NBT Breast Care Services

The request was partially successful.

Mrs D Havercroft

Dear North Bristol NHS Trust,

Please provide the following information:

1. The documented service specification for the model of care that is planned to be delivered at Southmead. This will be different to the service specification delivered at Frenchay, as we heard on 16th March, in Health Scrutiny Meetings.

2. The financial and business case that the NBT Board approved to
allocate £300,000 to refurbish ward E as temporary accommodation
for the NBT Breast Service, including the financial evidence that
substantiates the claim made to the Bristol Evening Post that "The
benefits of having all our cellular pathology and breast care
services on one site will deliver more than £300,000 in savings
through faster, more efficient services that operate under one
roof."

3. The financial implications for these anticipated savings caused by transfer of some of NBT's breast pathology work to an external provider.

4. The list of the issues raised by the three local PCT
Boards and the four local Overview and Scrutiny Commissions in
2009/10 with a document describing how these will all be addressed
in the context of early move proposals to Southmead.

5. Requirements from the Breast Review equalities workstream that need to be considered in the early move proposal

6. Communications plan and the material for engaging with women's groups (not breast cancer groups) on the early move to Southmead, including a list of Spokes and timescales for opening them and what they will be told about NBT having no onsite breast pathologists. Womens groups were consulted in 2009 on the breast clinical model and need to be offered the opportunity to be consulted on changes to it and the early move.

7. A list of GPs to be consulted and the consultation documentation. What will they be told about NBT having no specialist breast pathology on site to enable them to make a fully informed decision as to where to refer patients?

8. The letter that will be sent to patients about the early move proposal, including details of what they will be told about NBT having no specialist breast pathology services onsite.

9. Please provide the "clearly expressed patient and staff
travel plans, embracing the principles of green transport" (draft implementation plan) in respect of the early transfer of the NBT breast service to Southmead to show how they have been considered as part of the feasibility study and by whom.

10. Outsourced Pathology:

Who is the named NBT pathologist as prime contact for the contract

a. Please list the services outsourced.
b. What are the service level expectations for each service?

In your response, please include required standards eg completeness of text, completion of data sets, hormone receptors, Her2

Please include the following:

definition of and requirements for double reporting
Degree of specialism and experience of reporting pathologists
protocols for resolving difficult cases – protocol for expert referrals – to whom
protocols for specimen transfer and receipt
protocols for standard of request form and transfer of it
protocols for safe receipt of complete and final report
Protocols for supplementary reports
Protocols for ensuring all relevant material is available for MDT
Clear, documented agreement as to who is responsible for communicating the pathology diagnosis to the patients' lead clinicians, and by what means so there is a documented audit trail.
Contact details for reporting pathologist(s)
Published contact at remote site for lead clinician to speak to in case of query
Protocol for presentation of cases at MDT, by whom, how (Video conference/in person)?
Agreed turnaround times for results to Lead Clinician, MDT and patients
Process for monitoring adherence to turnaround times.
Process for audit/review of the Service – scope, frequency, how results will be published and to whom. Who will own any actions arising from the audit/review?

11. In-house pathology services.

a. Please list the services remaining in house and the service levels for each one including:

required standards eg completeness of text, completion of data sets, hormone receptors, Her2

Definition of and requirements for double reporting
Degree of specialism and experience of reporting pathologists
Clear, documented agreement as to who is responsible for communicating the pathology diagnosis to the patients' lead clinicians, and by what means so there is a documented audit trail.

Agreed turnaround times for results to Lead Clinician, MDT and patients
Process for monitoring adherence to turnaround times.
Process for audit/review of the Service – scope, frequency, how results will be published and to whom. Who will own any actions arising from the audit/review?

b. Please provide names and UK registration/qualifications/degree of breast specialism/length of breast specialist experience of staff performing the in-house service - including number of years of participation in breast EQA

Yours faithfully,

Mrs D Havercroft

Mrs D Havercroft

Dear North Bristol NHS Trust,

Please confirm that this FOI request has been logged and is receiving attention

Yours faithfully,

Mrs D Havercroft

Freedom of Information, North Bristol NHS Trust

Dear Mrs Havercroft,

I can confirm that this request has been received and we will respond by
14th April.

Nick Stibbs
Corporate Services Manager
Ext Frenchay 06601, Southmead 35057

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Mrs D Havercroft

Dear Freedom of Information,

The information requested is now overdue. Please provide it.

Yours sincerely,

Mrs D Havercroft

Nick Stibbs, North Bristol NHS Trust

8 Attachments

Dear Mrs Havercroft,

Here is our response to your request for information on 17^th March
regarding the early move of breast care services to Southmead.

Nick Stibbs

Corporate Services Manager

North Bristol NHS Trust

Frenchay 06601, Southmead 35057

North Bristol NHS Trust - www.nbt.nhs.uk

DISCLAIMER: The information in this message is confidential and may be
legally privileged. It is intended solely for the addressee. Access to
this message by anyone else is unauthorised. If you are not the intended
recipient, any disclosure, copying, or distribution of the message, or any
action or omission taken by you in reliance on it, is prohibited and may
be unlawful. Please immediately contact the sender if you have received
this message in error. Thank you.

Mrs D Havercroft

Dear North Bristol NHS Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of North Bristol NHS Trust's handling of my FOI request 'NBT Breast Care Services'.

I appreciate that the information requested falls on a handful of clinicians, but this is basic information that should be provided as part of proper patient and public consultation to deliver patient choice. I shouldn't have to ask for it under FOI.

Here are my comments on the responses. I note the intention to provide the outstanding information in early May and request that this feedback is taken into consideration in providing the full responses:

1. I didn't ask for the service specification for the pan-Bristol implementation. I asked for the service specification for the NBT breast service that NBT intends to provide at Southmead Hospital from May 2011. Patients and the public and GPs are entitled to see this detail so that they can make choices about which local breast care services to use.

Please provide this information, as previously requested.

2. I don't agree that you have provided a copy of the Business Case I requested. I asked for:

"The financial and business case that the NBT Board approved to allocate £300,000 to refurbish ward E as temporary accommodation for the NBT Breast Service, including the financial evidence that substantiates the claim made to the Bristol Evening Post that "The
benefits of having all our cellular pathology and breast care services on one site will deliver more than £300,000 in savings through faster, more efficient services that operate under one roof."

NBT has made claims in the public domain to justify spending £300k on refurbishing a ward that is planned to be demolished in a few years. I want to see the business case for this that was presented to the NBT Board to justify the £300k spend, please.

3. Thank you for the information

4. You haven't provided the list of the issues raised by the three local PCT Boards and the four local Overview and Scrutiny Commissions in 2009/10 with a document describing how these will all be addressed in the context of early move proposals to Southmead.

NHS Bristol's Project Manager took notes of issues raised at Health Scrutiny Committee meetings in early 2010 that were supposed to have been passed to the NBT breast implementation team for action. Also she reported that the PCT Boards raised some issues when considering the Breast Review and, again, these issues were supposed to have been passed to the NBT implementation team. It is this information I want. Instead you have provide unrelated documents - an update to a patient requirements document that I created in 2008 and a checklist of progress against statements made by the NHS to Overview and Scrutiny Committees.

5. Given that NBT wants to move the breast service to Southmead in a month's time, I think it imperative that the equalities and access considerations and consultation with patients, the public and GPs are instigated as a matter of urgency. I look forward to receiving the information requested.

6. The information you have provided so far shows that NBT has not engaged with women's groups (apart from breast cancer groups) on the early move to Southmead. Please confirm whether NBT has any plans to consult lawfully with local women's groups (example women's institute, townswomen's guilds) prior to any service move.

7. When is the consultation letter going to GP practices and what will GPs be told about the issues facing provision of breast pathology services at NBT to enable them to make decisions about whether or not to refer patients to NBT? The information provided in the letter is clearly inadequate for this purpose as it provides no information to show how long patients will have to wait for diagnostic results and treatment now that NBT has had to outsource some breast pathology services.

8. Thank you for the information.

9. Is it NBT's intention to produce a travel plan to cover early transfer, as part of lawful consultation?

10 & 11. I look forward to receiving this information as a matter of urgency in early May. I'm sure you appreciate that this is all part of the service specification that patients, the public and GPs should have access to, so as to enable informed choice about which provider's breast service to use.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/nb...

Yours faithfully,

Mrs D Havercroft

Freedom of Information, North Bristol NHS Trust

1 Attachment

Dear Mrs Havercroft,

A quick response to this e-mail. You're quite right about the business case
in question 2 and I now attach it!

Nick Stibbs
Corporate Services Manager
Frenchay 06601, Southmead 35057

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Nick Stibbs, North Bristol NHS Trust

1 Attachment

Dear Mrs Havercroft,

Mr Martin Bell has asked me to inform you that he is just completing an
internal review of the response to your above request. He is out of the
office for the next two days and will send you his comments on Friday.

Nick Stibbs

Corporate Services Manager

Frenchay 06601, Southmead 35057

North Bristol NHS Trust - www.nbt.nhs.uk

DISCLAIMER: The information in this message is confidential and may be
legally privileged. It is intended solely for the addressee. Access to
this message by anyone else is unauthorised. If you are not the intended
recipient, any disclosure, copying, or distribution of the message, or any
action or omission taken by you in reliance on it, is prohibited and may
be unlawful. Please immediately contact the sender if you have received
this message in error. Thank you.

Nick Stibbs, North Bristol NHS Trust

1 Attachment

Dear Mrs Havercroft,

Because of IT problems yesterday it appears that none of our external
e-mails will have reached their destination. Here, possibly again, is a
quick note about your request for a review of one of our responses
(request 65830).

Nick Stibbs

Corporate Services Manager

Frenchay 06601, Southmead 35057

show quoted sections

Nick Stibbs, North Bristol NHS Trust

2 Attachments

Dear Mrs Havercroft,

Attached is Mr Bell's review of our response to your request 65830 under
the Freedom of Information Act.

Nick Stibbs

Corporate Services Manager

North Bristol NHS Trust

Frenchay 06601, Southmead 35057

show quoted sections

Nick Stibbs, North Bristol NHS Trust

2 Attachments

Dear Mrs Havercroft,

Here is Mr Bell's further response to your review request as promised last
week.

Nick Stibbs

Corporate Services Manager

North Bristol NHS Trust

Frenchay 06601, Southmead 35057

DISCLAIMER: The information in this message is confidential and may be
legally privileged. It is intended solely for the addressee. Access to
this message by anyone else is unauthorised. If you are not the intended
recipient, any disclosure, copying, or distribution of the message, or any
action or omission taken by you in reliance on it, is prohibited and may
be unlawful. Please immediately contact the sender if you have received
this message in error. Thank you.