Bowel Management Patient Safety Alert (SPINE 01/19)

Tim Nicholson made this Freedom of Information request to Bedford Hospital NHS Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear Bedford Hospital 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,

Tim Nicholson

FOI, Bedford Hospital NHS Trust

Thank you for contacting the Freedom of Information (FOI).

 

We will ensure that you receive a response as soon as possible.

 

Kind regards,

Bedford Hospital NHS Trust

FOI team

 

FOI, Bedford Hospital NHS Trust

Dear Tim

I acknowledge receipt of your request under the Freedom of Information (FOI) Act, and you can expect the Trust’s response on or by 19/03/2019.
Yours sincerely,

IG/FOI Coordinator

Bedford Hospital NHS Trust
Kempston Rd | Bedford | MK42 9DJ

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FOI, Bedford Hospital NHS Trust

Dear Tim,

 

I write in response to your request under the Freedom of Information (FOI)
Act. 

 

Please see the Trust’s replies below.

 

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)?

 

Jacquelyn Harvey, Consultant Gastroenterologist

Tel.: 01234 355122

Email: [1][email address]

 

Catherine O’Brien, Matron

Tel.: 01234 355122

Email: Catherine.o’[email address]

 

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

 

as newly qualified nurses their competency development continues for at
least one year after registering with the NMC – this means they will be
competent with some elements but not all.

 

 

This information is provided for your personal use and is the property of
Bedford Hospital NHS Trust and subject to any existing Intellectual
Property and Database Rights.  Any commercial application or use of this
information may be subject to the provisions of the Re-use of Public
Sector Information Regulations 2015 (RPSI).  This means that if you wish
to re-use the information provided for commercial purposes for any reason
you must ask the Trust for permission to do so.

 

I hope that this information is of help to you but if you are not
satisfied with the Trust’s response, or want to complain about the way in
which your request has been handled, you are entitled to request an
internal review.  To do so, please contact Data Protection Officer and
Information Governance Manager [email address] and
should your complaint not be upheld you have the right to appeal against
the decision by contacting the Information Commissioner’s Office, Wycliffe
House, Water Lane, Wilmslow SK9 5AF.

 

 

 

Yours sincerely

 

IG/FOI Coordinator

 

Bedford Hospital NHS Trust

Kempston Rd | Bedford | MK42 9DJ

 

 

 

 

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Dear FOI,

I cannot see most of your replies via WhatDoTheyKnow, possibly because you've used shaded colouring which has been stripped out by the portal website. Please can you re-send response to [email address]

Yours sincerely,

Tim Nicholson

FOI, Bedford Hospital NHS Trust

Thank you for contacting the Freedom of Information (FOI).

 

We will ensure that you receive a response as soon as possible.

 

Kind regards,

Bedford Hospital NHS Trust

FOI team