ECT
Please provide ECT information under the FOI act to the following questions:
Please supply patient’s information ECT leaflet.
Refer to attached leaflet. Please note that the leaflet is for informative purposes and does not pertain to the Trust’s ECT database.
Please supply patient ECT consent form.
Please see attached consent form.
Please supply any ECT reports/investigations
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to interrogate and collate specific reports relating to ECT within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption
How many ECT in 2019?
Please see attached Spreadsheet - below
What proportion of patients were men/women?
Please see attached Spreadsheet.
6. How old were they?
Please see attached Spreadsheet.
What were the diagnoses and in what proportions?
Please see attached Spreadsheet.
What proportion of patients were classified BAME?
Please see attached Spreadsheet.
How many were receiving ECT for the first time?
Please see attached Spreadsheet.
How many patients consented to ECT?
29 patients consented to ECT, of these 6 patients consented twice as they had two courses of ECT treatment.
In addition, 36 patients had ECT Treatment under section of the Mental Health Act.
How many ECT complaints were investigated outside the NHS and CCG?
Not recorded on our system
How many patients died during or soon after ECT and what was the cause (whether or not ECT was considered the cause)?
Not recorded on the Incident Reporting System.
How many patients died a few months after ECT and what was the cause (whether or not ECT was considered the cause)?
Not recorded on the Incident Reporting System
How many patients died by suicide within a few months of receiving ECT (whether or not ECT was considered the cause)?
Not recorded on the Incident Reporting System
How many patients have suffered complications during and after ECT and what were those complications?
None.
Have there been any formal complaints from patients/relatives about ECT?
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to interrogate and collate specific complaints relating to ECT within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
If so, what was their concerns?
Not applicable please see above.
How many patients report memory loss/loss of cognitive function?
There have been some recognised side effects, however this cannot be quantifiable as the memory problems are varied with each patient
What tests are used to assess memory loss/loss of cognitive function?
The Trust is using Mini-ACE to assess memory loss/loss of cognitive function
Have MRI or CT scans been used before and after ECT?
MRI and CT scans are not specifically carried out before or after ECT treatments, however MRI / CT scans are carried out for older adult patients as part of their general assessment.
If so what was the conclusion?
Not applicable please see above.
How does the Trust plan to prevent ECT in the future?
The Trust does not have a plan to prevent the use of ECT in the future as it is a recognised treatment within psychiatric care.
Seclusion
Please provide SECLUSION information under the FOI act to the following questions: -
1.Please supply patient’s information SECLUSION leaflet.
Please find attached
Please supply patient SECLUSION consent form.
The Trust does not have a consent form as you cannot consent to be placed in seclusion. Seclusion is used as a last resort when a patient is exhibiting high levels of violence and aggression and when other less restrictive avenues have been explored and failed.
Please supply any SECLUSION reports/investigations
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question, as we are unable to interrogate and collate specific reports relating to seclusion within the system we use and will require manual searching. With this in mind, please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
How many SECLUSION in 2019?
Please see attached Spreadsheet - below
What proportion of patients were men/women?
Please see attached Spreadsheet. 6. How old were they?
Please see attached Spreadsheet.
What were the diagnoses and in what proportions?
Please see attached Spreadsheet.
What proportion of patients were classified BAME?
Please see attached Spreadsheet.
How many were receiving SECLUSION for the first time?
Please see attached Spreadsheet.
How many patients consented to SECLUSION?
Please see attached Spreadsheet.
How many SECLUSIONS were investigated outside the NHS and CCG ?
Not recorded on our system
How many patients died during or soon after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
0
How many patients died a few months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
|
Deaths |
Cause of Death |
|
1 |
Suspected Drug / Alcohol Related Death |
How many patients died by suicide within a few months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
0
How many patients have suffered complications during and after SECLUSION and what were those complications?
Not recorded on our system.
Have there been any formal complaints from patients/relatives about SECLUSION?
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to interrogate and collate the specific complaint relating to ECT within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
If so, what was their concerns?
Not Applicable please see above.
How many patients report memory loss/loss of cognitive function?
The Trust does not hold this information
What tests are used to assess memory loss/loss of cognitive function?
Memory loss/loss of cognitive function are clinically assessed and based on a psychiatric consultation , every patient’s mental state is assessed throughout their period of seclusion by a psychiatrist (at least daily) face to face.
Have MRI or CT scans been used before and after SECLUSION?
The Trust does not routinely use CT or MRI scans after seclusion, unless there is a specific clinical indication.
If so what was the conclusion?
Not applicable please see above
How does the Trust plan to prevent SECLUSION in the future?
The Trust seeks to prevent seclusion with the use of their 5-year violence reduction strategy, which looks at all aspects of restrictive practice
Restraints
Please provide restraints information under the FOI act to the following questions: -
Please supply RESTRAINTS patient’s information leaflet.
Please see attached.
Please supply patient RESTRAINTS consent form.
A restraints consent form is not used within the Trust and is not a feasible documentation due to the nature of a restraint.
Physical restraint is used to prevent individuals in mental health services from harming themselves or others. By this definition a patient cannot consent to a restraint
Please supply any Restraints/investigations
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to interrogate and collate specific reports relating to restraints within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
How many RESTRAINTS in 2019?
3591 - These are pertaining to physical restraints in 2019
What proportion of patients were men/women?
|
Gender |
Restraints |
|
F |
1980 |
|
M |
1611 |
How old were they?
|
Age Group |
Physical Restraints |
|
< 21 |
424 |
|
21 - 30 |
867 |
|
31 - 40 |
448 |
|
41 - 50 |
965 |
|
51 - 60 |
333 |
|
> 60 |
554 |
What were the diagnoses and in what proportions?
Diagnosis is not recorded on the Incident Reporting System
What proportion of patients were classified BAME?
|
Row Labels |
Count of INCIDENT_NUMBER |
|
|
A - British - White |
|
2395 |
|
B - Irish - White |
|
14 |
|
C - Other White - White |
|
91 |
|
D - White & Black Caribbean - Mixed |
|
81 |
|
E - White & Black African - Mixed |
|
12 |
|
F - White & Asian - Mixed |
|
167 |
|
G - Other Mixed - Mixed |
|
41 |
|
H - Indian - Asian Or Asian British |
|
30 |
|
J - Pakistani - Asian Or Asian British |
|
208 |
|
K -Bangladeshi - Asian Or Asian British |
|
19 |
|
L - Other Asian - Asian Or Asian British |
|
35 |
|
M - Black Caribbean - Black Or Black British |
|
200 |
|
N - Black African - Black Or Black British |
|
99 |
|
P - Other Black - Black Or Black British |
|
29 |
|
R - Chinese - Other Ethnic |
|
6 |
|
S - Other Ethnic Category - Other Ethnic |
|
81 |
|
U - Arab |
|
18 |
|
Z - Not Stated |
|
65 |
How many were receiving RESTRAINTS for the first time?
357
How many patients consented to RESTRAINTS?
Not applicable please refer to question 2.
How many RESTRAINTS were investigated outside the NHS and CCG ?
Not recorded on our system
How many patients died during or soon after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
No patient deaths occurred at the time of restraint
How many patients died a few months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
The table below shows the corresponding cause of death of patients who have died 3 months after a restraint related incident.
|
Cause of death |
Patient deaths |
|
Natural Cause / Clinical Condition |
3 |
|
Suspected Drug / Alcohol Related Death |
1 |
How many patients died by suicide within a few months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
There are no reported deaths by suicide within 3 months of a physical restraint.
How many patients have suffered complications during and after RESTRAINTS and what were those complications?
Not recorded on the Incident Reporting System
Have there been any formal complaints from patients/relatives about RESTRAINTS?
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to interrogate and collate specific complaint relating to restraints within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
If so, what was their concerns?
Not applicable please see above.
How many patients report memory loss/loss of cognitive function?
Not recorded on the Incident Reporting System
What tests are used to assess memory loss/loss of cognitive function?
Not recorded on the Incident Reporting System
Have MRI or CT scans been used before and after RESTRAINTS?
Not recorded on the Incident Reporting System
If so what was the conclusion?
Not applicable please see above.
How does the Trust plan to reduce restraints in the future?
The Trust has a 5-year restraint reduction process and have formally submitted a pledge to the Restraint Reduction Network (RRN) which has been published on their website.
In addition to this the Trust has formally started the process of accrediting the physical intervention training through the RRN and UKAS
Serious incident
Please provide SERIOUS INCIDENT information under the FOI act to the following questions: - 1. Please supply SERIOUS INCIDENT REPORTS patient’s information leaflet.
The Trust does not have a leaflet for serious incident reports; however the Trust is currently in the process of developing a leaflet.
Please supply patient SERIOUS INCIDENT REPORTS consent form.
This is not applicable, you cannot consent to a serious incident as a serious incident is in general terms something out of the ordinary or unexpected, with the potential to cause serious harm, which occurs on NHS premises or in the provision of an NHS service. The requirement for serious incident reviews is set out in national policy and in NHS contracts.
Please supply any serious incident reports/investigations
Exemption applied, Section 40 personal information.
The Trust is unable to provide the reports as the identity of the patient may become known from the description of the incident.
How many SERIOUS INCIDENT REPORTS in 2019?
76
What proportion of patients were men/women?
|
Gender |
Serious Incidents |
|
F |
25 |
|
M |
50 |
|
Unknown |
1 |
How old were they?
|
Age Group |
Serious Incidents |
|
21 - 30 |
13 |
|
31 - 40 |
18 |
|
41 - 50 |
18 |
|
51 - 60 |
11 |
|
> 60 |
16 |
What were the diagnoses and in what proportions?
Not applicable as patient diagnosis is not recorded on the Incident Reporting System.
What proportion of patients were classified BAME?
|
Ethnic Origin |
Serious Incidents |
|
A - British - White |
54 |
|
B - Irish - White |
2 |
|
C - Other White - White |
2 |
|
D - White & Black Caribbean - Mixed |
2 |
|
F - White & Asian - Mixed |
2 |
|
J - Pakistani - Asian Or Asian British |
2 |
|
L - Other Asian - Asian Or Asian British |
1 |
|
M - Black Caribbean - Black Or Black British |
4 |
|
S - Other Ethnic Category - Other Ethnic |
2 |
|
Z - Not Stated |
4 |
|
Unknown |
1 |
How many were receiving SERIOUS INCIDENT REPORTS for the first time?
69
How many patients consented to SERIOUS INCIDENT REPORTS?
This is not applicable, please refer to question 2.
How many SERIUOS INCIDENT REPORTS were investigated outside the NHS and CCG?
100% of our serious incident reports were investigated within BSMHFT through a lead trained patient safety officer who is independent to the service where the incident took place. Zero were investigated outside the NHS and CCG
How many patients died during or soon after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
The nature of Mental Health sadly means that a high proportion of our Serious Incidents are aligned to the death of an individual. This is very different to the range of serious incidents that are typically reported in general acute trusts and community trusts.
|
Confirmed Suicide |
|
24 |
|
Known Cause |
|
11 |
|
Natural Cause / Clinical Condition |
|
3 |
|
Suspected Accidental / Misadventure Death |
|
1 |
|
Suspected Drug / Alcohol Related Death |
|
2 |
|
Suspected Suicide |
|
6 |
|
Unknown Cause |
|
8 |
How many patients died a few months after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)? Zero.
How many patients died by suicide within a few months of receiving SERIOUS INCIDENT REPORTS (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
Zero
How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?
Zero
Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT
REPORTS?
No.
If so, what was their concerns?
Not applicable please see above.
How many patients report memory loss/loss of cognitive function?
Not recorded on the Incident Reporting System
What tests are used to assess memory loss/loss of cognitive function? Not recorded on the Incident Reporting System
Have MRI or CT scans been used before and after SERIOUS INCIDENT REPORTS?
Not recorded on the Incident Reporting System
If so what was the conclusion?
Not applicable, please see above.
How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
There are a range of areas which we seek to improve with the aim of reducing suicides. The key ones are shown pictorially below:-
Medication Errors
Please provide MEDICATION ERRORS information under the FOI act to the following questions: - 1. Please supply patient’s information MEDICATION ERRORS leaflet.
The Trust does not have an information leaflet for medication errors.
2. Please supply patient MEDICATION ERRORS consent form.
This is not applicable, the Trust does not hold consent forms for medication errors, due to the nature of medication errors this is not feasible as you cannot consent for a medication error.
A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. By the definition of the above a patient cannot consent for this to occur.
Please supply any MEDICATION ERRORS reports/investigations
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to integrate and collate specific reports relating to Medication Errors within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
How many MEDICATION ERRORS in 2019?
337
What proportion of patients were men/women?
|
Gender |
Medication Errors |
|
F |
132 |
|
M |
166 |
|
Unknown/Not Recorded |
39 |
How old were they?
|
Age Group |
Medication Errors |
|
< 20 |
13 |
|
21 - 30 |
64 |
|
31 - 40 |
94 |
|
41 - 50 |
55 |
|
51 - 60 |
40 |
|
> 60 |
30 |
|
Unknown/Not Recorded |
41 |
What were the diagnoses and in what proportions?
Diagnosis is not recorded on the Incident Reporting System
What proportion of patients were classified BAME?
|
Ethnicity |
Medication Errors |
|
A - British - White |
143 |
|
B - Irish - White |
6 |
|
C - Other White - White |
7 |
|
D - White & Black Caribbean - Mixed |
10 |
|
E - White & Black African - Mixed |
1 |
|
F - White & Asian - Mixed |
3 |
|
G - Other Mixed - Mixed |
8 |
|
H - Indian - Asian Or Asian British |
7 |
|
J - Pakistani - Asian Or Asian British |
37 |
|
K -Bangladeshi - Asian Or Asian British |
6 |
|
L - Other Asian - Asian Or Asian British |
5 |
|
M - Black Caribbean - Black Or Black British |
30 |
|
N - Black African - Black Or Black British |
12 |
|
P - Other Black - Black Or Black British |
7 |
|
S - Other Ethnic Category - Other Ethnic |
6 |
|
U - Arab |
3 |
|
Z - Not Stated/Unknown |
46 |
How many were receiving MEDICATION ERRORS for the first time?
203
How many patients consented to MEDICATION ERRORS?
Not applicable.
How many MEDICATION ERRORS S were investigated outside the NHS and CCG? Not recorded on our system
How many patients died during or soon after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?
No patient deaths occurred 3 months following a medication error
How many patients died a few months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?
No patient deaths occurred 3 months following a medication error
How many patients died by suicide within a few months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
No patient deaths occurred 3 months following a medication error
How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
Not recorded on the Incident Reporting System
Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
Exemption applied, Section 12
The Trust is unable to provide any information regarding this question as we are unable to integrate and collate the specific complaint relating to Medication Errors within the system we use and will require manual searching. With this in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption.
If so, what was their concerns?
Not applicable, please see above.
How many patients report memory loss/loss of cognitive function?
Not recorded on the Incident Reporting System
What tests are used to assess memory loss/loss of cognitive function?
Not recorded on the Incident Reporting System
Have MRI or CT scans been used before and after MEDICATION ERRORS?
Not recorded on the Incident Reporting System
If so what was the conclusion?
Not appliable, please see above.
How does the Trust plan to prevent MEDICATION ERRORS in the future?
Please see attached documentation.
Summary of patients placed in seclusion during 2019
There were a total of 229 individual patients placed in seclusion between 01/01/2019 and 31/12/2019.
Break down by gender
Female 72
Male 157
Breakdown by ethnic group
White - English/Welsh/Scottish/Northern Irish/British 94
White - Other 2
Black / Black British - African 18
Black / Black British - Caribbean 35
Black / Black British - Other 4
Mixed - White & Black African 4
Mixed - White & Black Caribbean 21
Asian / Asian British - Bangladeshi 2
Asian / Asian British - Indian 1
Asian / Asian British - Pakistani 19
Asian / Asian British - Chinese 1
Asian or Asian British - Any other background 6
Mixed - White & Asian 4
Arab 2
Any other Ethnic Group 5
Any other mixed / multiple ethnic background 4
Breakdown by Confirmed diagnoses during seclusion*
Acute and transient psychotic disorders 5
Bipolar affective disorder 39
Conduct disorders 1
Depressive episode 2
Hyperkinetic disorders 1
Manic episode 2
Mental and behavioural disorders associated with the puerperium, not elsewhere classified 1
Mental and behavioural disorders due to multiple drug use and use of other psychoactive substance 6
Mental and behavioural disorders due to use of alcohol 1
Mental and behavioural disorders due to use of cannabinoids 1
Mental and behavioural disorders due to use of opioids 1
Obsessive-compulsive disorder 1
Persistent delusional disorders 1
Personality and behavioural disorders due to brain disease, damage and dysfunction 1
Pervasive developmental disorders 7
Reaction to severe stress, and adjustment disorders 3
Recurrent depressive disorder 1
Not Stated (Client Refused) 5
Schizoaffective disorders 32
Schizophrenia 72
Specific personality disorders 34
No confirmed diagnosis at time of seclusion 37
Was this patient's first seclusion?
No 127
Yes 102
*Total here adds up to 250 as some patients had more than one primary diagnosis open during seclusion
Breakdown by age group
18 and under 12
19 to 25 28
26 to 32 61
33 to 39 47
40 to 46 30
47 to 53 29
54 to 60 16
60 to 65 6
Over 65 0
Summary of patients that started an ECT during 2019
There were a total of 59 individual patients that started an ECT between 01/01/2019 and 31/12/2019
Break down by gender
Female 39
Male 20
Breakdown by ethnic group
White - English/Welsh/Scottish/Northern Irish/British 35
White - Irish 2
Black / Black British - African 3
Black / Black British - Caribbean 3
Mixed - White & Black African 1
Asian / Asian British - Indian 6
Asian or Asian British - Pakistani 4
Asian / Asian British - Chinese 1
Asian or Asian British - Any other background 1
Any other mixed / multiple ethnic background 2
Any other Ethnic Group 1
Breakdown by Confirmed diagnoses during referral*
Bipolar affective disorder 9
Dementia in other diseases classified elsewhere 1
Depressive episode 18
Mental and behavioural disorders due to use of alcohol 1
Obsessive-compulsive disorder 1
Reaction to severe stress, and adjustment disorders 1
Recurrent depressive disorder 17
Schizoaffective disorders 2
Schizophrenia 6
Specific personality disorders 2
Other anxiety disorders 1
No confirmed diagnosis at time of referral 10
Breakdown by age group
18 and under 0
19 to 25 4
26 to 32 5
33 to 39 6
40 to 46 1
47 to 53 7
54 to 60 7
60 to 65 10
Over 65 19
*Total here adds up to 69 as some patients had more than one primary diagnosis open during referral
Was this patient's first ECT team referral?
No 20 Yes 39