Dear Essex Partnership University NHS Foundation Trust,

Thank you for your reply of earlier today
Can I please ask you the more simplier question

TMS treatment requests made by Eput vary significantly depending on patient location in Essex,

Why is there such dissparity on TMS treatment requests made by Eput (currently ifr) depending on were you live in Essex?

For example Basildon and Brentwood area there have been 13 IFR requests for TMS to date
However in the Southend only 1 IFR request to date

And ask for a review based on

1, as the ccg are partner organisation of Eput and you work closely together can you not liase on my behalf or somone in Eput already knows the answer eg Dr Pillay or Dr Karale or they would know how to findout?
Especialy as the Eput website says when eg patients make contact you may need to liaise with your partner organisations eg the Essex CCG

2, or is this just another NHS beaurocratic hurdle being put in the way so answers are never revealed?

3, In the past i have found i have to provide Eput with a lot personal information (some was not relevant in my opinion at all), but then not provided with answers to important questions I put?

4, But Eput itself is not so happy with providing information to the public or patients when it raises questions like the TMS disparity above?

Yours faithfully,

iain

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

Unfortunately once again, Eput has not answered the subject of my questions directly.
I have put my question and Eputs responses below in ""
1, Correspondence between myself and Eput (including FOI) has been going on now for a considerable number of months around this same subject/questions, it has become a bit of a saga which Eput seems to want to keep going?

Eput last response a bland answer only slightly connected to the original question I wished to be addressed, The question is about the Disparity in the number of TMS requests made by Eput clinicians in different areas of Essex.

I thought it was quite a simple question the answer has so far not been forthcoming from Eput however.

I am asking Eput not another NHS organization to answer my questions except for number 8 which I would like to call upon Eputs help.

2, Therefore If Eput does not understand the questions I would like Eput to answer can you please make contact with me, as I have Dyslexia?

Once again my questions, which Eput has failed to address as I intended from my last FOI request.

"TMS treatment requests made by Eput vary significantly depending on patient location in
Essex, I have added below Eput's data kindly provided on 22/03/2021

The number of TMS requests made by Eput clinicians
Basildon & Brentwood 13
Thurrock 5
Mid Essex 8
West Essex 2
Castle Point & Rochford 2
Southend 1
North East Essex 2

3) Why is there such Disparity on TMS treatment requests made by Eput (currently ifr)
depending on where you live in Essex?

For example Basildon and Brentwood area there have been 13 IFR requests for TMS to date
However in the Southend only 1 IFR request to date

Eputs response
Any referral for a patient that requires Commissioner funding, regardless of where they live in Essex has an IFR application made for them. It is not dependent on the patients address."

I will reword the question (giving it number 3 below) so it might be easier for Eput to provide an answer that explains the Disparity.

4) Why is there such a disparity in the number of TMS treatment requests made for patients by Eput clinicians depending on the area of Essex?

For example from Eput's own (recent FOI) data, in the Basildon and Brentwood area, there have been 13 requests for TMS , however, in Southend, only 1 request?
The same is true for a number of areas in Essex having much lower figures of requests, please see Eput figures above

5, For example, why have Eput clinicians in Basildon and Brentwood made more requests for patients to receive TMS 13 when compared to Eput clinicians in Southend 1?

6, Could you please expand in detail why patients in different areas of Essex get more and less TMS requests made?

My request for a review
"1, as the ccg are partner organisation of Eput and you work closely together can you not
liase on my behalf or someone in Eput already knows the answer eg Dr Pillay or Dr Karale or
they would know how to find out?
Especially as the Eput website says when eg patients make contact you may need to liaise
with your partner organisations eg the Essex CCG .

Eputs Response
You have not stated what it is you wish EPUT to liaise with the CCG about on your behalf
specifically. In relation to the Essex rTMS Service, we will only liaise with the IFR Team about
specific referrals that have been sent to them through our service. The CCG IFR Team has a
process to fol ow and set of criteria that each application for funding needs to meet. The
CCG would be in a better position to answer queries about this, as it is not control ed by
EPUT.

Eput then goes on to say.
The IFR process is one that belongs to the CCG and therefore you may wish to direct queries
in regards to this to:

NHS Basildon and Brentwood Clinical Commissioning Group
Phoenix Court
Christopher Martin Road
Basildon
Essex SS14 3HG"

7, In the above Eput response Eput suggests I could contact your NHS partner about IFR this is an example, of where Eput could help as I explained in my review request above.
In past, correspondence on the Disparity questions I have raised with Eput, Eput has suggested I contact your NHS partners.

8, Therefore could I please ask Eput to contact your partner NHS organizations on my behalf to answer the questions that Eput has and thinks the Partners are best placed to answer on Disparity over the previous months?

9, Could you please let me know what questions you have asked your NHS partners and which partner organization you have put the question to thank you?

Yours sincerely,
iain

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

I have requested that Eput contacts me on a number of occasions in our back and forth for correspondence over the months, if Eput can not comprehend the main question and I have also stated I have dyslexia?

Eput has once again dodged the main questions asked.
I am going to suggest that Eput does not want to answer the main question I have put as it shows Eput in a bad light. So Eput uses fancy words to look like Eput is answering the main question put as its a difficult question for Eput to face up to.
Eput are hoping I will give up trying to get Eput to acknowledge there has been a disparity in Eput clinicians referring patients for rTMS dependant on area as it harms Eput;s reputation.
Eput own freedom of information data shows this has been the case.

What Eput often does is gives answers to questions I have not asked, but slightly related so it looks like Eput is giving relevant answers to the difficult question.

For example, Eput gave an answer from the Eput rTMS team perspective, something on the lines of the rTMS service does not have any influence on the clinicians that are referring patients to the rTMS service.
1, This was not the question I asked, so why did Eput not contact me if Eput did not understand the simple question I had put before responding?
I have requested that Eput contacts me on a number of occasions if Eput can not comprehend the main question and I have stated I have dyslexia?

2, Eput has never contacted me to clarify the questions I wanted to answer, but has kept the correspondence going back forth for many months, why?

3, I was asking a question from the Eput clinician's perspective , not the rTMS service perspective, so why did Eput provide an answer from the rTMS team perspective when I did not ask this in my question?

The only thing Eput has done over the months is mostly given answers to questions I have not asked, answered questions that are harmless to Eput's reputation or stated i contact another NHS organization.

The rTMS service is run by Eput.
Eput clinicians refer patients to the rTMS service.

4, So how come Eput does not know why Eput clinicians in the Southend area have only referred 1 of Eputs patients to the rTMS service compared to the Eput clinicians in the Brentwood Basildon area who have refered 13 patients?

5, Your answer to my question 9, shows NHS organizations do no work together when it's not in the NHS organization's interest to do so.

Eput please answer the question or contact me if Eput cannot comprehend this simple but reputationally difficult question to answer.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

Are you going to review or would you rather I logged the request with the ICO?
Please do remember the Eput complaint team referred me to Eput foi months ago when I wanted to log as a complaint.
So the NHS has been using its standard delay tactics for many months now.

Yours sincerely,

iain

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

Still waiting for Eput after many months to answer the simple questions and provide information. Eput spends all its time trying not to answer simple questions and gives responses that are not related to what I have asked, even though i have asked eput to contact meif it cannot comprehend.
I wonder why, this is an additional question why have eput spent so much time not answering the questions but giving replies to questions i have not asked and therefore dragging the whole process out over a number of years?

[ GIVE DETAILS ABOUT YOUR COMPLAINT HERE ]

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

The information you sent me on 23/09/2021 to my personal email, by password-protected PDF I have pasted below with my name and address removed.
Unfortunately, once again I do not know what you are talking about as it does not relate to any FOI questions I have raised, I have not asked for any personal issues to be answered so do not understand this response at all?
I had a look at my emails and I have not sent FOI requests to Eput on 03-06-2021 or by any other means on the 03-08-2021.

Can you please review what you have sent me once again, and if you have trouble understanding the questions please contact me for clarification, before replying.

"23 September 2021

Legal Services Department

The Lodge
Lodge Approach
Runwell
Wickford
Essex SS11 7XX
Telephone 0300 123 0808

By Email Only

Mr xxx xxx
xxx
xxx

Essex xxx xxx

Dear Mr xxx

We are writing in response to your email of 3 June 2021.

We have contacted the RTMS service on your behalf who have advised that they have not
received a referral and therefore you will need to discuss this with your treating consultant
who if appropriate can make a referral to the service.

Yours sincerely

Legal Services

Essex Partnership University NHS Foundation Trust

Email: [email address]

The Lodge | Lodge Approach | Runwell | Wickford | Essex | SS11 7XX"

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

Can you please clarify a bit more clearly, does FOI response below of today just relate to the alleged email I sent on 03-06-2021?
"I write to acknowledge receipt of your email and advise you that as this is not an FOI request, I have forwarded it on to the relevant team so that they can deal directly with you."

As am still waiting for a review 'TMS treatment requests by Eput vary significantly depending on patient location in Essex', which foi have confirmed they are conducting, can you confirm this is actually happening?

Yours sincerely,

iain

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

[ I have not had a reply to my FOI request
Nor has anyone from EPUT contacted me, on the none foi subject that you refer to whatever that is as about]

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain gordon

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

I have contacted PALS,
However, I still see this as an FOI request for Eput to answer,
as I was advised by the Eput complaints that Eput FOI needs to answer this question in March 2021.

Yours sincerely,

iain gordon

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

I have made contact as Eput pals as eput foi have requested.
I would prefer email communication as I will not have answers in writing and will not remember verbal discussion well.
However, the original questions still remain unanswered and eput complaints said this was an issue for eput foi to answer.
So until someone explains why this is not a foi request I am still waiting for eput foi to answer my questions on TMS.

Yours sincerely,

iain gordon

Dear FOI (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST),

Just to confirm, I have contacted PALS as you kindly requested,
as Eput complaints said this was an issue for Eput FOI, so I am still waiting for FOI response.
Hopefully, pals will contact me soon by email and explain what they want to explain.

Yours faithfully,

iain gordon

Dear Essex Partnership University NHS Foundation Trust,

Unfortunately, eput foi has not answered the questions at all in all the correspondence over the months
But eput foi kept the communication going why?

Eput foi has advised I contact eput complaints, I did originally contact eput complaints in early 2021 with the same questions and they passed it to eput foi
Do you feel you're ever going round in circles?

Eput cites that it needs to look at all patient's records to answer my request and therefore too costly.
Unfortunately, this is just an excuse as you know for example significantly less patients in Southend have been referred for tms treatment its an issue with your clinicians in the Southend area not referring your patients not the patient's actual illness?
And this is the problem Eput appears from its correspondence just will not accept it has treated patients in different areas of Essex unequally regarding tms referrals.
And eput will use any technique can not answer the question.

Poor response from Eput all round and has kept the issue going back forth for months as eput does not want faceup to inequality.
Eputs retired Chairman Sally Morriss did comment on my observation of tms equality back in 2019, but did not address the matter. as it was not the issue being looked at at that time.

Yours faithfully,

iain gordon

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

Eput cites that it needs to look at all patient's records to answer my request and therefore too costly.
Unfortunately, I believe this is just an excuse for eput to not once again give an answer.
As Eput knows for example significantly less patients in Southend have been referred for tms treatment. The issue is with Eput clinicians in different areas of Essex not referring patients for tms not the patient's actual illnesses?

It would appear to me to be a matter of the clinicians in Southend not being "tms aware or friendly" and the clinicians in Basildon Brentwood having the eput tms clinic "on their doorstep, and tms training".
Or does Eput argue for example that the patients in Southend have unique mental health illnesses not amenable to TMS?
And only patients in Brentwood would benefit from tms?
Do not forget the populations are large in both these two areas so it would be expected to see a similar/ homogenous profiles of patients' illnesses/conditions living in both areas.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain gordon

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

Some additional information and issues that have not been addressed in my foi request.

I have asked Eput before because of disability to put my request questions before Eputs reply.
I have also asked previously if you do not understand the question I would like a response to contact me before replying.
As the matter has been back forth for many months, I do not know which two questions Eput is replying to for certain in the reply of today.

Eputs foi reply of 20-12-2021 today which I have put in """
"With regard to your first request, the Trust does not hold the information requested.
With regard to your second request in order to answer this the Trust would have to
review the files of every patient..."

I have been forced to re-ask questions many times and in simple steps as Eput appears it will do its best to find a reason why it does not have provide a direct answer. One example is how Eput looks at how a request is worded and stretches this ambiguity to its limits and therefore is able to give a reply not related to the meaning of my request.

1, I have been forced by Eput to ask questions on this foi which remain totally unanswered and not related directly to the original disparity issue, please answer these requests?

If eput had given the response it had today months ago then these the other foi questions would never have been raised.

It is clear That Eput does not want to address the issue of disparity and finally claims foi get out clauses as why it is not going to address the foi request.

2, Apparently according to Eput’s latest line, patients in Brentwood probably have a different condition to the patients for example in Southend with the same diagnosis???
As patients in Brentwood get TMS and patients in Southend do not.

3, And this strange phenomenon that's been uncovered with eput foi data would require all the patient's notes to be looked at, but Eput does not want investigate to help its patients?
Eput could then also could bring its “discovery” to the wider community attention and it could be used to help treat patients generally.

4, Eput would you not want look in to why why patients in Southend do not benefit from certain forms of treatment and patients in Brentwood do for the same condition?

5, I would argue its an eput clinician issue, not a patient issue that is the cause of the disparity between Southend and Brentwood, but that seems to be too simple for Eput as an explanation to own up to?

6, examples of eputs no need to give meaningful responses over the months
a, Eg the data is from one of eputs partner NHS organizations.
Yes the data is not exactly the same as Eputs data on the same facts, but both sets of data still raise the same questions of disparity so why go off on a tangent?
b, why did complaints pass the questions to foi in the first place if not foi request?
c, And why did foi engage with me for months knowing what I was trying to get answers to when you had no intention of doing so???
d, Why do I have to break requests down into simple request questions which then remain as I say totally unanswered?
e, its CCG issue, pass to your partner NHS organization, as I have worded the question in a way that makes this legitimate plausible response but not addressed the request issues I have actually trying to raise and I think eput knew that.

7, So eput foi please list all my request questions over the months in order and provide replies to all these request questions?

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain gordon

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

As questions remain unanswered
and they are not personal questions
I can understand personal issues would not be looked at by foi
These questions may or may not be issued for foi to answer, so all I can do is let the system run course and ICO can let me know.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain gordon

Dear Essex Partnership University NHS Foundation Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Essex Partnership University NHS Foundation Trust's handling of my FOI request 'TMS treatment requests by Eput vary significantly depending on patient location in Essex'.

Still waiting for a reply

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/t...

Yours faithfully,

iain gordon