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Bowel Management Patient Safety Alert (SPINE 01/19)

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Dear Derbyshire Healthcare 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,

Andrew Smart

FOIEnquiries (DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST), Derbyshire Healthcare NHS Foundation Trust

Thank-you for your e-mail.

This is an automated response to let you know that your e-mail has been
received by the Trust Freedom of Information Act team and will now receive
our attention. No further acknowledgement will be sent.

If your request does not constitute a request under the Act we will be in
touch to advise you of an alternative course of action, or redirect your
message elsewhere and let you know.

Valid Freedom of Information Act requests will receive a response as soon
as possible and we will endeavour to respond within the statutory
timescale of 20 working days. This is calculated as follows:-

•         20 working days, counted from the next working day after your
request was deemed to be received.
•         Public holidays and similarly recognised non-working days,
Saturdays and Sundays are not classified as working days.
•         Standard office hours are understood as 9am to 5pm. Requests
received after 5pm will be deemed to have arrived the next working day.

Please bear this in mind when calculating the “due date” for your request.

Our reply to you will confirm or deny whether we hold the information you
have requested, and we will either provide you with the information you
have requested, or explain why it has not been provided, quoting an
Exemption under the Act.

Under our obligation to advise and assist requestors we will contact you
for clarification should we fail to understand any part of your request.

 

If you require further information, please do not hesitate to contact us.

 

Kind regards.

 

Freedom of Information Office

Derbyshire Healthcare NHS Foundation Trust

 

The Ashbourne Centre

Kingsway Site

Kingsway

Derby DE22 3LZ

Tel 01332 623700

show quoted sections

FOIEnquiries (DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST), Derbyshire Healthcare NHS Foundation Trust

Dear Sir / Madam,

Thank you for your request for information under the Freedom of Information Act 2000.

The Trust is commissioned to provide mental health services and as such does not hold the information requested. You may wish to direct your request for information to University Hospitals of Derby and Burton NHS FT.

If you are unhappy in any way with the way in which your request has been handled, please do not hesitate to contact the FOI enquiries team again in the first instance or, alternatively, the Trust has an internal complaints procedure through which you can raise any concerns you might have. This can be done by writing to the Chief Executive at Ashbourne Centre, Kingsway Site, Kingsway, Derby DE22 3LZ.

If you remain dissatisfied you can apply to the Information Commissioner who will consider whether the Trust has complied with its obligations under the Freedom of Information Act 2000 and can require the Trust to remedy any problems. Information about how to do this can found on the Information Commissioner’s website at www.informationcommissioner.gov.uk. Complaints to the Information Commissioner should be sent to FOI/EIR Complaints Resolution, Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Kind regards.

Freedom of Information Office
Derbyshire Healthcare NHS Foundation Trust

The Ashbourne Centre
Kingsway Site
Kingsway
Derby DE22 3LZ

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Dear FOIEnquiries (DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST),

Spinal cord injured people may need in-patient or community care at any time in their lives.
Indeed, such care may be required many, many years after their original injury (and rehabilitation). Also, the primary reason why care is required might well be unrelated directly to the spinal cord injury.
For example, a spinal cord injured person may: have serious mental health issues which require in-patient treatment; be admitted to hospital following an accident or severe infection; or require ongoing care in the community.
Despite the above, you have advised that our bowel management freedom of information request is not applicable to your trust.
Please explain precisely why you believe that a spinal cord injured person could never require services from your trust in their lifetime.
It would be greatly appreciated if you could copy your WhatDoTheyKnow response to [email address]

Yours sincerely,

Andrew Smart

FOIEnquiries (DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST), Derbyshire Healthcare NHS Foundation Trust

Thank-you for your e-mail.

This is an automated response to let you know that your e-mail has been
received by the Trust Freedom of Information Act team and will now receive
our attention. No further acknowledgement will be sent.

If your request does not constitute a request under the Act we will be in
touch to advise you of an alternative course of action, or redirect your
message elsewhere and let you know.

Valid Freedom of Information Act requests will receive a response as soon
as possible and we will endeavour to respond within the statutory
timescale of 20 working days. This is calculated as follows:-

•         20 working days, counted from the next working day after your
request was deemed to be received.
•         Public holidays and similarly recognised non-working days,
Saturdays and Sundays are not classified as working days.
•         Standard office hours are understood as 9am to 5pm. Requests
received after 5pm will be deemed to have arrived the next working day.

Please bear this in mind when calculating the “due date” for your request.

Our reply to you will confirm or deny whether we hold the information you
have requested, and we will either provide you with the information you
have requested, or explain why it has not been provided, quoting an
Exemption under the Act.

Under our obligation to advise and assist requestors we will contact you
for clarification should we fail to understand any part of your request.

 

If you require further information, please do not hesitate to contact us.

 

Kind regards.

 

Freedom of Information Office

Derbyshire Healthcare NHS Foundation Trust

 

The Ashbourne Centre

Kingsway Site

Kingsway

Derby DE22 3LZ

Tel 01332 623700

show quoted sections

FOIEnquiries (DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST), Derbyshire Healthcare NHS Foundation Trust

Dear Sir / Madam,

Thank you for your request for information under the Freedom of Information Act 2000.

The Trust is commissioned to provide mental health services and as such does not hold the information requested. You may wish to direct your request for information to University Hospitals of Derby and Burton NHS FT.

If you are unhappy in any way with the way in which your request has been handled, please do not hesitate to contact the FOI enquiries team again in the first instance or, alternatively, the Trust has an internal complaints procedure through which you can raise any concerns you might have. This can be done by writing to the Chief Executive at Ashbourne Centre, Kingsway Site, Kingsway, Derby DE22 3LZ.

If you remain dissatisfied you can apply to the Information Commissioner who will consider whether the Trust has complied with its obligations under the Freedom of Information Act 2000 and can require the Trust to remedy any problems. Information about how to do this can found on the Information Commissioner’s website at www.informationcommissioner.gov.uk. Complaints to the Information Commissioner should be sent to FOI/EIR Complaints Resolution, Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Kind regards.

Freedom of Information Office
Derbyshire Healthcare NHS Foundation Trust

The Ashbourne Centre
Kingsway Site
Kingsway
Derby DE22 3LZ

show quoted sections

We don't know whether the most recent response to this request contains information or not – if you are Andrew Smart please sign in and let everyone know.