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Bowel Management Patient Safety Alert (SPINE 01/19)

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Dear Essex Partnership University 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 (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST), Essex Partnership University NHS Foundation Trust

Dear Jennifer Sims

 

RE: EPUT.FOI.19.977

 

The Essex Partnership University NHS Foundation Trust Freedom of
Information Service received your request for information under the
Freedom of Information Act 2000 on 20th February 2019.

 

You requested information, as outlined below.

 

The Act allows 20 working days for us to respond to your request so you
can expect a response by 19^th March 2019.  We will of course make every
effort to respond sooner if possible. A fee may be charged to cover
postage and photocopying costs.

 

You should also be aware that the Act does allow, in certain cases, for
the 20 working day time period to be extended. We will notify you as soon
as possible if there is a need to extend the time limit for responding to
your request.

 

The Trust has a statutory duty to provide advice and assistance to
applicants. If you have any questions now, or during the processing of
your request, please write or telephone me.

 

Kind Regards

 

Legal Services

Freedom of Information / Subject Access Requests

Essex Partnership University NHS Foundation Trust

The Lodge | Lodge Approach | Runwell | Wickford | Essex | SS11 7XX

E-mail: [email address] (Freedom of Information)

E-mail: [email address] (Subject Access Request)

Telephone: 01268 407753

rson, or print it.”

 

 

 

 

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Foi (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST), Essex Partnership University NHS Foundation Trust

2 Attachments

Dear Jennifer Sims,

 

Our Ref: EPUT.FOI.19.977

 

I am writing in response to your request for information, made under the
Freedom of Information Act 2000.

 

Please find attached a response from EPUT.

 

If you are dissatisfied with the response you have received, you have the
right to request a review of our decision or make a complaint about how
your request has been handled.  Your request should be made within 2
months of receipt of this letter and we will reply within 20 working days
of receipt.  Any such request received after 2 months will only be
considered at the discretion of the organisation.

 

If our decision is unchanged following a review and you remain
dissatisfied with this, you then have the right to make a formal complaint
to the Information Commissioner who can be contacted at: Information
Commissioners Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9
5AF.

 

Many thanks

Kindest regards

 

Legal Services

Freedom of Information / Subject Access Requests 

Essex Partnership University NHS Foundation Trust

The Lodge | Lodge Approach | Runwell | Wickford | Essex | SS11 7XX

E-mail: [1][email address] (Freedom of Information)

E-mail: [2][email address] (Subject Access Request)

 

 

 

 

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Dear Foi (ESSEX PARTNERSHIP UNIVERSITY 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,

Jennifer Sims

Foi (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST), Essex Partnership University NHS Foundation Trust

Dear Jennifer,

Thank you for your e-mail. May I take this opportunity to confirm that we will treat this as a review of the original information sent to you.

EPUT will conduct an internal review, investigating the questions you have raised. The Information Commissioner considers that a reasonable time for completing an internal review is 20 working days from the date of the request for review. Therefore you can expect a response no later than 1st June 2019.

In some cases, which involve exceptional circumstances, it may be reasonable to take longer. If this is the case EPUT will contact you again and provide a full explanation as to why more time is required.

In the meantime should you have any questions, or require further information or advice, please do not hesitate to contact me.

Kind Regards

Legal Services
Freedom of Information / Subject Access Requests
Essex Partnership University NHS Foundation Trust
The Lodge | Lodge Approach | Runwell | Wickford | Essex | SS11 7XX
E-mail: mailto:[email address] (Freedom of Information)
E-mail: mailto:[email address](Subject (Subject Access Request)

________________________________________
From: Jennifer Sims <[FOI #553939 email]>
Sent: 02 May 2019 13:21
To: Foi (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST)
Subject: Re: FOI Response (EPUT.FOI.19.977)

Dear Foi (ESSEX PARTNERSHIP UNIVERSITY 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,

Jennifer Sims

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Foi (ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST), Essex Partnership University NHS Foundation Trust

2 Attachments

Dear Jennifer

 

I am writing in response to your request for a review of the information
received from you on 02.05.2019.

 

You asked us to provide a further update as attached.

 

The Essex Partnership University NHS Foundation Trust is able to provide
the information you have requested, as attached.

 

If you are dissatisfied with the response you have received, you have the
right to request a review of our decision or make a complaint about how
your request has been handled.  Your request should be made within 2
months of receipt of this letter and we will reply within 20 working days
of receipt.  Any such request received after 2 months will only be
considered at the discretion of the organisation.

 

If our decision is unchanged following a review and you remain
dissatisfied with this, you then have the right to make a formal complaint
to the Information Commissioner who can be contacted at: Information
Commissioners Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9
5AF.

 

Kind Regards

Legal Services

Freedom of Information / Subject Access Requests

Essex Partnership University NHS Foundation Trust

The Lodge | Lodge Approach | Runwell | Wickford | Essex | SS11 7XX

Telephone: 01268 407753

E-mail: [1]mailto:[email address] (Freedom of Information)

E-mail: [2]mailto:[email address](Subject (Subject Access Request)

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