International Codes and Severity Grading of Mental Ill Health and Physical Illnesses and ABUSE

Steven King made this Freedom of Information request to Dorset HealthCare University NHS Foundation Trust

This request has been closed to new correspondence. Contact us if you think it should be reopened.

The request was partially successful.

Dear Sirs,

You will recall I asked about international codes in an earlier request, and received a partial response.

I realise it is far too late to go back to that request, and for the sake of clarity ask you to please supply me with a full and clear picture of DSM and ICD codes and grades used in the NHS and Dorset Healthcare.

For example , a diagnosis of Post Traumatic Stress Disorder may have a DSM code attached and a 'grading' of say viii or similar . Other mental health illnesses also have codes and gradings attached to them - this is the information I wish to receive and understand please.

I have also been told,certain mental ill health conditions also cause/ make worse many physical symptoms and illnesses , that also need to be appropriately identified with codes and grades when they stem from mental illness - examples are Irritable Bowel Syndrome and Gout for example - there are many others.

I would be keen to receive information also on how a psychiatrist who diagnoses a patient with mental health conditions, should then either diagnose or pass to another consultant for diagnosis, the physical symptoms of other physical illnesses caused by the mental illness/injury ?

As a vulnerable adult suffering abuse that I have reported and asked for help and advice with your trust that has not been provided, I consider part of my illnesses relates to the abuse I am suffering, and have suffered over the past 16 years - often reported but never dealt with.

I have read your Adult Safeguarding Policy and Procedures , but with respect find them weak and not covering many areas or abuse that is harmful to a vulnerable person.

I understand updates are required to your policies and procedures to take into account the findings of the DOH in reports published back in March 2016 - are those being implemented, and when will they form part of your Policies and Procedures ?

Please be kind enough to attach a copy of your Safeguarding Policy and Procedures for Vulnerable Adults at the date of this request.

I have turned to Wikipedia for further information and guidance.

Wikipedia have a section dedicated to ' Abuse ' a total of 26 pages with numerous descriptions of types of abuse that are recognised in Law.

However out of 80-100 listings on the Wikipedia ' Abuse ' section, only maybe 15-20 of these are shown within your policies and procedures.
I wish to establish if, when considering reports of abuse from patients, do your staff ONLY follow your own ' weak and ineffective ' policies and procedures to identify abuse, or are they expected to know the actual Laws relating to abuse and act on what Legislation requires - rather than incomplete policies and procedures ?

This is NOT a vexatious request, if you read the Wikipedia ' Abuse ' section ( 26 pages )
you will see my need to raise this with you and for prompt actions to be taken.

Yours faithfully,

Steven King

FOI ENQUIRIES (DHC),

FREEDOM OF INFORMATION REQUEST No: 134-16-17

Dear Steven,

Thank you for your request under the Freedom of Information Act.

I am currently investigating your request and look forward to getting a response back to you, if possible, within 20 working days as required by the Act.

Kind Regards

Sentinel House
4-6 Nuffield Road
Poole
Dorset
BH17 0RB

 
Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

Dear Mark Dobbs, FOI ENQUIRIES (DHC),

134 16-17

A gentle reminder that your response is due tomorrow, 07th September .

I trust you are now more aware of the numerous difficulties I am encountering,

Yours sincerely,

Steven King

Dear Mark Dobbs FOI ENQUIRIES (DHC),

134 16-17

Please update me as to when you intend to provide all the information I have asked for, as this request is now overdue and needs to be shown as a breech .

Yours sincerely,

Steven King

FOI ENQUIRIES (DHC),

Dear Steven,

Thank you for your email regarding the above and have been informed that you have sent a Subject Access Request to our Information Governance Team who are dealing with your request which is in the process of being dealt with.

Kind regards,

pp Mark

show quoted sections

Dear Mark Dobbs , FOI ENQUIRIES (DHC),

134 16-17

I am very disappointed , and wish to complain that private information regarding myself has been made public by Dorset Healthcare University Foundation Trust under this request by " pp Mark " on 20 September 2016.
Your trust did not seek or have consent to make this information public.
Please issue an immediate formal detailed apology from your Chief Executive on this website .

Whilst writing, I AGAIN remind you, your response to this FOIA request is several weeks overdue and my Rights in Law have been ignored - without reason or apology being offered, I feel this is a very serious breech of my Rights .
Clearly your trust is abusing their imbalance of power over me and failing to comply with my Rights, a form of abuse of me as a disabled vulnerable adult and not only in respect of this FOIA !
I find it very upsetting that your senior Safeguarding staff are unlikely to act regarding this concern, as they have already failed to act before !
Is this what they mean by a TOXIC NHS ?
Please pass this to your Chief Executive or Accountable Officer to be dealt with fully in the manner I have indicated , who I trust will also update me as to when this relatively straight forward request will receive the response due on 07 September ?
Some members of the public have kindly sent me several pieces of information regarding the international codes and grades , so I look forward to receiving complete lists please ?
A kind psychiatrist has also sent me information he has access to regarding the effects of abuse & stress agravating both mental and physical ill health, and this is important information that I wish to know more about, as your psychiatrist does not appear to have the knowledge or experience , or maybe simply does not care ? or is part of a cover up of what happened to me ? , to provide me with a full proper professional diagnosis

in the past 12 months to make available to me the support and treatment I need .

Yours sincerely,

Steven King

FOI ENQUIRIES (DHC),

Dear Steven,

Please accept my apologies for the delay in getting the response to you in this case.

You may appreciate that I have been on leave and to ensure that I got everything cleared up and did not forget anything before I left the office I put our response to you on a timed delivery. I set the message up to be sent to you at 2pm on 7th September. Unfortunately this did not work as I can see that the message is still stuck in my outbox. So I am sorry this failed but I will send you the response in due course this morning.

As regards the message that my colleague sent you on 20th Sept. This message was informing you that another department was dealing with a separate matter that you had contacted the Trust about. No private information of yours was released to the public.

Yours sincerely

Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

MARK DOBBS (DHC),

4 Attachments

Dear Steven,

 

Thank you for your request for information under the Freedom of
Information Act 2000. 

I can confirm that our response is:

Request:

Dear Sirs,

 

You will recall I asked about international codes in an earlier request,
and received a partial response.

 

I realise it is far too late to go back to that request, and for the sake
of clarity ask you to please supply me with a full and clear picture of
DSM and ICD  codes and grades used in the NHS and Dorset Healthcare.

 

For example , a diagnosis of Post Traumatic Stress Disorder may have a
DSM  code attached and a 'grading' of say viii or similar .  Other mental
health illnesses also have codes and gradings attached to them - this is
the information I wish to receive and understand please.

 

I have also been told,certain  mental ill health  conditions  also cause/
make worse  many physical symptoms and illnesses , that also need to be
appropriately identified with codes and grades when they stem from mental
illness  - examples are Irritable Bowel Syndrome  and Gout for example -
there are many others.

 

I would be keen to receive information also on how a psychiatrist who
diagnoses a patient with mental health conditions, should then either
diagnose or pass to another consultant for diagnosis, the physical
symptoms of other physical illnesses caused by the mental illness/injury ?

 

As a vulnerable adult suffering abuse that I have reported and asked for
help and advice with your trust that has not been provided, I consider 
part of my illnesses relates to the abuse I am suffering, and have
suffered over the past 16 years - often reported but never dealt with.

 

I have read your Adult Safeguarding Policy and Procedures , but with
respect find them weak and not covering many areas or abuse that is
harmful to a vulnerable person.

 

I understand updates are required to your policies and procedures to take
into account the findings of the DOH in reports published back in March
2016  -  are those being implemented, and when will they form part of your
Policies and Procedures ?

 

Please be kind enough to attach a copy of your Safeguarding Policy and
Procedures for Vulnerable Adults at the date of this request.

 

I have turned to Wikipedia  for further information and guidance.

 

Wikipedia have a section dedicated to  '  Abuse  '  a total of 26 pages
with numerous descriptions of types of abuse that are recognised in Law.

 

However out of 80-100 listings on the Wikipedia  '  Abuse ' section, only
maybe 15-20 of these are shown within your policies and procedures.    

I wish to establish if, when considering reports of abuse from patients,
do your staff ONLY follow your own ' weak and ineffective ' policies and
procedures to identify abuse, or are they expected to know the actual Laws
relating to abuse and act on what Legislation requires - rather than
incomplete policies and procedures ?

 

This is NOT a vexatious request, if you read the Wikipedia  ' Abuse '
section ( 26 pages ) you will see my need to raise this with you and for
prompt actions to be taken.

Response:

The Trust has now had the opportunity to fully consider your request and
responds as follows:

1.    The Trust can confirm that it only uses ICD codes and we have
already previously provided you with access to the ICD Codes website. We
have no other recorded information on this point other than our Clinical
Coding Policy, a copy of which is attached to this message. The Trust does
not use DSM codes, this appears an American publication.

2.    The Trust has no specific recorded information to answer this
particular question, but like anyone in the medical profession, should a
psychiatrist after assessing the condition of any patient feel they need
to refer them to another consultant in treating the patient’s particular
condition, then they will refer as necessary.

3.    Please find attached the current version of our Safeguarding Policy
that has recently been updated and agreed by a Joint Safeguarding Group
and so is compliant with the DOH “Care and support statutory guidance:
changes in March 2016” guidance.  The previous trust Safeguarding Policy
was compliant with the Care Act prior to the latest refresh, the
Department of Health guidance that was published in March was an update on
the Care Act and provided clarity on certain points. It did not change the
who has statutory responsibility for making enquiries into safeguarding
concerns.

4.    Mandatory Safeguarding training is provided 3 yearly to Trust staff.
The training includes reference to all relevant legislation. In addition
to this staff are expected to follow our internal policies and procedures
which reflect the Dorset Multi-Agency policy and procedures, all of which
are compliant with current safeguarding legislation and National guidance.

The information supplied to you in this communication, 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. 

If you wish to re-use the information supplied, in whole or in part, for
any other purpose e.g. commercial publications, please write to me stating
what information you wish to re-use, the purpose(s) you wish to re-use the
information for. We will respond within 20 working days of receiving your
request with any conditions and charges that relate to the re-use of the
information in accordance with the Re-use of Public Section Information
Regulations 2005. 

If you wish to discuss any of the above, please contact me, quoting the
reference above.

If you are unhappy with the way in which we have handled your request,
please contact myself in the first instance. If you wish to make a formal
complaint, you should write to our Complaints Manager at Dorset HealthCare
University NHS Foundation Trust, Trust HQ, Sentinel House, 4-6 Nuffield
Road, Poole, Dorset BH17 0RB   

If you are not content with the outcome of your complaint or the internal
review, you may apply directly to the Information Commissioner for a
decision. Generally, the Information Commissioner will only make a
decision once you have exhausted the complaints and/or internal review
process provided by us. The Information Commissioner can be contacted at:
The Information Commissioner’s Office, Wycliffe House, Water Lane,
Wilmslow, Cheshire, SK9 5AF.

Kind regards

 

 

 

[1]cid:image001.png@01CEDF9D.7631AE70Sentinel   Name                  Mark
House Dobbs

4-6 Nuffield Road Job Title              Freedom
of Information Officer &
Poole
                              
Dorset Policy Co-ordinator

BH17 0RB Department      Corporate
(  Tel: 01202 277017

          *
Email: [email address]

8 Web:
[2]www.dorsethealthcare.nhs.uk

[3]cid:image004.jpg@01D208E5.FC082190

 

 

References

Visible links
2. http://www.dorsethealthcare.nhs.uk/

D. Speers left an annotation ()

Still seeking answers Eh Mr King......I really don't know why you have to work this hard and I also hope Mr M Dobbs has had his PC looked at. Messages 'stuck in outbox' may be indicative of more serious concerns although I dont understand why you dont appear to have received this message now! Perhaps Mr Dobbs could forward for your file!
As ever
D.Speers

Steven King left an annotation ()

Hi D Speers,
thank you for your annotation which I find helpful.

I shall go down that route soon.

I know you have an interest in Mental Health services,
and think you may find my request to NHS South Gloucestershire CCG here on WDTK titled ' Avon and Wiltshire Mental Health Partnership Quality Improvement Group ' made on 11 08 2016 to be of interest.

Thank you for your interest shown , best wishes,

Steven King

MARK DOBBS (DHC),

4 Attachments

Dear Steven,

 

Thank you for your request for information under the Freedom of
Information Act 2000. 

I can confirm that our response is:

Request:

Dear Sirs,

 

You will recall I asked about international codes in an earlier request,
and received a partial response.

 

I realise it is far too late to go back to that request, and for the sake
of clarity ask you to please supply me with a full and clear picture of
DSM and ICD  codes and grades used in the NHS and Dorset Healthcare.

 

For example , a diagnosis of Post Traumatic Stress Disorder may have a
DSM  code attached and a 'grading' of say viii or similar .  Other mental
health illnesses also have codes and gradings attached to them - this is
the information I wish to receive and understand please.

 

I have also been told,certain  mental ill health  conditions  also cause/
make worse  many physical symptoms and illnesses , that also need to be
appropriately identified with codes and grades when they stem from mental
illness  - examples are Irritable Bowel Syndrome  and Gout for example -
there are many others.

 

I would be keen to receive information also on how a psychiatrist who
diagnoses a patient with mental health conditions, should then either
diagnose or pass to another consultant for diagnosis, the physical
symptoms of other physical illnesses caused by the mental illness/injury ?

 

As a vulnerable adult suffering abuse that I have reported and asked for
help and advice with your trust that has not been provided, I consider 
part of my illnesses relates to the abuse I am suffering, and have
suffered over the past 16 years - often reported but never dealt with.

 

I have read your Adult Safeguarding Policy and Procedures , but with
respect find them weak and not covering many areas or abuse that is
harmful to a vulnerable person.

 

I understand updates are required to your policies and procedures to take
into account the findings of the DOH in reports published back in March
2016  -  are those being implemented, and when will they form part of your
Policies and Procedures ?

 

Please be kind enough to attach a copy of your Safeguarding Policy and
Procedures for Vulnerable Adults at the date of this request.

 

I have turned to Wikipedia  for further information and guidance.

 

Wikipedia have a section dedicated to  '  Abuse  '  a total of 26 pages
with numerous descriptions of types of abuse that are recognised in Law.

 

However out of 80-100 listings on the Wikipedia  '  Abuse ' section, only
maybe 15-20 of these are shown within your policies and procedures.    

I wish to establish if, when considering reports of abuse from patients,
do your staff ONLY follow your own ' weak and ineffective ' policies and
procedures to identify abuse, or are they expected to know the actual Laws
relating to abuse and act on what Legislation requires - rather than
incomplete policies and procedures ?

 

This is NOT a vexatious request, if you read the Wikipedia  ' Abuse '
section ( 26 pages ) you will see my need to raise this with you and for
prompt actions to be taken.

Response:

The Trust has now had the opportunity to fully consider your request and
responds as follows:

1.    The Trust can confirm that it only uses ICD codes and we have
already previously provided you with access to the ICD Codes website. We
have no other recorded information on this point other than our Clinical
Coding Policy, a copy of which is attached to this message. The Trust does
not use DSM codes, this appears an American publication.

2.    The Trust has no specific recorded information to answer this
particular question, but like anyone in the medical profession, should a
psychiatrist after assessing the condition of any patient feel they need
to refer them to another consultant in treating the patient’s particular
condition, then they will refer as necessary.

3.    Please find attached the current version of our Safeguarding Policy
that has recently been updated and agreed by a Joint Safeguarding Group
and so is compliant with the DOH “Care and support statutory guidance:
changes in March 2016” guidance.  The previous trust Safeguarding Policy
was compliant with the Care Act prior to the latest refresh, the
Department of Health guidance that was published in March was an update on
the Care Act and provided clarity on certain points. It did not change the
who has statutory responsibility for making enquiries into safeguarding
concerns.

4.    Mandatory Safeguarding training is provided 3 yearly to Trust staff.
The training includes reference to all relevant legislation. In addition
to this staff are expected to follow our internal policies and procedures
which reflect the Dorset Multi-Agency policy and procedures, all of which
are compliant with current safeguarding legislation and National guidance.

The information supplied to you in this communication, 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. 

If you wish to re-use the information supplied, in whole or in part, for
any other purpose e.g. commercial publications, please write to me stating
what information you wish to re-use, the purpose(s) you wish to re-use the
information for. We will respond within 20 working days of receiving your
request with any conditions and charges that relate to the re-use of the
information in accordance with the Re-use of Public Section Information
Regulations 2005. 

If you wish to discuss any of the above, please contact me, quoting the
reference above.

If you are unhappy with the way in which we have handled your request,
please contact myself in the first instance. If you wish to make a formal
complaint, you should write to our Complaints Manager at Dorset HealthCare
University NHS Foundation Trust, Trust HQ, Sentinel House, 4-6 Nuffield
Road, Poole, Dorset BH17 0RB   

If you are not content with the outcome of your complaint or the internal
review, you may apply directly to the Information Commissioner for a
decision. Generally, the Information Commissioner will only make a
decision once you have exhausted the complaints and/or internal review
process provided by us. The Information Commissioner can be contacted at:
The Information Commissioner’s Office, Wycliffe House, Water Lane,
Wilmslow, Cheshire, SK9 5AF.

Kind regards

 

 

 

[1]cid:image001.png@01CEDF9D.7631AE70Sentinel   Name                  Mark
House Dobbs

4-6 Nuffield Road Job Title              Freedom
of Information Officer &
Poole
                              
Dorset Policy Co-ordinator

BH17 0RB Department      Corporate
(  Tel: 01202 277017

          *
Email: [email address]

8 Web:
[2]www.dorsethealthcare.nhs.uk

[3]cid:image004.jpg@01D208E5.FC082190

 

 

References

Visible links
2. http://www.dorsethealthcare.nhs.uk/

Dear MARK DOBBS (DHC),

134 16-17

I apologise for the delay in getting back to you, it really wears me down further and further causing severe mental ill health and associated physical reactions that knock me out of action for weeks on end , when I do not receive my Rights or information that should enable me to obtain a PROPER accurate and detailed diagnosis .

Delays cause me pain and suffering , and I know I am deteriorating as a result .

I remain unhappy that the email sent by " pp Mark " on 20 09 2016 was nothing to do with this or any other FOIA request ive made to you , and I have asked for a full and detailed apology from your CEO please. Please email your CEO with this request . I should mention the Legal deadlines have long gone by ( 55-60 days I think ), so further abuse of me by denying or delaying me my Rights ?

To assist me , who is " pp Mark " hiding behind your identity ?

I am pleased to see your Adult Safeguarding Policy has been slightly improved , although characteristics remain within the new one giving you a ' get out of jail free ' card when staff fail to act as they should when receiving concerns and reports of abuse . The policy requires further strengthening to be properly effective and compliant with all Legislation in this area.

Since making this request, a number of medical professionals and members of the public have contacted me after reading this on whatdotheyknow , and the lack of completeness in the information you are giving me.
You are clearly a highly intelligent person in a senior role in your organisation, and the information I am seeking is being used by the professional psychiatrists within your organisation . May I ask you to seek this information from a number of impartial independent psychiatrists within your trust as it MUST be held and used by them , and I fail to understand why the information I seek is being witheld ?
MY request is necessary for my health and wellbeing, as I need to use the information to correspond with a psychiatrist who does not appear to have the knowledge to provide a full and detailed diagnosis , that should then lead to my receiving treatment and support for the long term conditions I know I have .
Hence after 16 years of my injuries being covered up, and my remaining untreated and unsupported throughout this period of time, I NEED to get my life back before I die !

You mention you set up your computer to provide the response to me at 2pm on 07th September whilst you were on holiday ?
Please clearly explain the process , and the failings in the system you set up , and what prevented you from sending the response before you went on holiday ? I get the impression your response was just sitting there - when it could / should ? have been sent without delay ? Didnt anybody check ?

I shall not insult you by requesting a review of this request, at this stage , but ask you for assistance in highlighting all the of areas asked about in the first email of my FOIA request , and identifying clearly where you have responded to each/ all of the matters I needed to ask about .
Of course , if a number of areas have been ' missed ' by you, now would be a good opportunity to do the right thing ?
I am very ill, and trust you will PROPERLY assist me with these matters please ?

Yours sincerely,

Steven King

MARK DOBBS (DHC),

Mark Dobbs is now out of office until Monday 10th October 2016. During this period can all messags relating to Freedom of Information please be sent to [Dorset HealthCare University NHS Foundation Trust request email].
For anything urgent relating to Freedom of Information then please contact the Corporate Office, Sentinel House, 01202 277000.
Thank You

show quoted sections

FOI ENQUIRIES (DHC),

Dear Steven,

I am acknowledging your email of 6th Oct and have passed it on to my supervisor so that he can review how I have handled your request and I am sure he will be in contact in the near future.

Yours sincerely.

Sentinel House
4-6 Nuffield Road
Poole
Dorset
BH17 0RB

 
Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

Dear Mark , FOI ENQUIRIES (DHC),

134 16-17

Thank you for your email this morning.

I am being told there are a number of international codes , some of which you have provided,
but there are also a series of more complicated grades that are used to identify the type and
severity, and complicating factors such as abuse etc, that should be used by psychiatrists when
diagnosing the illness in detail , prior to treatment.
I am told the physical ill health that subsequently results, such as in a case of PTSD and severe
depression , and continues to get worse and leads to worsening physical ill health associated
to the MH conditions , also needs to be identified to ensure a suitable and complete course of
treatment can be offered .
I am told a diagnosis of just ' post traumatic stress disorder ' by a psychiatrist is not enough to
ensure the correct course of support and treatment is arranged .
I hope this helps,

Yours sincerely,

Steven King

FOI ENQUIRIES (DHC),

Dear Steven,

It would be helpful if you could provide the source of the 'more complicated grades' that you are referring to. Can you supply me with a document or link, something like that so I can see exactly what you are talking about.

I understand what you are saying but any further information from you would help me search for what information we may have within the Trust.

Yours sincerely.

Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

Dear Mark FOI ENQUIRIES (DHC),

134 16-17

Thank you for your email today.

The ' sources ' of the information I am seeking appear on two diagnosis' of me made by a psychiatrist back in 2011, a psychiatrist still working for the NHS Mental Health Trust who I am told ' no longer wishes to have any involvement with me.'
My ill health was caused by local agency failings and neglect back in 2000 2001, and is ongoing.
His diagnosis appears in a ' SUMMARY ' of my medical records, a carefully selected yet FAR from complete amount of papers dating back over FIVE YEARS , many of which I have never seen before - despite making Subject Access Requests and Access to Medical Records Requests regularly every year or 18 months whilst under the supposed ' CARE ' of that trust - you know who I mean !
PLEASE do not refer me to their PALS and Complaints dept, it is used as their defense shield rather than to make any attempt to properly resolve matters, and has done me more harm than good.
A PHSO report about their PALS and Complaints service is on the PHSO website.
Many of the records I have now been provided with are incomplete, inaccurate , a misrepresentation of the true facts, even deliberate lies on documents that have been shared outside the NHS.
I have also been contacted by mental health professionals and members of the public who have guardedly discussed the grading system, and the grades on their own diagnosis' in some cases.
If I had access to documents or links I would not bother you with this request.
I have seen online that some private and BUPA doctors mention the particular illnesses and GRADES that they have specialisms with.

YOU WILL RECALL I HAVE ALREADY REFERRED YOU TO THE SPECIALIST MENTAL HEALTH PSYCHIATRISTS THAT ARE EMPLOYED BY DORSET HEALTHCARE - OTHER THAN THE PSYCHIATRIST I HAVE ALREADY SEEN AT DORSET HEALTHCARE - , as surely a part of their training and the information I am seeking is held by them?
Did you contact any/all of them for the information I am seeking ?
It will greatly boost my current levels of confidence in Dorset Healthcare if you answer this question in full, and with total honesty, openness and transparency ?

I do not wish to disclose in full my full diagnosis codes on here, but surely a psychiatrist will recognise codes similar to vi, vii , ii, viii , etc etc, and others such as F4110 , F4120 , 30000 , F3200 , 31100 ??
I should make it clear these above are not necessarily of specific interest to me, but I wish to see and know about and understand ALL the codes that are used , and their meanings , as it is still delaying me from seeing again the Psychiatrist from your trust that I have met and received a ' VERY WOOLY ' diagnosis from, that covers up much more than it identifies about what caused my illness , the daily effects it is having upon me, and contains no codes whatsoever AND no proper detail .

Maybe part of the ongoing cover up ?

I would be interested to know about the guidance/advice given by your supervisor ?

Yours sincerely,

Steven King

FOI ENQUIRIES (DHC),

Dear Steven,

Thank you for that all noted.

I wish to reassure you that I do continue to work on your request. I do intend to go down a different route than I went before to try and find information that we may have to answer the psychiatrist diagnosis part of your request. I have also further discussed the Trust's use of ICD codes with our Clinical Coding officer. Once I have pieced this all together I will get a response to you as soon as I can.

Regarding my supervisor, he took the view that I should continue with my work and try and answer your request as best I can, which I will do.

Yours sincerely

Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

Dear Mark ,FOI ENQUIRIES (DHC),

134 16-17,

Thank you VERY MUCH for your kind and timely reply, and the matters you have answered.

I have found it necessary to be very clear regarding the certain areas and the need for my request,
you may remember one of my earlier requests about professionals closing ranks !!

Would it help you if I give you consent to see my diagnosis' and communications to and from the main medical professional and others at your trust, so you can identify the areas of concern I have and the information I am seeking ? Chris Gray , IGM has the information readily to hand .

Several years on since my diagnosis , I am still awaiting answers and for the so called ' professionals '
to put matters right.

Yours sincerely,

Steven King

FOI ENQUIRIES (DHC),

Dear Steven,

No thank you, that is not required.

Many thanks

 
Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
CC Tel: 01202 277017
Email: [email address]
mmWeb: www.dorsethealthcare.nhs.uk

show quoted sections

MARK DOBBS (DHC),

3 Attachments

FREEDOM OF INFORMATION REQUEST NO: 134-16-17

 

Dear Steven,

 

I have obtained some further information which I hope helps you.

 

ICD Codes:

 

In relation to the use of the ICD codes in this Trust.

 

The Trust’s Psychiatrists are trained in the use of the ICD10 diagnostic
codes and  forms part of their professional training.

 

The codes from the ICD10 classification are those which are stored in our
patient record system and which are used by our clinicians when making a
diagnosis of a patient.

 

I have liaised with our clinical coding office regarding the use of the
ICD codes in the Trust. They confirm that as a Trust we only use the main
ICD code and digit after the first decimal point. 

 

To illustrate this point there is a document available on the internet
(copy attached, this is not a Dorset Healthcare publication). As a guide,
on page 32 the document provides codes in relation to Stress conditions
(shown below).

 

Code F43 is the code relating to Stress and Adjustment Disorders. Then
there are a number of further stress related conditions that are
identified by a further digit i.e. F43.2 which relates to Adjustment
disorders. This Trust has the main code (in this example F43) and the 
additional codes (in this example 43.2) entered into our patient system
and so could be used by any member of medical staff, such as a
psychiatrist when assessing a patient.

 

But under the F43.2 condition there are a further set of sub codes (greyed
out below) after the second decimal point, which relate to a more specific
diagnosis of a patient’s condition. This Trust does not use these
additional codes after the second decimal point. Other NHS Trusts may do,
but we do not. The ability to use digits after the second decimal point is
not possible with the browser that our particular patient record provider
supplies. Despite this limitation, Psychiatrists could add comments or
more detail into a patient’s electronic record, should they wish to, but
carrying out a check of our system last week, we could not find such
additional codes being used. We believe most Trusts are using the same
patient record provider as us, although there are some Trusts that do not
and may therefore use the second decimal point. I do not have a list of
which Trusts use the same provider as us.

 

I have used this section just as an example, but where other conditions in
the ICD codes are broken down by additional codes, this Trust will not use
those codes, but other Trusts might.

 

F43 Reaction to severe stress, and adjustment disorders

F43.0 Acute stress reaction

F43.1 Post-traumatic stress disorder

F43.2 Adjustment disorders

         .20 Brief depressive reaction

         .21 Prolonged depressive reaction

         .22 Mixed anxiety and depressive reaction

         .23 With predominant disturbance of other emotions

         .24 With predominant disturbance of conduct

         .25 With mixed disturbance of emotions and conduct

.        28 With other specified predominant symptoms

F43.8 Other reactions to severe stress

F43.9 Reaction to severe stress, unspecified   

 

When making a diagnosis of a patient, we do not recognise the use of a
‘grading’ or a digit, such as ‘viii’ in relation to the recording of a
diagnosis, our clinicians will refer only to the ICD Codes and the
associated narrative that accompanies each code(s) in the ICD codes list
to determine a condition of a patient. Therefore we have no other
information to provide you regarding use of ‘gradings’ or other digits
such as ‘viii’. 

 

The DSM-V refers to the Diagnostic and Statistical Manual, Version V,
which is the diagnostic system used in the USA.  This is not the
classification system used in the Trust or the UK, although would be
widely known by psychiatrists, as we do not use the DSM Codes we do not
have information to provide you about them.

 

Psychiatrists Diagnosis:

 

I have liaised with senior medial/psychiatric staff and they have all told
me that we have no document in the Trust to provide you that sets how a
psychiatrist diagnoses a patient and the subsequent care pathway that
should follow. I have been unable to obtain a manual of guidance or
training material regarding such information.

 

I have been told that psychiatrists will refer to the descriptions that
accompanies each ICD code in the classification document.

 

Following diagnosis, treatment decisions made by our staff, including
psychiatrists will be made with reference to the relevant NICE Guidelines
(NICE who advise the NHS on caring for the public). I have been on to the
NICE website and have found pages that relate to conditions that may be of
interest to you and may provide you with information regarding care
pathways in this area of health. Please use the following link to access
the relevant pages:  [1]https://www.nice.org.uk/guidance

 

I have been on the Royal College of Psychiatrists web site and have found
a section which deals with Evidence Based Treatment Pathways and if you
use the following link [2]http://www.rcpsych.ac.uk/workinpsychiatry you
see two links in the centre of the page, relating to early intervention
which may help you with information relating to care following assessment.

 

I have also found a further section on the Royal College of Psychiatrists
which provides general information for the public regarding health
information. [3]http://www.rcpsych.ac.uk/expertadvice

 

I hope this information assists you.

 

Yours sincerely.

 

 

 

Name                  Mark Dobbs

Job Title              Freedom of Information Officer &

                               Policy Co-ordinator

Department      Corporate

CC Tel: 01202 277017

            Email: [4][email address]

mmWeb: [5]www.dorsethealthcare.nhs.uk

 

 

 

show quoted sections

MARK DOBBS (DHC),

3 Attachments

FREEDOM OF INFORMATION REQUEST NO: 134-16-17

 

Dear Steven,

 

I have obtained some further information which I hope helps you.

 

ICD Codes:

 

In relation to the use of the ICD codes in this Trust.

 

The Trust’s Psychiatrists are trained in the use of the ICD10 diagnostic
codes and  forms part of their professional training.

 

The codes from the ICD10 classification are those which are stored in our
patient record system and which are used by our clinicians when making a
diagnosis of a patient.

 

I have liaised with our clinical coding office regarding the use of the
ICD codes in the Trust. They confirm that as a Trust we only use the main
ICD code and digit after the first decimal point. 

 

To illustrate this point there is a document available on the internet
(copy attached, this is not a Dorset Healthcare publication). As a guide,
on page 32 the document provides codes in relation to Stress conditions
(shown below).

 

Code F43 is the code relating to Stress and Adjustment Disorders. Then
there are a number of further stress related conditions that are
identified by a further digit i.e. F43.2 which relates to Adjustment
disorders. This Trust has the main code (in this example F43) and the 
additional codes (in this example 43.2) entered into our patient system
and so could be used by any member of medical staff, such as a
psychiatrist when assessing a patient.

 

But under the F43.2 condition there are a further set of sub codes (greyed
out below) after the second decimal point, which relate to a more specific
diagnosis of a patient’s condition. This Trust does not use these
additional codes after the second decimal point. Other NHS Trusts may do,
but we do not. The ability to use digits after the second decimal point is
not possible with the browser that our particular patient record provider
supplies. Despite this limitation, Psychiatrists could add comments or
more detail into a patient’s electronic record, should they wish to, but
carrying out a check of our system last week, we could not find such
additional codes being used. We believe most Trusts are using the same
patient record provider as us, although there are some Trusts that do not
and may therefore use the second decimal point. I do not have a list of
which Trusts use the same provider as us.

 

I have used this section just as an example, but where other conditions in
the ICD codes are broken down by additional codes, this Trust will not use
those codes, but other Trusts might.

 

F43 Reaction to severe stress, and adjustment disorders

F43.0 Acute stress reaction

F43.1 Post-traumatic stress disorder

F43.2 Adjustment disorders

         .20 Brief depressive reaction

         .21 Prolonged depressive reaction

         .22 Mixed anxiety and depressive reaction

         .23 With predominant disturbance of other emotions

         .24 With predominant disturbance of conduct

         .25 With mixed disturbance of emotions and conduct

.        28 With other specified predominant symptoms

F43.8 Other reactions to severe stress

F43.9 Reaction to severe stress, unspecified   

 

When making a diagnosis of a patient, we do not recognise the use of a
‘grading’ or a digit, such as ‘viii’ in relation to the recording of a
diagnosis, our clinicians will refer only to the ICD Codes and the
associated narrative that accompanies each code(s) in the ICD codes list
to determine a condition of a patient. Therefore we have no other
information to provide you regarding use of ‘gradings’ or other digits
such as ‘viii’. 

 

The DSM-V refers to the Diagnostic and Statistical Manual, Version V,
which is the diagnostic system used in the USA.  This is not the
classification system used in the Trust or the UK, although would be
widely known by psychiatrists, as we do not use the DSM Codes we do not
have information to provide you about them.

 

Psychiatrists Diagnosis:

 

I have liaised with senior medial/psychiatric staff and they have all told
me that we have no document in the Trust to provide you that sets how a
psychiatrist diagnoses a patient and the subsequent care pathway that
should follow. I have been unable to obtain a manual of guidance or
training material regarding such information.

 

I have been told that psychiatrists will refer to the descriptions that
accompanies each ICD code in the classification document.

 

Following diagnosis, treatment decisions made by our staff, including
psychiatrists will be made with reference to the relevant NICE Guidelines
(NICE who advise the NHS on caring for the public). I have been on to the
NICE website and have found pages that relate to conditions that may be of
interest to you and may provide you with information regarding care
pathways in this area of health. Please use the following link to access
the relevant pages:  [1]https://www.nice.org.uk/guidance

 

I have been on the Royal College of Psychiatrists web site and have found
a section which deals with Evidence Based Treatment Pathways and if you
use the following link [2]http://www.rcpsych.ac.uk/workinpsychiatry you
see two links in the centre of the page, relating to early intervention
which may help you with information relating to care following assessment.

 

I have also found a further section on the Royal College of Psychiatrists
which provides general information for the public regarding health
information. [3]http://www.rcpsych.ac.uk/expertadvice

 

I hope this information assists you.

 

Yours sincerely.

 

 

 

Name                  Mark Dobbs

Job Title              Freedom of Information Officer &

                               Policy Co-ordinator

Department      Corporate

CC Tel: 01202 277017

            Email: [4][email address]

mmWeb: [5]www.dorsethealthcare.nhs.uk

 

 

 

show quoted sections

Dear MARK DOBBS (DHC),

Your ref 134 16-17

Unlike some, I must remain polite and professional when dealing with people , and certainly not refer to any mental health patient as THE BEAST when emailing people I work with ???

You give the impression you have struggled with this request , although I now know so much of the information I was seeking is easily and readily available to medical professionals in your trust.

I need to give you some new background information :

I was invited to attend a major specialist Post Traumatic Stress conference held for medical professionals in Swindon, hosted by the Swindon Trauma Group on 14 October 2016 9am - 17.30pm .

Many psychiatrists, psychologists , therapists and mental health professionals from England and Wales
attended, and I learned so much about my injury in one day, that has never been explained or made available to me in the 17 years I have been seeking information and treatment within the NHS - including a senior psychiatrist with your own trust.

The medical professionals spoke to me in a caring and humane way, I was actually ' A REAL PERSON ' for a day, and received detailed information about my injury - and how so many of the 'services' I have received from Dorset Healthcare and the Avon and Wiltshire Mental Health Partnership should have been provided to me.

Knowing I was a patient, the professionals enquired about my current state of health and the treatment and support I am supposed to be receiving - which of course remains at absolutely nothing !

So now I know more about my injury and the dangerous effects it is having on my body, and the damage that has been done by the 17 years of abuse and cover up I have suffered from multiple agencies, including Dorset of course.

After learning so much, I was hoping to make real progress with obtaining treatment and trying to get my life back after so many years, although one told me due to the delays and ongoing re traumatisation and abuse that I am suffering, I need to prepare myself that without considerable support I may never recover .

I received a data disclosure from your trust, so much missing - so much not supplied to me in accordance with my Rights - about 200 pieces of data I estimate - that totally destroyed my physical and mental health for months - and today is the first time for months that I have felt well enough to share my experience with you.

Maybe you do not care , but you cannot imagine how much damage was caused by being referred to as THE BEAST .

So, thank you for the limited information you supplied over a protracted period, I now have 90% more than you supplied me with.

My experiences with your Trust have most certainly damaged me, and I wish your trust to swiftly and effectively offer me the necessary support to obtain my FULL medical and health records including my Rio records and the audio recordings taken by Dr Rodin, and data that I am entitled to, and a PROPER full diagnosis.

I have attempted to get Legal Advocacy and IMCA support, but none has been provided , so I remain unsupported and very ill.

Please pass this on to Dr Rodin without delay - who is not responding to correspondence from my member of Parliament - and ask him to contact me in writing to remedy this situation that exists , give me a proper FULL diagnosis,
at least ARRANGE the support he stated I required and notified NHS Wiltshire CCG Chairman by letter.

NO CARE IN WILTSHIRE EITHER - just multiple cover ups.

So please also supply me with the Policies and Procedures , and NHS Constitution and Legislation that should be protecting me under these circumstances - this is my FOIA request .

Currently I feel a number of NHS organisations are taking actions that are likely to lead to a significant deterioration in my health and wellbeing - and are knowingly doing so.

Please take a look at my FIRST FOIA request to your Trust , here on whatdotheyknow that you dealt with.

Yours sincerely,

Steven King

FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST), Dorset HealthCare University NHS Foundation Trust

3 Attachments

Dear Steven,

 

Thank you for your message.

 

For your information I have forwarded your message to our Information
Governance Manager to deal with your Subject Access Request (medical
records).

 

I have also copied the message to Dr Rodin to make him aware of your
request for him to contact you in writing.

 

As regards your request for the NHS Constitution and Legislation, this
information is publicly available to you and I have provided links so that
you can access these documents.

 

[1]https://www.gov.uk/government/collection...

 

 

[2]https://www.england.nhs.uk/about/equalit...

 

With reference to your first request that you sent us we have already
provided you with copies of our own Safeguarding and the Dorset
Safeguarding Board policy documents.

 

I hope the above provides you with the information that you require.

 

Yours sincerely

 

Mark Dobbs

 

 

 

 

Sentinel House Name Mark Dobbs

4-6 Nuffield Road Job Title Freedom of Information Officer &

Poole Policy Co-ordinator

Dorset Department Corporate
( Tel: 01202 277017
BH17 0RB
* Email: [3][email address]

8 Web: [4][email address]

 

 

 

 

 

Dear MARK DOBBS (DHC),

 

Your ref 134 16-17

 

Unlike some, I must remain polite and professional when dealing with
people , and certainly not refer to any mental health patient as THE BEAST
when emailing people I work with ???

 

You give the impression you have struggled with this request , although I
now know so much of the information I was seeking is easily and readily
available to medical professionals in your trust.

 

I need to give you some new background information :

 

I was invited to attend a major specialist Post Traumatic Stress
conference held for medical professionals in Swindon, hosted by the
Swindon Trauma Group on 14 October 2016 9am - 17.30pm .

 

Many psychiatrists, psychologists , therapists and mental health
professionals from England and Wales attended, and I learned so much about
my injury in one day, that has never been explained or made available to
me in the 17 years I have been seeking information and treatment within
the NHS - including a senior psychiatrist with your own trust.

 

The medical professionals spoke to me in a caring and humane way, I was
actually ' A REAL PERSON ' for a day, and received detailed information
about my injury - and how so many of the 'services' I have received from
Dorset Healthcare and the Avon and Wiltshire Mental Health Partnership
should have been provided to me.

 

Knowing I was a patient, the professionals enquired about my current state
of health and the treatment and support I am supposed to be receiving -
which of course remains at absolutely nothing !

 

So now I know more about my injury and the dangerous effects it is having
on my body, and the damage that has been done by the 17 years of abuse and
cover up I have suffered from multiple agencies, including Dorset of
course.

 

After learning so much, I was hoping to make real progress with obtaining
treatment and trying to get my life back after so many years, although one
told me due to the delays and ongoing re traumatisation and abuse that I
am suffering, I need to prepare myself that without considerable support I
may never recover .

 

I received a data disclosure from your trust, so much missing - so much
not supplied to me in accordance with my Rights - about 200 pieces of data
I estimate - that totally destroyed my physical and mental health for
months - and today is the first time for months that I have felt well
enough to share my experience with you.

 

Maybe you do not care , but you cannot imagine how much damage was caused
by being referred to as THE BEAST .

 

So, thank you for the limited information you supplied over a protracted
period, I now have 90% more than you supplied me with.

 

My experiences with your Trust have most certainly damaged me, and I wish
your trust to swiftly and effectively offer me the necessary support to
obtain my FULL medical and health records including my Rio records and the
audio recordings taken by Dr Rodin, and data that I am entitled to, and a
PROPER full diagnosis.

 

I have attempted to get Legal Advocacy and IMCA support, but none has been
provided , so I remain unsupported and very ill.

 

Please pass this on to Dr Rodin without delay - who is not responding to
correspondence from my member of Parliament - and ask him to contact me in
writing to remedy this situation that exists , give me a proper FULL
diagnosis, at least ARRANGE the support he stated I required and notified
NHS Wiltshire CCG Chairman by letter.

 

NO CARE IN WILTSHIRE EITHER - just multiple cover ups.

 

So please also supply me with the Policies and Procedures , and NHS
Constitution and Legislation that should be protecting me under these
circumstances - this is my FOIA request .

 

Currently I feel a number of NHS organisations are taking actions that are
likely to lead to a significant deterioration in my health and wellbeing -
and are knowingly doing so.

 

Please take a look at my FIRST FOIA request to your Trust , here on
whatdotheyknow that you dealt with.

 

Yours sincerely,

 

Steven King

 

show quoted sections

FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST),

Dear Mark Dobbs,

134 16-17

Thank you for your email of todays date.

I request that appropriate action is taken regarding the information contained within the first paragraph of my previous email to you dated 06 02 2016 I believe, and that a victim impact statement is taken from me by a suitably qualified member of staff who will write down the way I was affected when reading this description of me, and enable the person responsible to remedy this situation to my satisfaction .
Please write to me by post, as this FOIA request has now received your trusts response.

Yours sincerely,

Steven King

FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST), Dorset HealthCare University NHS Foundation Trust

Dear Steven,

To help me action your request I really need a little more information from you.

But I am conscious any message you send me in response is made public on the Whatdotheyknow website and in the circumstances it might be better for you to write to me direct to provide further details, address is shown below.

If you do respond to this message all I would ask you to confirm are the basic details to include which Trust and department the correspondence in question originated from.

With these details I will then know who needs to deal with your request.

Yours sincerely

Mark Dobbs

Sentinel House
4-6 Nuffield Road
Poole
Dorset
BH17 0RB

Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
DD Tel: 01202 277017
Email: [email address]
nnWeb: [email address]

show quoted sections

Dear Mark Dobbs, FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST),

Thank you for your email of 09 02 2017, but of course this FOIA request is now closed , and I fail to understand why you are abusing this website , as you and others at your Trust have my home address and telephone number. Please contact me SOLELY to make arrangements for an afternoon appointment with an appropriate person to deal with the matters I have raised with you in the manner I have requested, by telephone or in writing SOON please.

YOU and others I have dealt with at your Trust over 3 years now, know of my serious mental health injury, my disabilities and my being classed as a vulnerable adult , and I fail to understand why I am not being offered va suitable level of adequate support and treated as such by yourself and others at your trust , in accordance with your own policies and procedures - NHS guidance and requirements, and of course in total compliance with current Legislation ?

Again, please do not use THIS FOIA request to contact me again.

Yours sincerely,

Steven King

FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST), Dorset HealthCare University NHS Foundation Trust

Dear Steven,

Please, all I need you to confirm is that the matter you have referred to and wish to be followed up involved a Dorset Healthcare member of staff?

A simple yes or no will suffice and will assist us to take things forward.

Yours sincerely.

Name Mark Dobbs
Job Title Freedom of Information Officer &
Policy Co-ordinator
Department Corporate
DD Tel: 01202 277017
Email: [email address]
nnWeb: [email address]

show quoted sections

Dear Mark Dobbs, FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST),

You have my home address, telephone number - please use them .

This is NOT the place to continue this correspondence PLEASE !!

Yours sincerely,

Steven King