Resource allocation in the event that ITU/mechanical invasive ventilation demand outstrips supply

Mr David Johnson made this Freedom of Information request to Southport and Ormskirk Hospital NHS Trust as part of a batch sent to 6 authorities

Automatic anti-spam measures are in place for this older request. Please let us know if a further response is expected or if you are having trouble responding.

The request was partially successful.

Mr David Johnson

Dear Southport and Ormskirk Hospital NHS Trust,

I make this request in the context of the ongoing coronavirus pandemic.

Firstly, please provide a spreadsheet which discloses the following data, in respect of each date from and including 1 February 2020 to and including 30 April 2020:

1. The total capacity of ITU beds (including any surge capacity created as part of the pandemic response) which are available within your NHS Trust;

2. Of that total capacity of ITU beds (including any surge capacity created as part of the pandemic response), the number of ITU beds which were, for any period of time on the given date, occupied by a patient (whether because of Covid-19 or for another clinical reasoning);

3. Of that number of ITU beds which were, for any period of time on the given date, occupied by a patient; the percentage rate of the total occupation number where the need for the ITU bed arose from the patient suffering Covid-19;

4. The total capacity of mechanical invasive ventilators (including any surge capacity created as part of the pandemic response) which are available within your NHS Trust;

5. Of that total capacity of mechanical invasive ventilators (including any surge capacity created as part of the pandemic response), the number of mechanical invasive ventilators which were, for any period of time on the given date, occupied by a patient (whether because of Covid-19 or for another clinical reasoning);

6. Of that number of mechanical invasive ventilators which were, for any period of time on the given date, occupied by a patient; the percentage rate of the total occupation number where the need for the mechanical invasive ventilator arose from the patient suffering Covid-19;

In addition to providing the above data sets, please also confirm whether, at any time since the Covid-19 pandemic began in December 2019, the Trust has created and/or adopted an official policy concerning the criteria to be applied in circumstances where the demand for ITU beds and/or mechanical invasive ventilators outstrips supply; i.e. because the number of patients in need of such resources is higher than the number of resources available.

If such a policy has been created and/or adopted, please confirm the date(s) during which the policy is or has been in effect, and please provide a complete copy of the policy, as well as any supporting documents or information which are referred to within the policy and/or which are reasonably required to understand and execute the policy and its implications.

Yours faithfully,

Mr David Johnson

FOI (SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST), Southport and Ormskirk Hospital NHS Trust

Thank you for your email received by the Freedom of Information team at Southport and Ormskirk Hospital NHS Trust.

We are now processing your request for information and will respond to you in full as soon as possible.

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Your request for information may be delayed due to urgent operational responses to dealing with Public Health priorities. We apologise for any inconvenience this may cause, we do remain committed to responding to your request and will respond as soon as we are able. Should our response to your request breach the statutory timeframe and you remain unhappy with our response you have the right to complain to the Information Commissioners Office and you can contact them at https://ico.org.uk/global/contact-us/

If you have any queries then please contact me by return e-mail to [Southport and Ormskirk Hospital NHS Trust request email]

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FOI (SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST), Southport and Ormskirk Hospital NHS Trust

1 Attachment

Dear David

Re: FOI 2021 0018

Please find within a response to your request for information submitted under the Freedom of Information Act 2000 to Southport and Ormskirk Hospital NHS Trust, which for clarity I have included below.

Request:

Firstly, please provide a spreadsheet which discloses the following data, in respect of each date from and including 1 February 2020 to and including 30 April 2020:

1. The total capacity of ITU beds (including any surge capacity created as part of the pandemic response) which are available within your NHS Trust;

2. Of that total capacity of ITU beds (including any surge capacity created as part of the pandemic response), the number of ITU beds which were, for any period of time on the given date, occupied by a patient (whether because of Covid-19 or for another clinical reasoning);

3. Of that number of ITU beds which were, for any period of time on the given date, occupied by a patient; the percentage rate of the total occupation number where the need for the ITU bed arose from the patient suffering Covid-19;

Response:

For questions 1-2-3 see spreadsheet attached. Please note the total number of ventilators available and the number of people who are in hospital with Covid 19 is reported daily at the government briefings.

Request:

4. The total capacity of mechanical invasive ventilators (including any surge capacity created as part of the pandemic response) which are available within your NHS Trust;

5. Of that total capacity of mechanical invasive ventilators (including any surge capacity created as part of the pandemic response), the number of mechanical invasive ventilators which were, for any period of time on the given date, occupied by a patient (whether because of Covid-19 or for another clinical reasoning);

Response:
The capacity is as per the spread sheet as each bed described has a mechanical ventilator the spread sheet shows the period of time a mechanical ventilator bed was occupied but does not show if mechanical ventilation was ongoing.

Request:

Of that number of mechanical invasive ventilators which were, for any period of time on the given date, occupied by a patient; the percentage rate of the total occupation number where the need for the mechanical invasive ventilator arose from the patient suffering Covid-19;

Response:

Section 12 of the FOIA allows a public authority to refuse a request where it estimates that it would exceed the appropriate limit to comply with the request. The relevant section states:

12. (1) - Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

where the appropriate limit is equal to 18 hours of staff time as set by the Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004

In determining the time limit, the Trust can only take into account

•determining whether the information is held;
•locating the information, or a document containing it;
•retrieving the information, or a document containing it; and
•extracting the information from a document containing it.

In order to determine whether the information is held in respect of your request, the Trust would need to review 450 medical UTU records and charts for the time requested. A simple report cannot be produced as there is not a specific code relating to mechanical invasive Ventilators. These medical records are very complicated and would need to be read fully to obtain this by a qualified specialist which would take many hours possibly per record

Calculation - Across the Trust there are approximately 450 records need full review. If it took 30 minutes per record, the total time for determining whether the information is held and retrieving this information would equal 225 hours

Advice and Assistance
Under section 16 of the FOIA, advice and assistance should be provided to allow the request to come under the appropriate limit by scaling or modifying the request.

Unable to narrow
However, as the information is not readily available and the number of attendances so large, it would not be easy to scale down the request in this instance, for example, to one site. It would also not be possible to scale the request to one month as this would still exceed the time limit.
Unfortunately, the Trust is unable to provide further assistance in this instance.
Request:

In addition to providing the above data sets, please also confirm whether, at any time since the Covid-19 pandemic began in December 2019, the Trust has created and/or adopted an official policy concerning the criteria to be applied in circumstances where the demand for ITU beds and/or mechanical invasive ventilators outstrips supply; i.e. because the number of patients in need of such resources is higher than the number of resources available.

If such a policy has been created and/or adopted, please confirm the date(s) during which the policy is or has been in effect, and please provide a complete copy of the policy, as well as any supporting documents or information which are referred to within the policy and/or which are reasonably required to understand and execute the policy and its implications.

Response:

The trust does not have a policy concerning this.

The Trust is continually striving to improve the way it handles FOI requests. To help us, we would be grateful if you could spend a few minutes to complete our FOI customer care survey - http://www.smart-survey.co.uk/s/78233NVEPO
Responses are anonymous unless you enter your reference number or name.

We hope that you will find the information provided both informative and helpful. We also hope that you will be satisfied with the manner in which we have dealt with your Freedom of Information request. If not, please do let me know or you may ask for a formal review under the FOI internal review procedure at Southport and Ormskirk Hospital NHS Trust. If you would like a formal review please write to:

Trish Armstrong-Child
Chief Executive Officer
Southport and Ormskirk Hospital
Town Lane
Kew
Southport
PR8-6PN

Internal review requests should be submitted within two months of the date of receipt of this response.

If you remain dissatisfied after the internal review, you may make an approach to the Information Commissioner.

Further Information about your rights is available from the Information Commissioner at: Information Commissioner's Office
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF,
Telephone: 0303 123 1113, www.ico.gov.uk

If there is anything you need clarification on, please do not hesitate to contact me by return email to [email address] quoting your FOI reference number.

Yours Sincerely,

FOI Team

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