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Bowel Management Patient Safety Alert (SPINE 01/19)

We're waiting for Andrew Smart to read recent responses and update the status.

Dear Devon Partnership 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,

Andrew Smart

Safer-Information (DEVON PARTNERSHIP NHS TRUST), Devon Partnership NHS Trust

Dear Andrew,

Devon Partnership NHS Trust can confirm safe receipt of your Freedom of Information Request and will provide a full written response within 20 working days.

If you have any further queries or concerns, please do not hesitate to contact us on the details below.

Safer Information Team
[email address]
01392 675678

Devon Partnership NHS Trust
Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

www.dpt.nhs.uk

-----Original Message-----
From: Andrew Smart [mailto:[FOI #553926 email]]
Sent: 20 February 2019 10:16
To: DPT, Ig (DEVON PARTNERSHIP NHS TRUST)
Subject: Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear Devon Partnership 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,

Andrew Smart

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

Please use this email address for all replies to this request:
[FOI #553926 email]

Is [Devon Partnership NHS Trust request email] the wrong address for Freedom of Information requests to Devon Partnership NHS 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 may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.

For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail

hide quoted sections

Safer-Information (DEVON PARTNERSHIP NHS TRUST), Devon Partnership NHS Trust

1 Attachment

Good morning Andrew,

Please see the attached response to your Freedom of Information Request received by Devon Partnership NHS Trust on the 20th February 2019.

If you have any additional questions or concerns please do not hesitate to contact us on the details below.

Safer Information Team
[email address]
01392 675678

Devon Partnership NHS Trust
Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

www.dpt.nhs.uk
-----Original Message-----
From: Andrew Smart [mailto:[FOI #553926 email]]
Sent: 20 February 2019 10:16
To: DPT, Ig (DEVON PARTNERSHIP NHS TRUST)
Subject: Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear Devon Partnership 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,

Andrew Smart

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

Please use this email address for all replies to this request:
[FOI #553926 email]

Is [Devon Partnership NHS Trust request email] the wrong address for Freedom of Information requests to Devon Partnership NHS 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 may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.

For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail

hide quoted sections

Dear Safer-Information (DEVON PARTNERSHIP NHS 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

Safer-Information (DEVON PARTNERSHIP NHS TRUST), Devon Partnership NHS Trust

Good afternoon,

Devon Partnership NHS Trust can confirm safe receipt of your Freedom of Information request submitted on 2nd May 2019 and will provide a written response within 20 working days.

The Freedom of Information Act 2000 defines a number of exemptions that may restrict the release of the requested information. There will be an assessment and if any of the exemptions categories apply then the information may not be released. You will be informed if this is the case, including your rights of appeal.

The information provided will be in an English, normal pt. 12 font size PDF document. If you require alternative formats, e.g. other language, audio, large print, etc. Please notify us and we endeavour to meet your requirements.

Safer Information Team
[email address]
01392 675678

Devon Partnership NHS Trust
Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

www.dpt.nhs.uk

-----Original Message-----
From: Andrew Smart [mailto:[FOI #553926 email]]
Sent: 02 May 2019 13:18
To: Safer-Information (DEVON PARTNERSHIP NHS TRUST)
Subject: RE: Freedom of Information request - Bowel Management Patient Safety Alert (SPINE 01/19)

Dear Safer-Information (DEVON PARTNERSHIP NHS 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

-----Original Message-----

Good morning Andrew,

Please see the attached response to your Freedom of Information Request received by Devon Partnership NHS Trust on the 20th February 2019.

If you have any additional questions or concerns please do not hesitate to contact us on the details below.

Safer Information Team
[email address]
01392 675678

Devon Partnership NHS Trust
Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

www.dpt.nhs.uk

-------------------------------------------------------------------
Please use this email address for all replies to this request:
[FOI #553926 email]

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 may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.

For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail

hide quoted sections

Safer-Information (DEVON PARTNERSHIP NHS TRUST), Devon Partnership NHS Trust

2 Attachments

Dear Andrew,

 

Please see attached the response to your Freedom of Information Request
submitted to Devon Partnership NHS Trust on the 2nd May 2019.

 

 

Please do not hesitate to contact us with any further questions, queries
or concerns.

 

 

Safer Information Team

[1][email address]

01392 675678

 

[2]logo

Devon Partnership NHS Trust

Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

[3]www.dpt.nhs.uk

 

 

-----Original Message-----
From: Andrew Smart [mailto:[FOI #553926 email]]
Sent: 02 May 2019 13:18
To: Safer-Information (DEVON PARTNERSHIP NHS TRUST)
Subject: RE: Freedom of Information request - Bowel Management Patient
Safety Alert (SPINE 01/19)

 

Dear Safer-Information (DEVON PARTNERSHIP NHS 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 [4][email address]

 

Yours sincerely,

 

Andrew Smart

 

-----Original Message-----

 

Good morning Andrew,

 

Please see the attached response to your Freedom of Information Request
received by Devon Partnership NHS Trust on the 20th February 2019.

 

If you have any additional questions or concerns please do not hesitate to
contact us on the details below.

 

Safer Information Team

[email address]

01392 675678

 

Devon Partnership NHS Trust

Prentice Building, Langdon Hospital, Exeter Road, Dawlish, Devon, EX7 0NR.

 

[5]www.dpt.nhs.uk

 

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

Please use this email address for all replies to this request:

[6][FOI #553926 email]

 

Disclaimer: This message and any reply that you make will be published on
the internet. Our privacy and copyright policies:

[7]https://www.whatdotheyknow.com/help/offi...

 

For more detailed guidance on safely disclosing information, read the
latest advice from the ICO:

[8]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 may contain confidential information. If you are not the
intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or
take any action in relation to its contents. To do so is strictly
prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS
staff in England and Scotland. NHSmail is approved for exchanging patient
data and other sensitive information with NHSmail and other accredited
email services.

For more information and to find out how you can switch,
https://portal.nhs.net/help/joiningnhsmail

References

Visible links
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7. https://www.whatdotheyknow.com/help/offi...
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hide 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.