Pathology Services Review Consultation Information request 1

The request was successful.

Dear Bristol Primary Care Trust (PCT),

Freedom of Information Request to the Healthy Futures Programme Board

Please provide the following information under the Act:

For Meetings/workshops/events referred to in the September Lay Approach Document, please provide:

1. Documents for the Workshop discussion 26th October 2011 in respect of the new management arrangements for an integrated pathology service.

2. Documents distributed at the workshop discussion 12th October 2011 with pathology medics and scientists regarding service configuration evolution and evidence.

3. Documented output from the “interactive feedback session” at the 12th October workshop.

4. “Vision for the Future” documentation for the 28th October 2011 meeting, output from that meeting, including the Q&A session.

5. NBT's proposals for lay involvement which were to be reviewed by email mid October.

6. Documents to be presented at a meeting 7th November on development of the service specification (description of the service) and key performance indicators.

7. NHS Bristol's policy for its “Duty of Care” obligations to patients, members of the public and groups involved in service change consultation and its policy for protecting their rights under the Data Protection Act.

8. Copies of the minutes of the most recent Project Board and Project Team Meetings

9. Copy of the latest version of the Project Status Report.

10. Copy of the latest risk, issue and change logs.

11. Copy of the latest IT and Logistics documents, including proposals to ensure that future IT systems can integrate with Cancer Registry IT systems to ensure efficient and timely transmission of cancer pathology data sets and information for national cancer data.

12. Copy of the latest version of the Histopathology Inquiry Recommendations showing current progress.

13. Details of the Histopathology services outsourced to external providers by UHBT and NBT (specialities, name of external providers, standard operating procedures, quality control measures, how cases reported by external providers are presented at MDT and by whom).

14. Review issue Log 16 “Currently no benchmarking data for current and future pathology service against national centres of excellence (amount of specialisation, research, staffing comparisons, attrition and long term sickness rates, equipment, facilities)” “Impact - Unable to identify where improvements are required and will be unable to demonstrate if any reconfiguration results in benefits” Status as at 9th August - “Current baseline data has been gathered and presentation being pulled together to be shared at project team meeting.”

Please provide this baseline data – raw data that was used to compile the presentation as well as the presentation itself.

Yours faithfully,

Mrs D Havercroft

on behalf of the Southwest Whistleblowers Health Action Group

http://swwhag.wordpress.com/

Tucker Kathryn,

Dear Mrs Havercroft

Please accept this as acknowledgment of your Freedom of Information
request. This has been given reference number FOI 1112 266 please use
this in all future correspondence.

We will respond to your request by 25th November 2011.

If following review of your request we require any further clarification
we will contact you as soon as possible.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
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Tucker Kathryn,

7 Attachments

Dear Mrs Havercroft

Please find our response to your freedom of information request attached
to this email. I trust this is satisfactory, but if you feel that it is
not then please do not hesitate to contact us again and we will
endeavour to assist you further.

Please note that if you are unhappy with the way in which your request
has been administered, you have the right to request a review.

You also have the right to appeal any response with the Information
Commissioner for Freedom of Information, as stated under the Freedom of
Information Act. Information regarding this is available on their
website www.ico.gov.uk .

'If you wish to re-use the information you have requested, in whole or
in part, please write to me stating 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 or charges that relate to the
re-use of the information. These will be determined in line with the
'Re-use of Public Sector Information Regulations 2005 (SI 2005 No.
1515).'

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

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Dear Bristol Primary Care Trust (PCT),

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

I am writing to request an internal review of Bristol Primary Care Trust (PCT)'s handling of my FOI request 'Pathology Services Review Consultation Information request 1'.

You have refused to provide the information requested under Q 14 claiming Section 21 Exemption. The Section 21 exemption can only be used when the information requested is available by other means. In this case it is not available by other means. Please therefore provide it.

The 9th August 2011 version of the project issues log says the information exists:

“Current baseline data has been gathered and presentation being pulled together to be shared at project team meeting.”

Furthermore the minutes of the 13th September Project Team meeting say" Baseline Data and Progress of Lean work - The Project Team received a joint presentation from clinical representatives from University Hospitals Bristol NHS Foundation Trust (UHBristol), North Bristol NHS Trust (NBT) and Weston Area Health NHS Trust (WAHT)."

I am entitled to the information now that currently exists on baseline performance data because it is my right under the NHS Constitution. One of the reasons being that I want it to make decisions about healthcare. Please provide it without further delay.

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

Yours faithfully,

Mrs D Havercroft

Tucker Kathryn,

Dear Mrs Havercroft

Thank you for your further email, I am sorry to hear that you are not
satisfied with NHS Bristol's response to your Freedom of Information
request. I have accepted your email as a request for an internal review
of our initial response.

I will ensure that a full review is carried out, and will ensure that a
further response is provided to you by 11th January 2011.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

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Tucker Kathryn,

1 Attachment

Dear Mrs Havercroft

Please find attached a response to your internal review request.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

show quoted sections

Dear Ms Evans

I suggest you and your colleagues start delivering some consistent and accurate information to the public and its elected representatives.

On the one hand your PCT tells SWWHAG that baseline information exists, but we can't have it until you deign to provide it.

On the other hand, to use UH Bristol CEO Mr Robert Woolley's terminology, a "cohort" of NHS managers (including Lindsey Scott, representing the PCT Cluster), when asked by South Gloucestershire Health Scrutiny Select Committee on 4th January for information to compare Bristol's histopathology services with other centres nationally, told the Committee that they did not have that information.

The NHS "cohort" was asked by the Committee to find out how local services compare with other places and to report back.

I am not sure whether you are being deliberately obfuscatory or whether you genuinely have a problem understanding that a "jam tomorrow" answer to this Freedom of Information request is not a satisfactory response to my request for baseline information that your PCT admits exists NOW.

All the Lean process stuff is an internal matter for the NHS because it is about how you deliver the services. Therefore it is not relevant to my request. I am interested in the end product - namely the quality and safety standards of the Pathology Services you commission NOW and how they stand up against comparable services in other parts of the UK.

Let me be explicitly clear. What I want is the baseline data that you tell me exists NOW so that I, other members of SWWHAG and the rest of the public can scrutinise the safety and quality of pathology services NOW to enable us to make choices and decisions about healthcare NOW, as we have a legal right to do under the NHS Act 2006 and as we have a constitutional right to do under the Department of Health's NHS Constitution. Giving us this information at some future, unspecified time is no use at all.

I point out the following from Information Commissioner's Office (ICO) Guidance:

1. "Section 22 provides a qualified exemption, so public authorities must consider whether the public interest in applying the exemption is greater than the public interest in providing the information."

You have not demonstrated that your claim for Section 22 exemption overrides the public interest test (statutory and constitutional right) to have information about current services.

2. Your Pathology Review Project Team minutes 13th September note that "NHS Improvement had written to Trust Chief Executives back in April noting the poor quality of data and the seeming reluctance of Trusts to fully engage in the lean work".

The ICO says "There will often be a private interest in withholding information which would reveal incompetence on the part of or corruption within the public authority or which would simply cause embarrassment to the authority. However, the public interest will favour accountability and good administration and it is this interest that must be weighed against the public interest in not disclosing the information."

Clearly the publication of poor quality service baseline data would be embarrassing to NHS Bristol, but that is not a lawful reason to withhold it.

3. The ICO says "Section 22 applies only when the information is held with a view to publication at the time the request for it was received. If a decision to publish is not made until after the request has been made, the exemption cannot apply."

The information was presented at a Project Team meeting at which the Pathology Service Lay Reference Group used to be represented, until the Group was unilaterally disbanded by the NHS.

I think it's time to test the Information Commissioner's view about the behaviour of NHS Bristol, which has known for many months that some members of the Lay Reference Group wanted information about current service baselines (this is documented), and disbanded the Group shortly before the meeting at which this data would have been available to these lay people, if they had been allowed to attend.

The only logical reason (linked to embarrassment) I can think of for your refusal to provide the information that I have asked for, and that you say exists, is to fend off potential competition. Indeed I have heard several remarks made in your Pathology Service Review meetings that indicate that some current service information has been withheld so it doesn't fall into the hands of potential competitors.

Advisory Panel Chair Ian Barnes' presentation contains a statement that confirms my view that fending off competition takes precedence over providing service information to patients.

"There is no ‘do nothing’ option, this offers the best response to the real competitive threat".

The fact that you are so coy about current service baselines indicates lack of confidence that they stand up well against comparable services. It looks very much as though you wish to hold patients and the public captive so as to prevent them comparing services and deciding whether to use the pathology services you commission or go elsewhere, as they have a right to do.

Based on some data we have gathered, I can understand why you are reluctant to give the public data to compare services. For example, the Manchester Breast Centre double reports ALL its breast pathology specimens (double reporting defined as review by at least two pathologists), Taunton double reports 80 - 90%, whereas under Dr Pitcher's Bristol regime NO breast pathology specimens will be mandated to be double reported.

Mr Woolley and his "cohort" told the South Gloucestershire Health Scrutiny that there are no Tertiary referral standards for histopathology. Odd that he seems unaware that Royal College of Pathology documents refer to tertiary referral histopathology services and Birmingham Women's Hospital Trust's website confirms it provides a tertiary referral service for histopathology.

If Mr Woolley had read his Internal Inquiry report carefully, he would realise that in 2008, a nationally/internationally recognised gynaecological histopathologist left Bristol to work at the Birmingham gynae. tertiary referral centre, prompting Mr Woolley's Panel to comment that specialist review of gynaecological cancer cases ceased when this histopathologist left Bristol. This indicates that there has been NO specialist gynaecological cancer histopathology reporting in Bristol for over three and a half years. I wonder what Bristol, North Somerset and South Gloucestershire women would make of this if it was widely known?

We will see as time progresses how long your "mushroom" approach to patient and public involvement (keeping them in the dark/excluding them from meaningful and lawful consultation about service change), can be sustained. Especially as SWWHAG's remit is to shine light into dark NHS crevices; and what a very deep, dark and gloomy crevice we have here, especially with the all the very serious histopathology matters that UHBT's internal inquiry panel ignored, lurking and writhing at the bottom of the abyss.

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

Yours faithfully,

Mrs D Havercroft

on behalf of the South West Whistleblowers Health Action Group

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

Yours faithfully,

Mrs D Havercroft

Tucker Kathryn,

1 Attachment

Dear Mrs Havercroft

Please find attached a response letter to your email dated 6th January
2012.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

show quoted sections

Tucker Kathryn,

1 Attachment

Dear Mrs Havercroft

Please find attached a copy of the presentation which we advised we
would be publishing. I can confirm that this presentation includes all
of the raw data available and has now been published on the Pathology
Review Website.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol & NHS North Somerset
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

show quoted sections

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