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Bowel Management Patient Safety Alert (SPINE 01/19)

Dan Burden made this Freedom of Information request to Medway NHS Foundation Trust

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Dear Medway 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,

Dan Burden

Freedomofinformation (MEDWAY NHS FOUNDATION TRUST), Medway NHS Foundation Trust

4 Attachments

Dear Mr Burden,

 

Freedom of Information Request: reference 5281

 

Thank you for your email requesting information regarding Medway NHS
Foundation Trust. Your request is being dealt with under the terms of the
Freedom of Information Act 2000 and will be responded to within the
statutory 20 working day deadline.

 

Yours sincerely

 

Freedom of Information Team

[1][email address]

 

Medway NHS Foundation Trust
Windmill Road
Gillingham
Kent
ME7 5NY

Website: [2]www.medway.nhs.uk 

[3][IMG]    [4][IMG]    [5][IMG] 

 

For future reference, please note that the Trust’s FOI email address has
now changed to:  [6][email address]

 

 

 

 

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Freedomofinformation (MEDWAY NHS FOUNDATION TRUST), Medway NHS Foundation Trust

4 Attachments

Dear Mr Burden

 

Freedom of Information Request: reference 5281

 

Thank you for your request under the Freedom of Information Act 2000 and
please accept our apologies for the delay in responding.

 

The information you have requested is as follows:

 

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?

(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. The Trust are in the process of devising a new policy

 

Q3.   Is your policy based on the policy template that the Spinal Injuries
Association circulated to your trust in August 2018?

(a) Yes the policy will be

 

Q4. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention – Digital
removal faeces?

(b) No

 

Q5. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Digital rectal
stimulation?

(b) No

 

Q6. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Trans anal
irrigation?

(b) No

 

Q7. Are staff available seven days a week to undertake these bowel care
interventions?

(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. This will reviewed as part of the policy

 

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

 

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) This will happen as part of the launch of the new policy in relation
to this directive, supported by a communication strategy. The alert has
been shared with 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? 

(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) yes

 

Q13.  What are the contact details for the “appropriate clinical
leader”(ie name, position, telephone and email)?
Dr Paul Kitchen, Consultant and Deputy Medical Director, who is
contactable via email at:  [1][email address] or
via switchboard on telephone 01634 830000

 

Q14.  Why has your Trust not appointed an “appropriate clinical leader”?-
Not applicable

(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

 

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.”

 

 

I hope that this gives you the answer you need, but if you are
dissatisfied with the handling of your request, you have the right to ask
for an internal review. Internal review requests should be submitted
within two months of the date of receipt of this email and should be
addressed to:

 

Rachel Adams

Interim Information Governance Manager

Medway NHS Foundation Trust

Windmill Road

Gillingham

Kent

ME7 5NY

 

Please remember to quote the reference number in any future
communications.

 

In line with our obligations under the Freedom of Information Act the
Trust publishes responses to Freedom of Information Act Requests on the
Trust’s Disclosure Log which can be accessed via our website at:
[2]https://www.medway.nhs.uk/patients-and-p...

 

Yours sincerely

 

Freedom of Information Team

[3][email address]

 

 

Medway NHS Foundation Trust
Windmill Road
Gillingham
Kent
ME7 5NY

Website: [4]www.medway.nhs.uk 

[5][IMG]    [6][IMG]    [7][IMG] 

 

 

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