Bowel Management Patient Safety Alert (SPINE 01/19)

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

Dear Wirral University Teaching Hospital 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,

Tim Nicholson

Accesstoinformationoffice (WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST), Wirral University Teaching Hospital NHS Foundation Trust

1 Attachment

Our Ref:           LMS/LG/JT/Access.60538-02-19

 

 

Dear Mr Nicholson

 

We acknowledge receipt of your request for information received in this
office on 26^th February 2019.

 

Please note, as the Freedom of Information Act requires us to produce your
requested information within 20 working days, any information we hold
should be sent out by 26^th March 2019.

 

In accordance with the Act no charge is applicable unless the costs
involved exceed £450.00.  You will be advised if a charge is appropriate
before the information is sent to you.

 

Please be aware that it is important that you advise us at the time of
each new application if you wish to re-use the information we provide for
commercial purposes.  When you receive our completed response and are
satisfied with the information provided we would be grateful if you could
email us to officially request re-use and for what purpose.  

 

Yours sincerely

 

Jan Taylor

 

Sent by Jan Taylor (Mrs) on behalf of Lin Snow

Head of Information Governance & Records Management

Data Protection Officer and Copyright Lead

With responsibility for Data Quality, Clinical Coding & Information
Security

Information Governance Department

 

Direct dial: 0151 604 7120

Internal extension: 8477

Email [1][Wirral University Teaching Hospital NHS Foundation Trust request email]

Normal Office Hours: Monday to Friday 8.30am to 5pm

 

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Accesstoinformationoffice (WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST), Wirral University Teaching Hospital NHS Foundation Trust

1 Attachment

Our Ref:            LMS/LG/JT/Access.60538-02-19

 

 

Dear Mr Nicholson,

 

We do apologise profusely for the continued delay in responding to your
request for information.

 

Please be advised your request is currently being processed but we are
still awaiting information from the department supplying the response on
behalf of the Trust. We have sent a reminder to them today.

 

Therefore, we would respectfully like to request more time in which to
respond.

 

Hopefully a full and final response should be with you shortly.

 

 

 

Yours sincerely

 

Jan Taylor

 

Sent by Jan Taylor (Mrs) on behalf of Lin Snow

Head of Information Governance & Records Management

Data Protection Officer and Copyright Lead

With responsibility for Data Quality, Clinical Coding & Information
Security

Information Governance Department

 

Direct dial: 0151 604 7120

Internal extension: 8477

Email [1][Wirral University Teaching Hospital NHS Foundation Trust request email]

Normal Office Hours: Monday to Friday 8.30am to 5pm

 

[2][IMG]

 

P Consider the Environment/Save Paper - Do you really need to print this
e-mail?

 

The information contained in this e-mail 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
e-mail and your reply cannot be guaranteed. Any views or opinions
presented are solely those of the author and do not necessarily represent
those of Wirral University Teaching Hospital. If you are not the intended
recipient, be advised that you have received this e-mail in error and that
any use, dissemination, forwarding, printing or copying of this email is
strictly prohibited. If you have received this e-mail in error please
notify the sender.

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