soon exceeded and we would have to apply a Section 12
exemption based on cost.

 

If there is anything else we could help with then please do not hesitate
to ask.

 

Kind regards

Graham Trainor

Head of Information Governance

Chelsea & Westminster Hospital NHS Foundation Trust

 

 

 

show quoted sections