Bowel Management Patient Safety Alert (SPINE 01/19)

The request was successful.

Dear Wye Valley 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,

Carol Hornett

Information, Freedom (WVT), Wye Valley NHS Trust

Your email has reached the mailbox of the Freedom of Information
Coordinator of Wye Valley NHS Trust.

 

If your enquiry is a Freedom of Information Request please take this as an
acknowledgement, and your request will be responded to within 20 working
days.

 

Yours faithfully,

 

Freedom of Information Coordinator

Wye Valley NHS Trust

Monkmoor Court

31-34 Commercial Road

Hereford

HR1 2DX

 

“This e-mail, together with any attachments is intended for the named
addressee(s) only.  It contains information which may be confidential and
which may also be privileged.  Unless you are the named addressee, you may
neither copy nor disclose it to anyone else.  If you have received it in
error, please notify me immediately by return e-mail and delete the
message from the computer.

 

Please note that Wye Valley NHS Trust may monitor e-mails sent by you to
the Trust in accordance with current legislation.”

“Any opinion expressed in this e-mail or any attached files are those of
the individual and not necessarily those of Herefordshire Council,
Herefordshire Clinical Commissioning Group (HCCG), Wye Valley NHS Trust or
2gether NHS Foundation Trust. You should be aware that Herefordshire
Council, Herefordshire Clinical Commissioning Group (HCCG), Wye Valley NHS
Trust & 2gether NHS Foundation Trust monitors its email service. This
e-mail and any attached files are confidential and intended solely for the
use of the addressee. This communication may contain material protected by
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Information, Freedom (WVT), Wye Valley NHS Trust

1 Attachment

Dear Ms Hornett,

Please find attached Wye Valley NHS Trust’s response to your Freedom of Information request, reference 8194.

Yours sincerely,

Freedom of Information Coordinator
Wye Valley NHS Trust
Monkmoor Court
31-34 Commercial Road
Hereford
HR1 2DX

“This e-mail, together with any attachments is intended for the named addressee(s) only. It contains information which may be confidential and which may also be privileged. Unless you are the named addressee, you may neither copy nor disclose it to anyone else. If you have received it in error, please notify me immediately by return e-mail and delete the message from the computer.

Please note that Wye Valley NHS Trust may monitor e-mails sent by you to the Trust in accordance with current legislation.”

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