Resources to support safer bowel care for patients at risk of autonomic dysreflexia (SIA 02/19)

Tim Nicholson made this Freedom of Information request to Powys Teaching Health Board

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The request was successful.

Dear Powys Teaching Health Board,

I work for the Spinal Injuries Association (SIA), the leading national user-led charity supporting spinal cord injured people and their families. Being a user led organisation , SIA understand the challenges of living with a spinal cord injury (SCI). We strive to support all people living with SCI to access the services and support they need to stay healthy and enjoy fulfilling and active lives.

Part of my role is to assist the Head of Public Affairs with FOI requests, such as the one that follows.

As a request under the Freedom of Information Act, please provide the following information about the recent NHS Wales Patient Safety Notice “Resources to support safer bowel care for patients at risk of autonomic dysreflexia” (October 2018)(Ref: PSN 046)

I would emphasise that spinal cord injured people may need such in-patient or community bowel care at any time in their lives. Indeed, such care may be required many, many years after their original spinal cord injury and rehabilitation. Also, the primary reason why a spinal cord injured individual is a patient at any given time might not be related directly to their original spinal cord injury.

It would be greatly appreciated if you could copy your WhatDoTheyKnow response to [email address]

Q1. Does the Board have a formal written policy for digital rectal examination, digital rectal stimulation and the digital removal of faeces in spinal cord injured and other patients with neurogenic bowel dysfunction?

(a) Yes
(b) No

Q2. Following recommendation of this patient safety notice, did the Board “review your local clinical policy and guidance relating to bowel assessment and management”?

(a) Yes – produced a new policy
(b) Yes - revised an existing policy
(c) Yes – retained existing policy
(d) No – did not review an existing policy
(e) No – no bowel assessment and management policy in place

Q3. Is your policy based on the Spinal Injuries Association’s template?

(a) Yes
(b) No
(c) No bowel assessment and management policy in place

Q4. If admitted to the Board will a person with neurogenic bowel dysfunction receive the following bowel care intervention – Digital removal faeces?

(a) Yes
(b) No

Q5. If admitted to the Board will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Digital rectal stimulation?

(a) Yes
(b) No

Q6. If admitted to the Board will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Trans anal irrigation?

(a) Yes
(b) No

Q7. Are staff available seven days a week to undertake these bowel care interventions?

(a) Yes
(b) No

Q8. Has the Board reviewed local education and training provision for interventional bowel management, as recommended in the Patient Safety Notice?

(a) Yes
(b) No

Q9. Has the Board shared “reviewed local guidance, advice on how to identify staff who can provide DRF, and the key messages in this note with medical, nursing and other relevant clinical staff”?

(a) Yes
(b) No

Q10. Does the Board have a policy that allows for the personal care assistants/carers of spinal cord injured patients to assist with this element of the patient's care?

(a) Yes
(b) No

Q11. As recommended in the Patient Safety Notice, have you identified “an appropriate clinical leader to co-ordinate implementation of this notice”?

(a) Yes (please answer Q12, but ignore Q13)
(b) No (please answer Q13, but ignore Q12)

Q12. What are the contact details for the “appropriate clinical leader”(ie name, position, telephone and email)?

Q13. Why has your Board not appointed an “appropriate clinical leader”?

(a) Notice implemented without appointment of a clinical leader
(b) Took no action following Patient Safety Notice, as policy already in place
(c) Took no action. No existing policy in place
(d) Other

Yours faithfully,

Tim Nicholson

FOI (Powys Teaching Health Board - FOI), Powys Teaching Health Board

Please accept this email as an acknowledgement of your request for information under the Freedom of Information Act 2000. We will manage your request in accordance with the procedures laid down by the Act, please refer to our leaflet which explains our obligations in respect of this legislation.

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FOI Team

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FOI (Powys Teaching Health Board - FOI), Powys Teaching Health Board

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Please find attached our response to your request


Regards FOI Team




Amanda Smart - Information Governance Officer

Powys Teaching Health Board, Vera Vallins Office, Bronllys Hospital,
Bronllys, Brecon, Powys LD3 0LS

Tel: 01874 71(2763)  Fax: 01874 71(2756) Email:
[1][email address]



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