Dear Andrew Smart

Thank you for your email requesting information regarding neurogenic bowel
dysfunction.

We are treating your correspondence as a request for information under the
Freedom of Information Act 2000.

You should expect to receive a further reply from us within 20 working
days from the day when your request was originally received by this
Department.

Kind regards

Carol Embriaco on behalf of

Mark M. Underwood
Head of Information Governance

IM&T Department, Oxford Health NHS Foundation Trust

The White Building, Littlemore MHC, 33 Sandford Road, Oxford, OX4 4XN
direct dial: 01865 902554 
email: [1][email address]

[2]cid:image001.png@01D3E227.25D081E0

From: Andrew Smart <[FOI #554266 email]>
Sent: 21 February 2019 11:25
To: Foiarfi (RNU) Oxford Health <[email address]>
Subject: Freedom of Information request - Bowel Management Patient Safety
Alert (SPINE 01/19)

Dear Oxford Health NHS Foundation 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
[3][email address]

Yours faithfully,

Andrew Smart

-------------------------------------------------------------------

Please use this email address for all replies to this request:
[4][FOI #554266 email]

Is [5][Oxford Health NHS Foundation Trust request email] the wrong address for Freedom of
Information requests to Oxford Health NHS Foundation Trust? If so, please
contact us using this form:
[6]https://www.whatdotheyknow.com/change_re...

Disclaimer: This message and any reply that you make will be published on
the internet. Our privacy and copyright policies:
[7]https://www.whatdotheyknow.com/help/offi...

For more detailed guidance on safely disclosing information, read the
latest advice from the ICO:
[8]https://www.whatdotheyknow.com/help/ico-...

Please note that in some cases publication of requests and responses will
be delayed.

If you find this service useful as an FOI officer, please ask your web
manager to link to us from your organisation's FOI page.

-------------------------------------------------------------------

References

Visible links
1. mailto:[email address]
3. mailto:[email address]
4. mailto:[FOI #554266 email]
5. mailto:[Oxford Health NHS Foundation Trust request email]
6. https://www.whatdotheyknow.com/change_re...
7. https://www.whatdotheyknow.com/help/offi...
8. https://www.whatdotheyknow.com/help/ico-...

Please find the Trust response attached above.

regards.  FoIA Team

On behalf of:

IM&T Services, Oxford Health NHS Foundation Trust, The White Building,
LMHC, Sandford Road, Littlemore, Oxford, OX4 4XN
email: [1][email address]

From: Andrew Smart <[FOI #554266 email]>
Sent: 21 February 2019 11:25
To: Foiarfi (RNU) Oxford Health <[email address]>
Subject: Freedom of Information request - Bowel Management Patient Safety
Alert (SPINE 01/19)

Dear Oxford Health NHS Foundation 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
[2][email address]

Yours faithfully,

Andrew Smart

-------------------------------------------------------------------

Please use this email address for all replies to this request:
[3][FOI #554266 email]

Is [4][Oxford Health NHS Foundation Trust request email] the wrong address for Freedom of
Information requests to Oxford Health NHS Foundation Trust? If so, please
contact us using this form:
[5]https://www.whatdotheyknow.com/change_re...

Disclaimer: This message and any reply that you make will be published on
the internet. Our privacy and copyright policies:
[6]https://www.whatdotheyknow.com/help/offi...

For more detailed guidance on safely disclosing information, read the
latest advice from the ICO:
[7]https://www.whatdotheyknow.com/help/ico-...

Please note that in some cases publication of requests and responses will
be delayed.

If you find this service useful as an FOI officer, please ask your web
manager to link to us from your organisation's FOI page.

-------------------------------------------------------------------

References

Visible links
1. mailto:[email address]
2. mailto:[email address]
3. mailto:[FOI #554266 email]
4. mailto:[Oxford Health NHS Foundation Trust request email]
5. https://www.whatdotheyknow.com/change_re...
6. https://www.whatdotheyknow.com/help/offi...
7. https://www.whatdotheyknow.com/help/ico-...