Freedom of Information Request Acknowledgement

Thank you for your request which was received by us on 26^th February 2019

Under the Freedom of Information (FOI) Act 2000 we are required to provide
a response within 20 working days. You should expect to receive a response
by 26^th March 2019

We will advise you if we do not hold the information requested or if an
exemption applies.

Your request has been given the reference number FOI 19-10795 .

FOI Team

T: 01284 712941 | Ext: 2941

West Suffolk NHS Foundation Trust
Hardwick Lane|Bury St Edmunds|SUFFOLK|IP33 2QZ

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We are due to respond to your FOI request 19-10795 by 26^th March 2019.
Our team have requested an extension . Can we please request a 7 working
day extension.

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Dear Tim Nicholson

I am writing to confirm that the West Suffolk NHS Foundation Trust has now
completed its search for the information which you requested on 26^th
February 2019

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 – however the Heads of Nursing are actively developing this, with a
deadline of end of April 2019.  We do have existing community Bowel Care
Guidelines, which we are incorporating into our new policy (following the
integration of our organisations).  At present we work to best practice
guidelines, supported by the Royal College of Nursing guidance.

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 – as above, this process is underway.

(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 – that is our plan.

(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 – though access to this care is limited at present.  This would be
escalated via the Heads of Nursing and urgent plans put in place to ensure
this care is provided.

(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- as above.

(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 – not at present.  Though this would be escalated to the Heads of
Nursing for urgent resolution.

Q7. Are staff available seven days a week to undertake these bowel care
interventions?

(a) Yes – via escalation, as above.

(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 – this is underway at present.

(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 – this is underway at present.

(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 – as above, this will be shared via the Integrated Spinal Pathway
Group.

(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    - to be incorporated into new policy.     

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) Yes.

(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)? Sharon Basson, Head of
Nursing (Community/Integrated Services, [1][email address]) and
Helen Beard, Head of Nursing (Surgery, [2][email address]) – 01284
713000

Q14.  Why has your Trust not appointed an “appropriate clinical leader”?
N/A

(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 – as these are part of the new educational standards for nurses
upon entering the Register, I anticipate that this will be the case.

(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

The information supplied to you continues to be protected by the
Copyright, Designs and Patents Act 1988. You are free to use it for your
own purposes, including any non-commercial research and for the purposes
of news reporting. Any other reuse, for example commercial publication,
would require the permission of the copyright holder.

If you are unhappy with the service you have received in relation to your
request and wish to make a complaint or request a review of our decision,
you should write to:

Chief Executive

West Suffolk NHS Foundation Trust

Hardwick Lane

Bury St Edmunds

Suffolk IP33 2QZ

If you are not content with the outcome of your complaint, you may request
the Information Commissioner’s Office to carry out a review.

Kind regards

FOI Team

T: 01284 713043 | Ext: 3043

West Suffolk NHS Foundation Trust
Hardwick Lane|Bury St Edmunds|SUFFOLK|IP33 2QZ

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