Bowel Management Patient Safety Alert (SPINE 01/19)

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Dear University Hospitals Coventry and Warwickshire 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,

Dave Bracher

Freedom Of Information (RKB), University Hospitals Coventry and Warwickshire NHS Trust

Dear Dave

We acknowledge receipt of your Freedom of Information request and can confirm that we are currently considering your request and we will respond within 20 working days.

Kind regards

Emma

Emma Pulham
FOI and Access to Health Records Officer
University Hospitals Coventry & Warwickshire NHS Trust
CSB Room 20018
Clifford Bridge Road
Walsgrave
Coventry
CV2 2DX

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Address: UHCW NHS Trust, Executive suite, 3rd Floor Rotunda, University Hospital, Clifford Bridge Road, Coventry, CV2 2DX

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Freedom Of Information (RKB), University Hospitals Coventry and Warwickshire NHS Trust

1 Attachment

Good afternoon

Please find our response to your FOI request attached.

Many thanks,

Dan Gilbert

FOI and Access to Health Records Officer
University Hospitals Coventry & Warwickshire NHS Trust
CSB Room 20018
Clifford Bridge Road
Walsgrave
Coventry
CV2 2DX

Internal 29125
Direct Line 02476 968771

For Health Records queries email [email address]
For Freedom of Information email [University Hospitals Coventry and Warwickshire NHS Trust request email]

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DISCLAIMER: This email and any attachments are confidential and may be privileged or otherwise protected from disclosure. If you are not the intended recipient you must not copy this message or any attachment or disclose the contents to any other person, nor take any action in reliance of its contents: to do so is strictly prohibited and may be unlawful. If you have received this message in error please accept our apologies and contact us at the address below or by email at [email address]
Any files attached to this email will have been checked by us with virus detection software before transmission. You should carry out your own virus checks before opening any attachment. UHCW (University Hospitals Coventry and Warwickshire NHS Trust) accepts no liability for any loss or damage which may be caused by software viruses.
Any views or opinions expressed are those of the author and do not represent the views of the Trust unless explicitly stated.
The information contained in this email may be subject to public disclosure under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this email and your reply cannot be guaranteed.
Address: UHCW NHS Trust, Executive suite, 3rd Floor Rotunda, University Hospital, Clifford Bridge Road, Coventry, CV2 2DX

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