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Bowel Management Patient Safety Alert (SPINE 01/19)

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Dear Oxleas 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 [email address]

Yours faithfully,

Andrew Smart

FOI (OXLEAS NHS FOUNDATION TRUST), Oxleas NHS Foundation Trust

Dear Andrew,

FREEDOM OF INFORMATION ACT 2000 – SECTION 8 REQUEST

Thank you for your request for information dated 21/02/2019. Your request has been managed under the terms of the Freedom of Information Act 2000.

Please note that the information you have requested is not held by the Trust. Oxleas NHS Foundation Trust do not run acute hospitals but are a community NHS Trust specialising in community health, mental health and learning disability services. For more information on services provided by Oxleas NHS Foundation Trust please visit our website at http://oxleas.nhs.uk/services/.

Following this response, your request for information will be closed.

If you have any queries or concerns or are dissatisfied with the service you have received in relation to your request, please do not hesitate to contact us. If you wish to make request a review of the decision, you should write to the: Information Governance Manager, Julie Lucas via email at [email address] in the first instance. If you remain unsatisfied with the outcome of your review and wish to make a formal compliant please address this to the Head of Complaints, Oxleas NHS Foundation Trust, Pinewood House, Pinewood Place, Dartford DA2 7WG - Email: [email address]

In addition if you are not satisfied with the outcome of your complaint or review, you may apply directly to the Information Commissioner’s Office (ICO) for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Trust. The ICO can be contacted at: Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF (Telephone: 0303 123 1113 or 01625 545 745 - www.ico.org.uk).

Kind regards,

Paul Bransgrove
Information Governance Officer
E: [Oxleas NHS Foundation Trust request email]
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF

________________________________________
From: Andrew Smart <[FOI #554268 email]>
Sent: 21 February 2019 11:26
To: FOI (OXLEAS NHS FOUNDATION TRUST)
Subject: Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear Oxleas 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 [email address]

Yours faithfully,

Andrew Smart

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

Please use this email address for all replies to this request:
[FOI #554268 email]

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show quoted sections

Dear FOI (OXLEAS NHS FOUNDATION 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 (OXLEAS NHS FOUNDATION TRUST), Oxleas NHS Foundation Trust

Dear Andrew,

Apologies for our delayed response.

This email is to confirm receipt of your email and that we are processing your request.

We hope to provide you with a comprehensive response as soon as possible.

Kind regards

Information Governance Office
E: [Oxleas NHS Foundation Trust request email]
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF

________________________________________
From: Andrew Smart <[FOI #554268 email]>
Sent: 07 May 2019 10:04
To: FOI (OXLEAS NHS FOUNDATION TRUST)
Subject: Re: FOI 5094 - Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear FOI (OXLEAS NHS FOUNDATION 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

show quoted sections

FOI (OXLEAS NHS FOUNDATION TRUST), Oxleas NHS Foundation Trust

1 Attachment

Dear Andrew,

FREEDOM OF INFORMATION ACT 2000 – SECTION 8 REQUEST

Further to the emails below, we can confirm that your original request was closed as Oxleas NHS Foundation Trust are not an acute hospital Trust and do not admit patients with neurogenic bowel dysfunction.

However, further to your email dated 07/05/2019 our District Nursing teams have confirmed that our community nurses do carry out the specified procedures at hospitals / in the community subject to referrals from the patient's hospital / GP.

As such, please see attached our response to your original request dated 21/02/2019.

If you have any queries or concerns or are dissatisfied with the service you have received in relation to your request, please do not hesitate to contact us. If you wish to request a review of the decision, you should write to the Information Governance Manager, Julie Lucas via email at [email address] in the first instance. If you remain unsatisfied with the outcome of your review and wish to make a formal complaint, please address this to: Complaints, Oxleas NHS Foundation Trust, Pinewood House, Pinewood Place, Dartford, DA2 7WG - Email: [email address]

In addition if you are not satisfied with the outcome of your complaint or review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Trust. The Information Commissioner can be contacted at: Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF (Telephone: 0303 123 1113 or 01625 545 745 - www.ico.org.uk).

Kind regards

Paul Bransgrove
Information Governance Officer
E: [Oxleas NHS Foundation Trust request email]
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF

Have you completed the New GDPR Compliant Data Security E-learning ?

________________________________________
From: FOI (OXLEAS NHS FOUNDATION TRUST)
Sent: 10 May 2019 12:12
To: Andrew Smart
Cc: [email address]
Subject: Re: FOI 5094 - Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear Andrew,

Apologies for our delayed response.

This email is to confirm receipt of your email and that we are processing your request.

We hope to provide you with a comprehensive response as soon as possible.

Kind regards

Information Governance Office
E: [Oxleas NHS Foundation Trust request email]
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF

________________________________________
From: Andrew Smart <[FOI #554268 email]>
Sent: 07 May 2019 10:04
To: FOI (OXLEAS NHS FOUNDATION TRUST)
Subject: Re: FOI 5094 - Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear FOI (OXLEAS NHS FOUNDATION 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

show quoted sections

We don't know whether the most recent response to this request contains information or not – if you are Andrew Smart please sign in and let everyone know.