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Bowel Management Patient Safety Alert (SPINE 01/19)

Dan Burden made this Freedom of Information request to Birmingham Women's and Children's NHS Foundation Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

We're waiting for Dan Burden to read a recent response and update the status.

Dear Birmingham Women's and Children's 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,

Dan Burden

Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

Dear Mr Burden

Please accept this email as formal acknowledgement of your request for information received on 19 February 2019.

This request will be processed in accordance with the Freedom of Information Act 2000 and unless you are otherwise informed, your request will be processed within a maximum of twenty working days from receipt.

At this moment we are unaware of any fees, charges or exemptions likely to be applied to your request. However, if during the course of processing your application it becomes clear that fees will apply, we will inform you of this. In the event that costs are applicable, no information will be provided unless the costs are paid within three months of us informing you. In the event that some or all of the information you have requested is exempt from disclosure, we will inform you of this.

We will also contact you if during the process it emerges that we do not have sufficient detail to locate the information or we are unclear exactly what it is that you have requested.

In the meantime if you wish to discuss any aspect of your request please feel free to contact us at this email address.

Yours sincerely

FOI Lead/Publicaton Scheme Co-ordinator

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CHOUDHURY, Fateha (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

We apologise for the delay in responding to this request and hope to respond in the next week or so. If there is a further delay, we will write to let you know.

Regards

FOI Lead/Publication Scheme Co-ordinator

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Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

Thank you for your request. Having reviewed it, we can confirm that this request is not applicable to our organisation.

Regards

FOI Lead/Publication Scheme Co-ordinator

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Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

1 Attachment

We do not hold the information that you have requested.

 

Regards

 

FOI Lead/Publication Scheme Co-ordinator

 

 

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Dear Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S 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,

Dan Burden

Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

Dear Mr Burden

Thank you for your follow up email requesting clarity on why your request is not applicable to us.

Our response is that patients with spinal chord injury would be managed at the Royal Orthopaedic Hospital (RoH), not by the Birmingham Women's and Children's NHS Foundation Trust.

During the processing of this request we liaised with RoH who advised that it is very uncommon that they have any spinal cord injured patients under their care (one a year on average) and that they have a close working relationship with the Midlands Centre for Spinal Injury at the Robert Jones and Agnes Hunt Hospital in Oswestry. It is their policy to liaise with them for specialist guidance on all aspects of the management of every individual spinal cord injured patient and they follow their instructions for all RoH patients.

We hope the above explanation now concludes your request.

Regards

FOI Lead/Publication Scheme Co-ordinator

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