Bowel Management Patient Safety Alert (SPINE 01/19)

The request was successful.

Lauren Theodosi

Dear Bradford Teaching Hospitals 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,

Lauren Theodosi

FOI, Bradford Teaching Hospitals NHS Foundation Trust

Dear Lauren,
Thank you for your recent Freedom of Information request. Under the terms of the Freedom of Information Act we will endeavour to respond to this request promptly within 20 working days and are now investigating the nature of the request, the quantity of information requested and whether we hold the information requested.
There are a number of exemptions which the Act permits with respect to disclosure of information. The information will be assessed for these exemptions prior to disclosure and we will advise you if we are unable to provide the information requested.
If there is a cost involved in collecting the information then we will suspend the period for response until such time as we receive your payment. We will advise you of any such costs.
Please send any further correspondence to [email address].
Kind regards,

Michal Mangham
Freedom of Information Officer | Working Week: Mon 8-3 Tues/Wed 8-2
Communications | Duckworth Lane Cottage, Bradford Royal Infirmary
Bradford Teaching Hospitals NHS Foundation Trust
T: 01274 36 4774
http://www.bradfordhospitals.nhs.uk
-----Original Message-----
From: Lauren Theodosi [mailto:[FOI #558412 email]]
Sent: 05 March 2019 10:36
To: FOI
Subject: FOI 18608

Dear Bradford Teaching Hospitals 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,

Lauren Theodosi

-------------------------------------------------------------------

Please use this email address for all replies to this request:
[FOI #558412 email]

Is [Bradford Teaching Hospitals NHS Foundation Trust request email] the wrong address for Freedom of Information requests to Bradford Teaching Hospitals NHS Foundation Trust? If so, please contact us using this form:
https://www.whatdotheyknow.com/change_re...

Disclaimer: This message and any reply that you make will be published on the internet. Our privacy and copyright policies:
https://www.whatdotheyknow.com/help/offi...

For more detailed guidance on safely disclosing information, read the latest advice from the ICO:
https://www.whatdotheyknow.com/help/ico-...

Please note that in some cases publication of requests and responses will be delayed.

If you find this service useful as an FOI officer, please ask your web manager to link to us from your organisation's FOI page.

-------------------------------------------------------------------
This message is confidential. It may also contain privileged information. The contents of this e-mail and any attachments are intended for the named addressee only. Unless you are the named addressee or authorised to receive the e-mail of the named addressee you may not disclose, use or copy the contents of the e-mail. If you are not the person for whom the message was intended, please notify the sender immediately at Bradford Teaching Hospitals NHS Foundation Trust and delete the material from your computer. You must not use the message for any other purpose, nor disclose its contents to any person other than the intended recipient. Bradford Teaching Hospitals NHS Foundation Trust does not accept responsibility for this message and any views or opinions contained in this e-mail are solely those of the author unless expressly stated otherwise.

hide quoted sections

FOI, Bradford Teaching Hospitals NHS Foundation Trust

2 Attachments

Dear Lauren,

Please find attached our response to your Freedom of Information request.

Kind regards,

[1]hellomynameis
Michal Mangham
Freedom of Information Officer
Working Week: Mon 8-3 Tues/Wed 8-2
Communications | Duckworth Lane Cottage, Bradford Royal Infirmary
Bradford Teaching Hospitals NHS Foundation Trust
T: 01274 36 4774
[2]http://www.bradfordhospitals.nhs.uk

 

This message is confidential. It may also contain privileged information.
The contents of this e-mail and any attachments are intended for the named
addressee only. Unless you are the named addressee or authorised to
receive the e-mail of the named addressee you may not disclose, use or
copy the contents of the e-mail. If you are not the person for whom the
message was intended, please notify the sender immediately at Bradford
Teaching Hospitals NHS Foundation Trust and delete the material from your
computer. You must not use the message for any other purpose, nor disclose
its contents to any person other than the intended recipient. Bradford
Teaching Hospitals NHS Foundation Trust does not accept responsibility for
this message and any views or opinions contained in this e-mail are solely
those of the author unless expressly stated otherwise.

References

Visible links
1. http://hellomynameis.org.uk/
2. http://www.bradfordhospitals.nhs.uk/