Friendship group affiliated to HVN

Request

Trust Response

1. Please supply patient’s information ECT leaflet.

Attached

2. Please supply patient ECT consent form.

Attached

3. Please supply any ECT reports/investigations

No reports or investigations taken place

4. How many ECT in 2021?

33 patients / 396 treatments

5. What proportion of patients were men/women?

Men – 11

Women – 22

6. How old were they?

Age 21 x 1

Age 23 x 1

Age 32 x 1

Age 37 x 2

Age 40 x 1

Age 46 x 2

Age 49 x 2

Age 54 x 1

Age 55 x 2

Age 56 x 1

Age 58 x 1

Age 60 x 2

Age 62 x 1

Age 63 x 3

Age 64 x 1

Age 67 x 1

Age 72 x 1

Age 74 x 2

Age 76 x 1

Age 77 x 1

Age 78 x 1

Age 79 x 1

Age 80 x 1

Age 81 x 2

7. What proportion of patients were classified BAME?

6 patients

8. How many were receiving ECT for the first time?

26 patients

9. How many patients consented to ECT?

20 patients

10. How many ECT complaints were investigated outside the NHS and CCG?

None

11. How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?

None

12. How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?

None

13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?

None

14. How many patients have suffered complications during and after ECT and what were those complications?

None

15. Have there been any formal complaints from patients/relatives about ECT?

None

16. If so, what was their concerns?

17. How many patients report memory loss/loss of cognitive function?

Follow up tests are carried out by the consultant 14 days, 4 weeks, 8 weeks and 12 weeks after treatment.

18. What tests are used to assess memory loss/loss of cognitive function?

MMSE / HAM-D / Patient Experience of ECT

19. Have MRI or CT scans been used before and after ECT?

No

20. If so what was the conclusion?

21. How does the Trust plan to prevent ECT in the future?

The Trust plans to continue with ECT.

Request

Trust Response

1. Please supply any serious incident reports/investigations

Following careful consideration, the Trust has estimated that the cost of complying with this part of your request would exceed the appropriate limit costs under Section 12 of the Freedom of Information Act 2000 and, therefore, the Trust is not obliged to comply with your request. The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 currently sets the appropriate costs limit at £450.  This represents the estimated cost of one person spending 2½ (18 hours) working days in determining whether the Department holds the information and locating, retrieving and extracting the information.  Under Section 12 of the Freedom of Information Act, the Trust is not obliged to comply with your request if this appropriate limit is exceeded.

In summary, serious incident reports that have been used as source data to support the coroner to conduct his or her review are already in the public domain and can be requested from the coroner’s office.

For Serious Incident investigations that focus on other issues than death, we would need to obtain consent from patients to support release. 

Therefore, in accordance with Section 17 of the Freedom of Information Act 2000, please treat this response as a Refusal Notice in respect of the information that you have asked for in this question. 

2. How many SERIOUS INCIDENT REPORTS in 2021?

70

3. What proportion of patients were men/women?

14 Female, 30 Male, 26 related to Organisational Issues(s); i.e. ward closure due to infection.

4. How old were they?

5. What proportion of patients were classified BAME?

6 classified as BAME. 13 other SIRI relate to patients where ethnic background is unknown.

6. How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?

None

7. How many patients died during or 1 month after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?

None

8. How many patients died within 6 months after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?

1 patient had died within 6 months after the Serious Incident. The patient was on an end-of-life pathway.

9. How many patients died by suicide within 6 months of receiving SERIOUS INCIDENT REPORTS (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?

None

10. How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?

None

Please note that the Trust has provided this response in the absence of a definition of “complication”.

11. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?

None

12. If so, what was their concerns?

N/A

13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?

The Trust takes action, where identified, to prevent future serious incidents occurring.  Action taken is reported through the Trust’s governance structures.

Request

Trust Response

1. Please supply any Restraints/investigations

The Trust does not hold any specific investigation reports that focus solely on restraint.

2. How many RESTRAINTS in 2021?

2316 incidents involving physical restraint.

3. What proportion of patients were men/women?

Female = 1303

Male = 991

Other/unknown = 22

4. How old were they?

5. What proportion of patients were classified BAME?

6. How many RESTRAINTS were investigated outside the NHS and CCG?

None

7. How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?

3 patients.

Patient 1: cause of death awaited

Patient 2: cause of death awaited

Patient 3: injection paraphernalia

8. How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?

As above.

Patient 4: natural causes

Patient 5: deterioration in physical health

Patient 6: unknown

9. How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?

None

10. How many patients have suffered complications during and after RESTRAINTS and what were those complications?

2316 incidents involving restraint. This will take a review of Carenotes; at 15 mins per incident equates to 579 hours.

11. Have there been any formal complaints from patients/relatives about RESTRAINTS?

None

12. If so, what was their concerns?

13. Are counts of forced injections available?

The Trust does not use the terminology forced injection and therefore does not hold information that supports responding to this request.

14. How does the Trust plan to reduce restraints in the future?

Following national guidance, clinical risk assessments and formulation, use of positive behaviour support plans, involving patients in care planning, therapeutic engagement, training including de-escalation and debrief post restraint events. 

Request

Trust Response

1. Please supply any SECLUSION reports/investigations

The Trust does not hold any specific investigation reports that focus solely on restraint.

2. How many SECLUSIONS in 2021?

590

3. What proportion of patients were men/women?

Female = 447

Male = 142

Other/unknown = 1

4. How old were they?

5. What proportion of patients were classified BAME?

6. How many SECLUSIONS were investigated outside the NHS and CCG?

None

7. How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?

2 patients

Patient 1 – cause of death awaited

Patient 2 – injected paraphernalia

8. How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?

No additional patients.

9. How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?

None

10. How many patients have suffered complications during and after SECLUSION and what were those complications?

Following careful consideration, the Trust has estimated that the cost of complying with this part of your request would exceed the appropriate limit costs under Section 12 of the Freedom of Information Act 2000 and, therefore, the Trust is not obliged to comply with your request. The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 currently sets the appropriate costs limit at £450.  This represents the estimated cost of one person spending 2½ (18 hours) working days in determining whether the Department holds the information and locating, retrieving and extracting the information.  Under Section 12 of the Freedom of Information Act, the Trust is not obliged to comply with your request if this appropriate limit is exceeded.

In summary, the Trust is unable to provide any information regarding this question as we are unable to review seclusions in the period. To obtain the answer we need to review Carenotes for each incident. 15 minutes per seclusion equates to 147 hours.

11. Have there been any formal complaints from patients/relatives about SECLUSION?

None

12. If so, what was their concerns?

13. How does the Trust plan to prevent SECLUSION in the future?

Following national guidance, clinical risk assessments and formulation, use of positive behaviour support plans, involving patients in care planning, therapeutic engagement, training including de-escalation and debrief post restraint events. 

Request

Trust Response

1. Please supply any MEDICATION ERRORS reports/investigations

The Trust reviews all medication errors, and produces quarterly learning style reports.  We moved this approach in-order to highlight key areas of learning. The three most recent copies are attached.

2. How many MEDICATION ERRORS in 2021?

239

3. What proportion of patients were men/women?

Female = 109

Male = 109

Unknown/ other = 1

Not known = 20

4. How old were they?

5. What proportion of patients were classified BAME?

6. How many MEDICATION ERRORS were investigated outside the NHS and CCG?

None

7. How many patients died during or 1 month after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?

None

8. How many patients died within 6 months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?

4 patients.

Patient 1 – not known

Patient 2 – natural causes

Patient 3 – cause of death awaited

Patient 4 – not known

9. How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?

None

10. How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?

None

Please note that the Trust has provided this response in the absence of a definition of “complication”.

11. Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?

None

12. If so, what was their concerns?

N/A

13. How does the Trust plan to prevent MEDICATION ERRORS in the future?

Preventing medication errors and promoting the safe use of medicines is one of the main “business as usual” functions of clinicians within the Trust. As part of this work we continually assess our practices to prevent medication errors.  Thus, this approach is reflected in our policies, training and the approach we take in all of our day to day work.