Bowel Management Patient Safety Alert (SPINE 01/19)

The request was successful.

Dear East Suffolk and North Essex 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,

Jennifer Sims

FOI Requests CGH, East Suffolk and North Essex NHS Foundation Trust

Dear Jennifer,

 

Please be advised that we have received your request for information.

 

From 1st July 2018, Ipswich and Colchester Hospitals merged to become East
Suffolk and North Essex NHS Foundation Trust. Therefore, unless otherwise
specified, responses are on behalf of East Suffolk and North Essex NHS
Foundation Trust.

 

Your reference number is 5481

 

We shall deal with your request in accordance with the Trust's Freedom of
Information Act 2000 procedures.

 

In the meantime, if you have any queries, please do not hesitate to
contact us. Please direct any responses to the address supplied or email
[East Suffolk and North Essex NHS Foundation Trust request email] 

 

Kind regards,

 

Amy Witham

Freedom of Information Team

East Suffolk and North Essex NHS Foundation Trust

Email: [1][East Suffolk and North Essex NHS Foundation Trust request email]

 

show quoted sections

FOI Requests CGH, East Suffolk and North Essex NHS Foundation Trust

From 1^st July 2018, Ipswich and Colchester Hospitals merged to become
East Suffolk and North Essex NHS Foundation Trust. Therefore, unless
otherwise specified, responses are on behalf of East Suffolk and North
Essex NHS Foundation Trust.

 

Thank you for your recent enquiry regarding information held by the East
Suffolk and North Essex NHS Foundation Trust:

 

Your enquiry has been dealt with in accordance with the Trust’s Freedom of
Information Act 2000 Policy and Procedures. We are pleased to enclose the
information you requested:

 

This response is on behalf of Ipswich Hospital – information to follow for
Colchester Hospital

 

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

 

1)      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?

ü  Yes 

 

2)      Following recommendation of this patient safety alert, did the
Trust “review your local clinical policy and guidance relating to bowel
assessment and management”?

ü  Yes - revised an existing policy

 

3)      Is your policy based on the policy template that the Spinal
Injuries Association circulated to your trust in August 2018?

ü  Yes,  partially

 

4)      If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention – Digital
removal faeces?

ü  Yes

 

5)      If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Digital rectal
stimulation?

ü  Yes

 

6)      If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Trans anal
irrigation?

ü  Yes. Would not be commenced in the acute phase after SCI.

 

7)      Are staff available seven days a week to undertake these bowel
care interventions?

ü  Yes

 

8)      Has the Trust “reviewed your local education and training
provision for interventional bowel management” as recommended in the
Patient Safety Alert?

ü  Yes

 

9)      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”?

ü  Yes

 

10)   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”?

ü  No. The policy is currently is in the final stages of being ratified.
Once this process is complete there is a plan in place to meet the above.

 

11)   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? 

ü  No policy in place, but we would be happy for the care to be continued
by the personal care assistant and develop an individualised care plan on
admission.

 

12)   As recommended in the Patient Safety Alert, have you identified “an
appropriate clinical leader to co-ordinate implementation of this alert”?

ü  Yes   (please answer Q13, but ignore Q14)

 

13)   What are the contact details for the “appropriate clinical
leader”(i.e. name, position, telephone and email)? 

Joanne Murphy, Spinal Nurse Specialist at Ipswich Hospital.

E-mail [1][email address] or
[2][email address]

 

15)   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’?

ü  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 about the enclosed information please contact us,

 

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We hope that we have been able to answer your query to your satisfaction
and that you find the information provided useful.

 

Regards,

 

Amy Witham

Freedom of Information Team

East Suffolk and North Essex NHS Foundation Trust

Email: [4][East Suffolk and North Essex NHS Foundation Trust request email]

 

This e-mail and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received. Content of emails received by this Trust will be subject to disclosure under the Freedom of Information Act 2000, subject to the specified exemptions, including the The General Data Protection Regulation (EU) 2016/679 and Caldicott Guardian principles. East Suffolk and North Essex NHS Foundation Trust, Turner Road, Essex, CO4 5JL

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