Dear Barts Health NHS Trust,

Bowel management for spinal cord injured people

Hello my name is Derry Felton and I work for the Spinal Injuries Association (SIA). I just have a few questions that need answering for our Public Affairs department.

As a request under the Freedom of Information Act, please provide the following information on bowel management for spinal cord injured people and others with neurogenic bowel dysfunction
1. Does the Trust have a formal written policy for digital rectal examination/check, digital rectal stimulation and the digital removal of faeces (manual bowel evacuation) in spinal cord injured and other patients with neurogenic bowel dysfunction ?
2. If the Trust does, please supply a copy of this document.
3. If the Trust does not, how is bowel care managed in the above patient groups who present with this care need?
4. Does the Trust employ a specialist continence nurse(s)?
5. If the Trust employs a specialist continence nurse(s) can they (a) undertake digital rectal checks, digital rectal stimulation and digital removal of faeces (manual bowel evacuation), otherwise known as 'intimate digital bowel care procedures' (b) provide instruction to other nurses to enable them to perform intimate digital bowel care procedures'?
6. If the Trust does not employ a specialist continence nurse, is there another health care professional who undertakes intimate digital bowel care procedures including manual bowel evacuation? If yes, who does this?
7. Does your Trust have a policy in place that will allow your staff to do trans-anal irrigation (TAI) of the bowel as a method of bowel care management for spinal cord injured patients? Do you train your staff to do TAI/ bowel irrigation?
8. Do you run bowel care courses for your staff that allows them to deliver the full range of bowel care required by spinal cord injured patients or others with a neurogenic bowel?
9. If yes, please provide details. If no, does the Trust have a policy which allows for the personal care assistants (PAs) of spinal cord injured patients to assist with this element of the patient's care?

Yours faithfully,

derry felton

FAO Mr Derry Felton, The Spinal Injuries Association  

 

Dear Mr Felton

                                

Your Request for Information [FOI-810-16]

 

Thank you for your recent request for information.  This will be processed
in accordance with the requirements of the Freedom of Information Act and
you will receive a response within the stipulated timescale.

 

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If you have any queries then please contact us at [Barts Health NHS Trust request email]

 

If you are dissatisfied on how your request has been handled, you can
complain in writing to The Information Governance Manager, Barts Health
NHS Trust:  E-mail [Barts Health NHS Trust request email]

 

Postal address:

The Information Governance Manager,

c/o Archives and Records Centre,

Barts Health NHS Trust,

Lower Ground Floor,

9 Prescot Street,

Aldgate, London E1 8PR

  

If, after  we have addressed your  complaint, you remain dissatisfied with
how we have responded, you are entitled to appeal to the Information
Commissioner (Tel: 01625 545 745).  Details are shown at www.ico.org.uk

    

Yours sincerely,

 

Pamela Wood

 

Corporate Records 

Barts Health NHS Trust 

 

==========================================================================================================

 

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1 Attachment

FAO Derry Felton, Spinal Injuries Association  

 

Dear Derry

 

Your Request for Information [FOI-810-16]

 

I am writing in response to your request for information relating to bowel
management for spinal cord injured people.  In reply to the questions you
have asked, we would advise you as follows:

 

Your Question 1:  Does the Trust have a formal written policy for digital
rectal examination/check, digital rectal stimulation and the digital
removal of faeces (manual bowel evacuation) in spinal cord injured and
other patients with neurogenic bowel dysfunction ?

Our Response:  Yes

 

Your Question 2:    If the Trust does, please supply a copy of this
document.

Our response:  This is attached

 

Your Question 3:  If the Trust does not, how is bowel care managed in the
above patient groups who present with this care need?

Our response:      As stated in the policy document, nurses would carry
out manual evacuation.  In certain circumstances nurses are also
instructed how to undertake anal irrigation

 

Your Question 4:  Does the Trust employ a specialist continence nurse(s)?

Our response:   Yes.  We have five specialist continence nurse who work
across acute and primary care

 

Your Question 5:   If the Trust employs a specialist continence nurse(s)
can they (a) undertake digital rectal checks, digital rectal stimulation
and digital removal of faeces (manual bowel evacuation), otherwise known
as 'intimate digital bowel care procedures' (b) provide instruction to
other nurses to enable them to perform intimate digital bowel care
procedures'?

Our response:  Our specialist nurses will train all nurses in the Trust
how to perform digital rectal examinations and evacuation

 

Your Question 6:  If the Trust does not employ a specialist continence
nurse, is there another health care professional who undertakes intimate
digital bowel care procedures including manual bowel evacuation? If yes,
who does this?

Our response:  As stated above, all nurses are trained to carry out these
procedures

 

Your Question 7:   Does your Trust have a policy in place that will allow
your staff to do trans-anal irrigation (TAI) of the bowel as a method of
bowel care management for spinal cord injured patients? Do you train your
staff to do TAI/ bowel irrigation?

Our response:  A draft policy has been prepared and is awaiting
ratification

 

Your Question 8:  Do you run bowel care courses for your staff that allows
them to deliver the full range of bowel care required by spinal cord
injured patients or others with a neurogenic bowel?

Our response:  Yes

 

Your Question 9:  If yes, please provide details. If no, does the Trust
have a policy which allows for the personal care assistants (PAs) of
spinal cord injured patients to assist with this element of the patient's
care?

Our response:  Bowel care training is offered three times a year,  with ad
hoc, additional training provided by special request

 

I hope that this information will be of value to you but please let us
know if you require any further information ([Barts Health NHS Trust request email]).   
We would be grateful if you would take a minute to fill out our FOI
Feedback Questionnaire at www.bartshealth.nhs.uk/foi-feedback.   

 

If you are dissatisfied on how your request has been handled, you can
complain in writing to: The Information Governance Manager, Barts Health
NHS Trust:   Email;  [Barts Health NHS Trust request email]

 

Postal address:  The Information Governance Manager 

                                 Barts Health NHS Trust,

                                 Lower Ground Floor

                                 9 Prescot Street,

                                 Aldgate, 

                                 London E1 8PR

 

If, after we have addressed your complaint, you remain dissatisfied with
how we have responded,  you are entitled to appeal to the Information
Commissioner  (Tel 01625 545 745)   details are shown at www.ico.org.uk

 

Yours sincerely,

 

PAMELA WOOD

 

Corporate Records 

Barts Health NHS Trust

 

  

 

====================================================================================================

 

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