BERKSHIRE 2024

foi.bht@berkshire.nhs.uk

ECT response:

Please supply patient’s information ECT leaflet

The following leaflets are not routinely given to patients, however, are provided in the instances where a patient asks for further information:

We also have access to other language information from the Electroconvulsive Therapy Accreditation Service (ECTAS). The CQC information leaflet is only given to detained patients.

Please supply patient ECT consent form

Please supply any ECT reports/investigations

Please be advised the Trust does not release details where patients can be identified in line with UK GDPR, and we are withholding this information under Section 40 (1) (Personal Data) of the Act. Section 40(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many ECT in 2024?

There were 277 ECT sessions.

What proportion of patients were men/women?

Male: 35%
Female: 65%

How old were they?

19-50 years: 28%
51-64 years: 39%
65+ years: 33%

What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Ethnically diverse: 21%
White: 79%

How many people covered by the equality act - specific protected characteristics - excluding age + gender - received ECT ?

We do not report on this information.

As we do not have this information readily available for us to extract, for us to manually review individual patient records to determine if the patient was covered by the Equality Act would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many people were offered talking therapy prior to ECT ?

We would need to manually review patients records to determine if the patient was offered Talking Therapy sessions prior to them being seen by our ECT service.

As we do not have this information readily available, for us to manually search through patient records would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many were receiving ECT for the first time?

14.

How many patients consented to ECT?

100%

How many ECT complaints were investigated outside the NHS ?

None.

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

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

1 – the death was not in relation to ECT.

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

0 where cause of death has been confirmed at inquest to be suicide.

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

None due to ECT.

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

0 – there were no formal complaints regarding ECT in 2024.

If so, what was their concerns?

N/A.

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

This is addressed individually and would require a manual search through individual patient records.

As we do not have this information readily available in a format you have requested, for us to manually search through patient records would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

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

Six Item Cognitive Impairment Test (6CIT).

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

No.

If so, what was the conclusion?

N/A.

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

N/A.

Seclusion response:

Please supply any SECLUSION reports/investigations

Please be advised the Trust does not release details where patients can be identified in line with UK GDPR, and we are withholding this information under Section 40(1) (Personal Data) of the Act. Section 40(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many SECLUSIONS in 2024?

Within our mental health inpatient division (including learning disabilities inpatients), we recorded 112 seclusions in 2024.

What proportion of patients were men/women?

Female: 20
Male: 89
Other / not known: <5

Please note, there are some incident reports which do not have the patients gender listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

We are unable to provide all of this information as we are dealing with very small numbers of patients, and we believe that providing this information could lead to the identification of individuals as patients of our service and so we are withholding this information under section 40(2) of the FOI Act.

How old were they?

13-17 years: <5
18-20 years: 18
21-25 years: 21
26-30 years: 13
31-35 years: 22
36-40 years: 7
41-50 years: 6
51-60 years: 9
61-70 years: 7
71 and over years: <5

Please note, there are some incident reports which do not have the patients age listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

We are unable to provide all of this information as we are dealing with very small numbers of cases (<5), and we believe that providing this information could lead to the identification of individuals as patients of our service and so we are withholding this information under Section 40(2) of the FOI Act.

What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Ethnicities recorded	Total
White - English/Welsh/Scottish/Northern Irish/British	53
White - any other white background	8
Mixed - White and Black Caribbean	6
Mixed - White and Black African	<5
Asian or Asian British - Indian	<5
Asian or Asian British - Pakistani	5
Asian or Asian British - Any other Asian Background	9
Black or Black British - Caribbean	<5
Black or Black British - African	13
Black or Black British - Other Black Background	<5
Other ethnic category	<5
Not stated - refused	<5
Not Known - Waiting for first appointment/not recorded	5

Please note, there are some incident reports which do not have the patient’s ethnicity listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

How many people covered by the equality act - specific protected characteristics - excluding age + gender - were secluded ?

We do not report on this information within our incident record system.

How many SECLUSIONS were investigated outside the NHS?

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

0 – no patients died during a seclusion.

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

We do not report on this information within our incident record system.

As we do not have this information readily available for us to extract, for us to manually review individual patient records to determine if the patient died following a seclusion incident would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

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

We do not report on this information within our incident record system.

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

We do not report on this information within our incident record system.

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

0 – there were no formal complaints regarding seclusions in 2024.

If so, what was their concerns?

N/A.

How does the Trust plan to reduce SECLUSIONS in the future?

Alongside staff training, provision on risk assessments and safety planning in support of intervening early and avoid seclusion; we have introduced additional seclusion review points by Associate Nurse Consultants to enhance timely termination to unavoidable instances of seclusion whilst maintaining patient safety.

Restraints response:

Please supply any Restraints/investigations

Please be advised the Trust does not release details where patients can be identified in line with UK GDPR, and we are withholding this information under Section 40(1) (Personal Data) of the Act. Section 40(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many RESTRAINTS in 2024?

The below table outlines the number of restraints incidents recorded on our incident record system for 2024:

	Number of restraint incidents recorded
Mental health inpatients	837
Learning disabilities inpatients	64

Please note this data includes a range of interventions ranging from guiding a patient using minimal force to another area of a ward, to full restraint.

What proportion of patients were men/women?

Mental health inpatients	Learning disability inpatients
Female: 570 Male: 226 Other: <5	Female: 21 Male: 39

Please note, the figures above are for the total number of restraint incidents recorded rather than the number of individual patients.

There are some incident reports which do not have the patients gender listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

How old were they?

Mental health inpatients	Learning disability inpatients
13-17 years: <5 18-20 years: 88 21-25 years: 98 26-30 years: 28 31-35 years: 35 36-40 years: 97 41-50 years: 266 51-60 years: 45 61-70 years: 70 71 and over years: 52	21-25 years: 12 26-30 years: 21 31-35 years: 14 36-40 years: 10

Please note, the figures above are for the total number of restraints rather than the number of individual patients.

There are some incident reports which do not have the patients age listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Mental health inpatients – ethnicities recorded	Total
White - English/ Welsh/ Scottish/ Northern Irish/ British	566
White - any other white background	37
Mixed - White and Black Caribbean	12
Mixed - White and Black African	10
Mixed - Any other mixed background	3
Asian or Asian British - Indian	9
Asian or Asian British - Pakistani	46
Asian or Asian British - Any other Asian Background	14
Black or Black British - Caribbean	<5
Black or Black British - African	32
Black or Black British - Other Black Background	14
Other ethnic category	8
Not stated - refused	12
Not Known - Waiting for first appointment/not recorded	31

Learning disabilities inpatients – ethnicities recorded	Total
White - English/ Welsh/ Scottish /Northern Irish/ British	36
White - any other white background	<5
Asian or Asian British - Pakistani	7
Asian or Asian British - Any other Asian Background	15

Please note, the figures above are for the total number of restraints rather than the number of individual patients.

There are some incident reports which do not have the patient’s ethnicity listed. Therefore, we are not able to provide a breakdown for these patients without completing a manual search through individual patient records.

How many people covered by the equality act - specific protected characteristics - excluding age + gender - were restrainted?

We do not report on this information within our incident record system.

How many RESTRAINTS were investigated outside the NHS?

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

0 – no patients died during a restraint.

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

We do not report on this information within our incident record system.

As we do not have this information readily available for us to extract, for us to manually review individual patient records to determine if the patient died following a restrains incident would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

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

We do not report on this information within our incident record system.

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

We do not report on this information within our incident record system.

As we do not have this information readily available for us to extract, for us to manually review individual patient records to determine if the patient suffered complications during or following a restrains incident would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

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

2 formal complaints received regarding restraints in 2024.

If so, what was their concerns?

Concerns that restraint was used.

Are counts of forced injections available? if so how many people were forcible injected ?

There were 291 intramuscular (IM) injections reported. Please note, this does not mean they were all forced injections, as some patients prefer IM or even request IM.

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

We continue with regular monitoring of restrictive interventions, restraint being one of them. Ongoing monthly reviews through the Operations group which then feeds into the Quarterly Oversight Group led by our Deputy Director of Nursing. Patient and advocacy feedback continue to inform the focus through report.

How many of these restraints were face down restraints?

Out of the total number of restraints recorded for 2024, 19 were face down restraints.

Medication errors:

Please supply any MEDICATION ERRORS reports/investigations

Please be advised the Trust does not release details where patients can be identified in line with UK GDPR, and we are withholding this information under Section 40(1) (Personal Data) of the Act. Section 40(1) is an Absolute Exemption and is therefore not subject to the public interest test.

How many MEDICATION ERRORS in 2024?

Within mental health inpatients and learning disabilities inpatients, there were 45 medication errors reported in 2024.

Please note, these figures do not include any incidents classified as near misses or errors identified and reported by our team that did not occur under our care or as a result of any act or omission by the Trust.

What proportion of patients were men/women?

Female: 17

Male: 27

How old were they?

18-20 years: 8

21-25 years: <5

31-35 years: 7

36-40 years: <5

41-50 years: <5

51-60 years: 10

61-70 years: 6

71 and over years:6

What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Mental health and learning disability inpatients	Total
White - English/Welsh/Scottish/Northern Irish/British	33
White - any other white background	<5
Mixed - White and Black Caribbean	<5
Asian or Asian British - Indian	<5
Asian or Asian British - Pakistani	<5
Black or Black British - Caribbean	<5
Not Known - Waiting for first appointment/not recorded	<5

How many people covered by the equality act - specific protected characteristics - excluding age + gender - endured medication errors ?

We do not report on this information within our incident record system.

How many MEDICATION ERRORS were investigated outside the NHS ?

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)?

We do not report on this information within our incident record system.

As we do not have this information readily available for us to extract, for us to manually review individual patient records to determine if the patient died following a medication error incident would be in excess of the appropriate limit set for NHS organisations of £450 under Section 12 of the Act. This represents the estimated cost of one person spending 18 hours locating, retrieving and extracting and collating the information (where it exists). Section 12(1) is an Absolute Exemption and is therefore not subject to the public interest test.

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

We do not report on this information within our incident record system.

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

We do not report on this information within our incident record system.

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

We do not report on this information within our incident record system.

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

5 formal complaints received regarding medication errors in 2024.

If so, what was their concerns?

Incorrect dispensing of medication, wrong dosage prescribed and medication instructions not being followed.

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

The Trust will continue to reduce medication errors by:

Encourage more reporting of errors and more importantly near misses.

Promote a just culture and use of Patient Safety Incident Response Framework (PSIRF) toolkits.

Continue to invest in multidisciplinary Medication Safety Officers who review reported errors and disseminate relevant learning from local, national and international sources.

Continue to support the Medication Safety Group who monitor for trends and patterns and review action plans from reported medication errors.

Integration with the Patient Safety team for greater scrutiny of multifactorial incidents.

Continue to promote local learning from using learning from medication errors and associated learning materials.

Continue to promote standardisation, simplification of medication processes and increased use of technology.
Contribute to 4 x ICS Medication Safety Groups to share learning and work together to reduce errors