Bowel Management Patient Safety Alert (SPINE 01/19)

Response to this request is long overdue. By law, under all circumstances, The Shrewsbury and Telford Hospital NHS Trust should have responded by now (details). You can complain by requesting an internal review.

Dear The Shrewsbury and Telford Hospital NHS 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,

Jennifer Sims

COLE, Sophie (SHREWSBURY AND TELFORD HOSPITAL NHS TRUST),

3 Attachments

Dear Ms Sims,

 

Thank you for your request for information.

 

The Trust acknowledges your request and it is being processed as a new
request under the terms of the Freedom of Information Act 2000.

 

In some circumstances a fee may be payable and if that is the case, I will
let you know. A fees notice will be issued to you if necessary and you
will be required to pay before I will proceed to deal with your
request.                                                                            

                                                                  

Please find attached a briefing which explains:

 

o your rights to request a review by the Trust or to complain to the
Information Commissioner’s Office if you are not satisfied with the
response from the Trust,
o an outline of the Trust’s policy on the Reuse of Public Sector
Information

 

If you have any queries regarding this email, please contact me and quote
the reference number above in any future correspondence.

 

 

Kind regards,

Sophie Cole

 

[1]Description: Description: Description: Description: Description:
Description: Description: Description: cid:image001.png@01CF9543.36AA4670

Sophie Cole [4]Description: Description:
Description: Description: Description:
Assurance Team and Freedom of Description: Description: Description:
Information Administrator Description: Description:
cid:image001.jpg@01D051EC.FFAC2D70
 

Suite 2, Stretton House|

The Shrewsbury and Telford
Hospital NHS Trust | Royal
Shrewsbury Hospital | Mytton Oak
Road | Shrewsbury | Shropshire |
SY3 8XQ

 

Telephone 01743 261087

Email [2][email address]

FOI email [3][The Shrewsbury and Telford Hospital NHS Trust request email]

 

 

 

 

This message may contain confidential information. If you are not the
intended recipient please inform the sender that you have received the
message in error before deleting it. Please do not disclose, copy or
distribute information in this e-mail or take any action in relation to
its contents: to do so is strictly prohibited and may be unlawful.

 

 

 

 

 

 

 

 

 

show quoted sections

COLE, Sophie (SHREWSBURY AND TELFORD HOSPITAL NHS TRUST),

4 Attachments

Dear Ms Sims,

 

Thank you for your FOI request sent on 25^th February 2019. You asked:

 

 

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.”

 

 

Under Section 1(1)(a) of the Freedom of Information Act 2000, I can
confirm that The Shrewsbury and Telford Hospital NHS Trust holds
information that falls within the definition in your request. We believe
that you have received a response to this request from the Robert Jones
and Agnes Hunt Orthopaedic Hospital (attached). As we outsource our
Orthopaedic service to them, our answers will be the same.

 

Please also find attached a briefing which explains your rights to request
a review by the Trust or to complain to the Information Commissioner’s
Office if you are not satisfied with the response from the Trust, and an
outline of the Trust’s policy on the Reuse of Public Sector Information.

 

If you have any queries regarding this email, please contact the Freedom
of Information Officer via [1][The Shrewsbury and Telford Hospital NHS Trust request email] and quote the reference
number above in any future correspondence. If you would like to give
feedback please visit [2]https://www.surveymonkey.co.uk/r/DXTP8QQ for our
short questionnaire.

 

Kind regards,

Sophie Cole

 

[3]Description: Description: Description: Description: Description:
Description: cid:image001.png@01CF9543.36AA4670

Sophie Cole [6]Description: Description:
Description: Description: Description:
Assurance Team and Freedom of Description: Description: Description:
Information Administrator cid:image001.jpg@01D051EC.FFAC2D70

 

Suite 2, Stretton House|

The Shrewsbury and Telford
Hospital NHS Trust | Royal
Shrewsbury Hospital | Mytton Oak
Road | Shrewsbury | Shropshire |
SY3 8XQ

 

Telephone 01743 261087

Email [4][email address]

FOI email [5][The Shrewsbury and Telford Hospital NHS Trust request email]

 

 

 

 

This message may contain confidential information. If you are not the
intended recipient please inform the sender that you have received the
message in error before deleting it. Please do not disclose, copy or
distribute information in this e-mail or take any action in relation to
its contents: to do so is strictly prohibited and may be unlawful.

 

 

 

 

 

 

 

 

show quoted sections

Dear COLE, Sophie (SHREWSBURY AND TELFORD HOSPITAL NHS TRUST),

You do not seem to have sent a reply in respect of Shrewsbury & Telford Hospitals NHS Trust. Rather, you've sent through the (already rec'd) response for The Robert & Agnes Hunt Ortho Trust.

Please can you email the Shrewsbury response straightaway to my colleague Tim Nicholson ([email address])

Yours sincerely,

Jennifer Sims

Looking for an EU Authority?

You can request documents directly from EU Institutions at our sister site AskTheEU.org . Find out more .

AskTheEU.org