Dear Luton and Dunstable Hospital 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?
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?
(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?
Q5. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Digital rectal stimulation?
Q6. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Trans anal irrigation?
Q7. Are staff available seven days a week to undertake these bowel care interventions?
Q8. Has the Trust “reviewed your local education and training provision for interventional bowel management” as recommended in the Patient Safety Alert?
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”?
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”?
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?
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
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’?
Technical Note – Relevant annexe reads:-
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]
Thank you for your request for information which will be processed under the provisions of the Freedom of Information Act 2000. We will aim to provide you with the requested information within the 20 working days following the date of your request.
The request is subject to any exemption which the Trust is entitled to apply, some of which are absolute and some of which only apply where the public interest in maintaining the exemption outweighs that in disclosing the information.
Once the information has been identified the Trust may also ask that a fee be paid for processing and delivering the information to you. Details of any fee to be charged will be notified to you as soon as possible.
Any future correspondence you may have in relation to this matter should be marked private & confidential and sent to the Freedom of Information Lead. Luton and Dunstable NHS Trust, Lewsey Road, Luton, Beds, LU4 0DZ or emailed to the address above.
Freedom of Information Team
The Trust is very sorry for the delay in our response.
Our response is now attached and I would like to offer you my apologies on behalf of the Trust for the delay in providing this. I would also like to take this opportunity to assure you that the Trust is currently reviewing its FOI process.
I am writing in respect of your enquiry below for information held by the Trust. Your request has been handled under the provisions of the Freedom of Information Act.
The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting.
Most documents supplied by Luton and Dunstable University Hospital NHS Foundation Trust will have been produced by government officials and will be Crown Copyright. You can find details on the arrangements for re-using Crown Copyright on HMSOnline at: http://www.hmso.gov.uk/copyright/licence...
Information you receive which is not subject to Crown Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party (non Crown Copyright) information.
If for whatever reason you are unhappy with our response you are entitled to pursue any dissatisfaction by writing to The Information Governance Manager, Luton and Dunstable University Hospital NHS Foundation Trust, Lewsey Road, Luton, Beds, LU4 0DZ.
If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by Luton and Dunstable Hospital Foundation Trust. The Information Commissioner can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, and Cheshire SK9 5AF.
Please do not hesitate to contact the FOI team if you have any questions.
Freedom of Information Team
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