Tissue Viability services St Johns Hill

Sylvia Rushbrooke made this Freedom of Information request to St George’s University Hospitals NHS Foundation Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was partially successful.

Dear St George’s University Hospitals NHS Foundation Trust,

Please can you send me the policy/process that the community Tissue Viability team at St Johns hill work to, re pressure ulcers grade 3 and the safeguarding reporting protocol, responsibility and procedure that includes raising RCA and SIF

Please can you send the incident reporting policy relating to Tissue Viability nurses in the community visiting when visiting service users in care homes?

Who raises safeguarding re grade 3 pressure ulcers in the community and who monitors that the correct process is followed by TV community nurses

Please can you send me the organizational structure of community TV nurses and who has overall responsibility for them - and monitors procedure and policy is complied with by TV community nurses?

Yours faithfully,

Sylvia Rushbrooke

FOI, St George’s University Hospitals NHS Foundation Trust

Ref: 1516.213

Re: FOI Request - Acknowledgement of Request

Dear Sir / Madam

Thank you for your request for information. Your request was received on 17 September 2015 and we are dealing with it under the terms of the Freedom of Information Act 2000. Under the FOI Act the Trust has a statutory responsibility to respond to your request within 20 working days therefore you should expect a formal response no later than 15 October 2015.

In some circumstances a fee may be payable. If this is the case a fees notice will be issued to you, and you will be required to pay before we will proceed to deal with your request.

If you have any queries about this letter, please contact us. Please remember to quote the reference number above in any future communications.

Yours sincerely

FOI team
St George’s University Hospitals NHS Foundation Trust

show quoted sections

Dear FOI,
Thank you
The policy information requested should be available to the public so not sure why it has taken so many months to try and get from the TV department Lucy Chadder and Noyola McNicolls-Washington Tissue Viability
I have been writing to them for months and requests for specific information ignored and none of my dozen or so phone calls to them both over the last 3 weeks have been returned as assured
No one will tell me who their department head is
I am sure that department has the policy they work to so unsure why we a re forced to use this route?

Yours sincerely,

Sylvia Rushbrooke

FOI, St George’s University Hospitals NHS Foundation Trust

Dear Madam

Thank you for your email.

I have contacted Lucy and Noyola's office today and hope to send you the information you have requested very soon.

Regards

FOI Team

show quoted sections

Sylvia Rushbrooke

Dear FOI,
Thank you
I have as stated requested information from them multiple times since May - they have ignored my requests and my phone calls over the last month - that neither have responded to
I have received one policy from compliments and complaints but it does not really cover the matters requested

Yours sincerely,

Sylvia Rushbrooke

Sylvia Rushbrooke

Dear FOI,

Who must raise the safeguarding re avoidable grade 3 pressure ulcers diagnosed in the community in care homes attended to and diagnosed by TV nurses?

Does the duty of candour reg 20 that came in, in Nov 2014 apply to NHS TV nurse services in the community?

and what is the penalty for breaching duty of candour reg 20 by NHS TV nurse department?

If a TV nurse diagnoses a grade 3 pressure ulcer in the community and records on datix are they obliged to inform relevant persons representative ie LPAs and NOK under reg 20 duty of candour that a NHS serious incident has occurred?

who monitors that the correct process is followed by TV community nurses re obligatory NHS serious incident reporting regarding grade 3 pressure ulcers?

Who is responsible for raising a safeguarding for avoidable grade 3 pressure ulcers diagnosed in the community by NHS TV nurses?

Yours sincerely,

Sylvia Rushbrooke

FOI, St George’s University Hospitals NHS Foundation Trust

Ref: 1617.145

Re: FOI Request - Acknowledgement of Request

Dear Sir / Madam

Thank you for your request for information. Your request was received on 7 June 2016 and we are dealing with it under the terms of the Freedom of Information Act 2000. Under the FOI Act the Trust has a statutory responsibility to respond to your request within 20 working days therefore you should expect a formal response no later than 5 July 2016.

In some circumstances a fee may be payable. If this is the case a fees notice will be issued to you, and you will be required to pay before we will proceed to deal with your request.

If you have any queries about this letter, please contact us. Please remember to quote the reference number above in any future communications.

Yours sincerely

FOI team
St George’s University Hospitals NHS Foundation Trust

show quoted sections

FOI, St George’s University Hospitals NHS Foundation Trust

Dear Madam

                                 

I am writing to confirm that St George’s University Hospitals NHS
Foundation Trust has now completed its search for the information you
requested.

 

1.    Who must raise the safeguarding re avoidable grade 3 pressure ulcers
diagnosed in the community in care homes attended to and diagnosed by TV
nurses?  The TVN will raise an incident on DATIX to report the Grade 3
Pressure ulcer, as this ulcer happened in a nursing home it is classed as
external to the organisation. As this was an external it was reported as
an ‘external’ Serious Incident by the trust’s corporate risk team.

 

2.    Does the  duty of candour reg 20 that came in, in Nov 2014 apply to
NHS TV nurse services in the community?

It does if the incident happened during our care. In this instance the
patient was under the care of the Nursing home with input from the
Specialist Nurse, the duty of candour regulations would not apply to the
Specialist nurse in this instance.

 

3.    and what is the penalty for breaching duty of candour reg 20 by NHS
TV nurse department?

This isn’t applicable as they did not breach the duty of candour.

 

4.    If  a TV nurse diagnoses a grade 3 pressure ulcer in the community 
and records on datix  are they obliged to inform relevant persons
representative ie LPAs   and NOK under reg 20 duty of candour that  a NHS
serious incident has occurred?

The Grade 3 pressure ulcer would be identified by the Community Nurses and
verified by the TV nurse. The team who are taking clinical responsibility
for the patient,( in this instance, it would be the Community Nursing
team) are obliged to inform the relevant patient’s and or the patient’s
representative that a NHS serious incident has occurred.  This is
supported by the Duty of Candour guidance.

 

5.    who monitors that the correct process is followed by TV community
nurses re obligatory NHS serious incident reporting regarding grade 3
pressure ulcers?

This is monitored by the TV nurse’s manager.

 

6.    Who is responsible for raising a safeguarding for avoidable grade 3
pressure ulcers  diagnosed in the community by NHS TV nurses?

All Grade 3 pressure ulcers are reviewed by the Clinical Team Leader in
conjunction with the TV nurse as part of the rapid review of pressure
ulcers. If it is deemed that a safeguarding risk to the patient is
identified through this process, it is then raised to Social Services by a
member of the team managing the patient.

 

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Further information can be found at:
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If you are dissatisfied with the response provided you have the right to
file a complaint and request an internal review of our decision. All
complaints must be made in writing and sent to the Trust FOI Lead at
[2][St George’s University Hospitals NHS Foundation Trust request email].

 

If you are not content with the outcome of your complaint, you may apply
directly to the Information Commissioner for a decision. Generally, the
ICO cannot make a decision unless you have exhausted the internal review
procedure provided by the Trust.  The Information Commissioner can be
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Lane, Wilmslow, Cheshire SK9 5AF.

 

Please remember to quote the reference number above in any future
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Kind regards

FOI Lead

St George’s University Hospitals NHS Foundation Trust

 

 

 

From: David McCall
Sent: 29 June 2016 12:30
To: Hazel Tonge; FOI; Noyola McNicolls-Washington; Jenny Miles
Cc: Alison Ludlam; David Flood; Paul Courtman
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Dear Hazel,

 

I have read Noyola’s response, this all seems fine to me.

Regards,

David

 

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David McCall T: 020 8725 2230 (Bleep: 6152)
Clinical Nurse Specialist: Tissue F: 020 8725 1071
Viability
Corporate Nursing E: [3][email address]
St. George's University Hospitals NHS W: [4]www.stgeorges.nhs.uk
Foundation Trust

--------------------------------------------------------------------------

 

 

From: Hazel Tonge
Sent: 28 June 2016 18:16
To: FOI; Noyola McNicolls-Washington; Jenny Miles; David McCall
Cc: Alison Ludlam; David Flood; Paul Courtman
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Hi David M can you review

H

 

Hazel Tonge

Deputy Chief Nurse

T: 02087250956

E: [5][email address]

 

From: Ila Modhwadia On Behalf Of FOI
Sent: 28 June 2016 10:01
To: Noyola McNicolls-Washington; Jenny Miles
Cc: Alison Ludlam; David Flood; Hazel Tonge
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145
Importance: High

 

Dear All

 

Thank you for your comments below – can I have a confirmed response for
the questions below please – I do not feel qualified to go through the
information provided below and fill in a response for each question below.

 

I’d be grateful for an early response.

 

Thank

 

ila

 

 

 

1.    Who must raise the safeguarding re avoidable grade 3 pressure ulcers
diagnosed in the community in care homes attended to and diagnosed by TV
nurses?

 

2.    Does the  duty of candour reg 20 that came in, in Nov 2014 apply to
NHS TV nurse services in the community?

 

3.    and what is the penalty for breaching duty of candour reg 20 by NHS
TV nurse department?

 

4.    If  a TV nurse diagnoses a grade 3 pressure ulcer in the community 
and records on datix  are they obliged to inform relevant persons
representative ie LPAs   and NOK under reg 20 duty of candour that  a NHS
serious incident has occurred?

 

5.    who monitors that the correct process is followed by TV community
nurses re obligatory NHS serious incident reporting regarding grade 3
pressure ulcers?

 

6.    Who is responsible for raising a safeguarding for avoidable grade 3
pressure ulcers  diagnosed in the community by NHS TV nurses?

 

 

 

From: Alison Ludlam
Sent: 27 June 2016 11:06
To: Ila Modhwadia
Cc: Noyola McNicolls-Washington
Subject: Fw: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Ila

Please contact Noyola for any more details

Alison
Please note: Sent from my Blackberry
 

From: Noyola McNicolls-Washington
Sent: Thursday, June 23, 2016 08:35 AM
To: David Flood; Alison Ludlam
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145
 

Dear Alison,

 

There is nothing more that I can add to the response.

 

Kind regards

 

Noyola

 

From: David Flood
Sent: 22 June 2016 16:51
To: Alison Ludlam; Noyola McNicolls-Washington
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Apologies for the late reply

 

I have added  a couple of further thoughts to Jenny’s below

Best wishes

David

 

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David Flood T: 020 8725 1624 or 020 8672 1255 bleep8031
Lead Nurse Adult Safeguarding M: 
Corporate Nursing E: [6][email address]
St George's University W: [7]www.stgeorges.nhs.uk
Hospitals NHS Foundation Trust
   
Excellence in specialist and community healthcare

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P Save Paper - Do you really need to print this e-mail?

 

From: Alison Ludlam
Sent: 16 June 2016 17:37
To: David Flood; Noyola McNicolls-Washington
Subject: FW: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Can you complete the response please

 

From: Jenny Miles
Sent: 16 June 2016 15:10
To: David Flood; Noyola McNicolls-Washington
Cc: Alison Ludlam; Fleur Norwood
Subject: RE: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

 

Dear all,

 

I’ve put some details below in line with the queries – happy to
change/clarify once you’ve had a chance to read.

 

 

If a community nurse/TVN identify a patient with a grade 3 pressure ulcer,
then this must be reported on the trust’s incident reporting system. In
the case of this patient, this was completed.

 

At the time of this incident, the ‘external’ (pressure ulcer acquired
whilst the patient was at a nursing home and therefore is not a trust
incident) grade 3 pressure ulcer incident was reported as an ‘external’
Serious Incident by the trust’s corporate risk team.

This was reported in line with NHS England’s Serious Incident Framework,
as all grade 3 / grade 4 pressure ulcers were mandatory reportable as a
Serious Incident until March 2015 when the list of mandatory reportable
Serious Incidents was removed from the framework.

 

In the case of grade 3 / grade 4 pressure ulcers acquired whilst in the
care of the trust, the trust would have an obligation to understand
whether this met the criteria of a Serious Incident, in line with the
current Serious Incident Framework and undertake an investigation as
appropriate. The trust would then have an obligation to have a discussion
regarding the next steps with the patient/relative.

 

In this patient’s case, the nursing home would have had a responsibility
to investigate their pressure ulcer incident and fulfil the being open
requirements in line with the duty of candour regulations.

 

 

Kind regards

Jenny

--------------------------------------------------------------------------

Jenny Miles T: 020 8725 4054
Risk Manager F: 020 8725 2928
Corporate Risk & Assurance E: [8][email address]
St George's University Hospitals NHS W: [9]www.stgeorges.nhs.uk
Foundation Trust

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Original message --------
From: FOI <[12][St George’s University Hospitals NHS Foundation Trust request email]>
Date: 15/06/2016 15:14 (GMT+00:00)
To: Jennie Hall <[13][email address]>
Cc: Hazel Tonge <[14][email address]>
Subject: FW: FOI request - Tissue Viability services St Johns Hill FOI
1617.145

Dear Jennie

Please see FOI request below.  Please advise us who would be dealing with
this and could provide the information requested or if we need to
redirect.

The response is due back to me by 30 June (apologies for the short
notice).

Many thanks

Nii Turkson

Ref: 1617.145

Dear FOI,

Who must raise the safeguarding re avoidable grade 3 pressure ulcers
diagnosed in the community in care homes attended to and diagnosed by TV
nurses? David/Noyola – The issue here is we have no way of knowing
whether a pressure ulcer is avoidable until investigation is done.
Therefore any nurse in the community reviewing a pressure ulcer would have
to make a clinical decision as to whether there is evidence of neglect
based on the information they currently have. However the home ultimately
have a duty to report these incidents to either social services or NHS
funding authority

 

Does the  duty of candour reg 20 that came in, in Nov 2014 apply to NHS TV
nurse services in the community? Yes

and what is the penalty for breaching duty of candour reg 20 by NHS TV
nurse department? Jenny Miles please

If  a TV nurse diagnoses a grade 3 pressure ulcer in the community  and
records on datix  are they obliged to inform relevant persons
representative ie LPAs   and NOK under reg 20 duty of candour that  a NHS
serious incident has occurred? Jenny/Noyola

who monitors that the correct process is followed by TV community nurses
re obligatory NHS serious incident reporting regarding grade 3 pressure
ulcers? Noyola/jenny

Who is responsible for raising a safeguarding for avoidable grade 3
pressure ulcers  diagnosed in the community by NHS TV nurses?
David/Noyola – as point q

Yours sincerely,

Sylvia Rushbrooke

show quoted sections

Sylvia Rushbrooke

Dear FOI,
Many thanks for the information please can you clarify
Re 1
classed as external to the organisation. As this was an external it was reported as an ‘external’ Serious Incident by the trust’s corporate risk team.

Who is the contact person lead of appropriate risk team?

Re 2
I understand from TV nurses they are the wound care lead even though the treatment is undertaken in a care home and care is instructed and directed by TV nurse to the care home by way of reports and face to face instructions on site to the care home - as wound care lead are they responsible;e for ensuring the care and instructions given are complied with by the care home when visiting the patient?

Re 4
The team who are taking clinical responsibility for the patient,( in this instance, it would be the Community Nursing team) are obliged to inform the relevant patient’s and or the patient’s
representative that a NHS serious incident has occurred. This is supported by the Duty of Candour guidance.

Who is the named responsible person in this community nursing team who ensures the above happens? and how?
What is the process if this is not done and what action id taken when no duty of candour is undertaken ?

Re 5
Who is the named TV nurses manager?

Re 6
All Grade 3 pressure ulcers are reviewed by the Clinical Team Leader in conjunction with the TV nurse as part of the rapid review of pressure ulcers. If it is deemed that a safeguarding risk to the patient is
identified through this process, it is then raised to Social Services by a member of the team managing the patient.

Who is the clinical team leader?
Who is the named person responsible for raising a grade 3 safeguarding alert with social services?
How many grade 3 pressure ulcers were referred to the social services between Jan 2015 and March 2015?

Yours sincerely,

Sylvia Rushbrooke

FOI, St George’s University Hospitals NHS Foundation Trust

Ref: 1617.187

Re: FOI Request - Acknowledgement of Request

Dear Sir / Madam

Thank you for your request for information. Your request was received on 2 July 2016 and we are dealing with it under the terms of the Freedom of Information Act 2000. Under the FOI Act the Trust has a statutory responsibility to respond to your request within 20 working days therefore you should expect a formal response no later than 29 July 2016.

In some circumstances a fee may be payable. If this is the case a fees notice will be issued to you, and you will be required to pay before we will proceed to deal with your request.

If you have any queries about this letter, please contact us. Please remember to quote the reference number above in any future communications.

Yours sincerely

FOI team
St George’s University Hospitals NHS Foundation Trust

show quoted sections

Nii Turkson, St George’s University Hospitals NHS Foundation Trust

Dear Sylvia

Please ignore the previous email sent earlier today regarding this.

The CORRECT reference number for your FOI request is 1617.188.

My apologies for any confusion caused.

Thank you.

Best wishes

Nii Turkson

Re: 1617.188

Re: FOI Request - Acknowledgement of Request

Dear Sir / Madam

Thank you for your request for information. Your request was received on 2 July 2016 and we are dealing with it under the terms of the Freedom of Information Act 2000. Under the FOI Act the Trust has a statutory responsibility to respond to your request within 20 working days therefore you should expect a formal response no later than 29 July 2016.

In some circumstances a fee may be payable. If this is the case a fees notice will be issued to you, and you will be required to pay before we will proceed to deal with your request.

If you have any queries about this letter, please contact us. Please remember to quote the reference number above in any future communications.

Yours sincerely

FOI team
St George’s University Hospitals NHS Foundation Trust

show quoted sections

FOI, St George’s University Hospitals NHS Foundation Trust

Ref: 1617.188

Dear Sir / Madam

I am writing to confirm that St George’s University Hospitals NHS Foundation Trust has now completed its search for the information you requested.

Who is the contact person lead of appropriate risk team?
The Trust has a policy not to provide the names of staff below Executive Director level

Re 2
I understand from TV nurses they are the wound care lead even though the treatment is undertaken in a care home and care is instructed and directed by TV nurse to the care home by way of reports and face to face instructions on site to the care home - as wound care lead are they responsible for ensuring the care and instructions given are complied with by the care home when visiting the patient?

The TV nurses are the wound care lead for the organisation, St Georges Hospitals University Foundation NHS Trust. They provide support and advice to the care home in the provision of training, and support plans. They are not responsible for ensuring that the care and instructions given are complied with by the care home staff. The care home staff have their lead clinician who is responsible for ensuring that the instructions are complied with through their governance processes.

Re 4
The team who are taking clinical responsibility for the patient,( in this instance, it would be the Community Nursing team) are obliged to inform the relevant patient’s and or the patient’s representative that a NHS serious incident has occurred. This is supported by the Duty of Candour guidance.

In this instance the team who are taking clinical responsibility for the patient is the nursing home team. It would be their responsibility to inform the patient’s relative/ representative that a NHS serious incident has occurred according to the Duty of Candour guidance.

Who is the named responsible person in this community nursing team who ensures the above happens?

If this patient was being managed by the Community Nursing team, the Clinical Team leader will be the person responsible for ensuring that the Duty of Candour guidance is followed.

and how?

This is done by the CTL phoning the patient/ relative to advise them that a serious incident has occurred. This is then followed up with a letter confirming this. The CTL will also offer a meeting with the patient/ relative/ representative to discuss the process and to offer them the outcome from the investigation.

What is the process if this is not done and what action is taken when no duty of candour is undertaken ?

If the duty of candour guidance is not followed this is managed through our organisation’s capability procedure.

Re 5
Who is the named TV nurses manager?

The TV nurse will be managed by a Clinical Team Leader who is managed by the Head of Nursing.

Re 6
All Grade 3 pressure ulcers are reviewed by the Clinical Team Leader in conjunction with the TV nurse as part of the rapid review of pressure ulcers. If it is deemed that a safeguarding risk to the patient is identified through this process, it is then raised to Social Services by a member of the team managing the patient.

Who is the clinical team leader?

Currently this post is vacant and interim line management is being provided by the Head of Nursing.

Who is the named person responsible for raising a grade 3 safeguarding alert with social services?

The CTL is responsible for raising a Grade 3, pressure ulcer to social services if a safeguarding risk is identified.

How many grade 3 pressure ulcers were referred to the social services between Jan 2015 and March 2015?

Between Jan 2015 and March 2015, there were no Grade 3 pressure ulcers which were attributable to safeguarding. Therefore none were reported to Social services

Re-use of information and copyright

This information has been provided for your own use. However, you do not have an automatic right to re-use it and if you wish to re-use the information for commercial purposes for any reason you must ask us for permission to do so. Re-use of information for some purposes, including commercial, may be subject to the provisions of the Re-use of Public Sector Information Regulations 2015. These regulations provide a framework for public sector organisations to decide issues relating to the re-use of their information. The provisions of current copyright law apply to information provided.

Further information can be found at: http://www.legislation.gov.uk/uksi/2015/...

If you are dissatisfied with the response provided you have the right to file a complaint and request an internal review of our decision. All complaints must be made in writing and sent to the Trust FOI Lead at [St George’s University Hospitals NHS Foundation Trust request email].

If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the internal review procedure provided by the Trust. The Information Commissioner can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.

Please remember to quote the reference number above in any future communications.

Kind regards
FOI Lead
St George’s University Hospitals NHS Foundation Trust

show quoted sections

Sylvia Rushbrooke

Dear FOI,
Our mum died Oct 2016

I was advised in a FOI request that external serious incidents are recorded by the coporate risk department in the trust - Please advise which department stores/holds that recorded information on service users in the community re external steis sif nrls reports of serious wounds identified by the trust - as I understand they are not kept with the patients medical record?

Please advise which department hold/stores recorded information of service users regarding safeguarding discussions relating to serious wounds/incidents relating to external events identified in the community by TV viability nurses reporting to the trust - as I understand they are not kept with the patients medical record?

Yours sincerely,

Sylvia Rushbrooke

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