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Dear Ms Micklewright,
Apologies, please see below response letter copied into email.
Please reply to:
Elizabeth House
Fulbourn Hospital
Fulbourn
Cambridge
CB21 5EF
Tel. 0800 376775
Email: foi@cpft.nhs.uk
Website: www.cpft.nhs.uk
4th June 2024
Reference number: CPFT FOI F25-084
SENT BY EMAIL
Dear Ms Micklewright
Thank you for your email requesting information under the Freedom of Information Act 2000. Please find our responses below (in bold).
Your Request
1.Please supply patient’s information ECT leaflet
Please see attached patient information ECT leaflet
2.Please supply patient ECT consent form
Please see attached patient ECT consent form
3.Please supply any ECT reports/investigations
None in 2023
4.How many ECT in 2023?
There were 37 unique patients in 2023 and they received 352 sessions of ECT between them.
5.What proportion of patients were men/women?
8 were men & 29 were women
6.How old were they?
Age 18-30: 3
Age 31-40: 3
Age 51-60: 7
Age 61-70: 14
Age 71-80: 6
Age 81-90: 4
7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
5 were POC/BAME
8.How many people covered by the equality act received ECT?
We are unsure what is meant by this question, as we are all covered by the Equalities Act. We believe you may mean to ask us about people with a specific protected characteristic under the Equalities Act. If so, please could you reword your question, as we are unclear what you are asking for.
9.How many people were offered talking therapy prior to ECT?
Patients are too unwell at the point of having ECT to have talking therapy. Once they improve with ECT, they start talking therapy if they choose to have it.
10.How many were receiving ECT for the first time?
37 unique patients received ECT in 2023. This includes patients who have had ECT in the past and others who have never received ECT. We are unable to determine the patients who have not had ECT in the past without manual review of patient records.
11.How many patients consented to ECT?
When the courses of ECT were commenced there were
• 24 patients who were Informal (consenting) or detained (consenting) and
• 16 who were detained (lacking capacity, unable to give consent)
The total number of patients is 40 as three had more than one course in 2023
12.How many ECT complaints were investigated outside the NHS and CCG?
We are unable to answer this question, as we are only able to provide information on complaints we have received or investigated.
13.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
No patients died during ECT.
According to our records, one patient died within one month – we are unable to give specific cause of death due to patient confidentiality.
14.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
None to our knowledge
15.How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
None to our knowledge
16.How many patients have suffered complications during and after ECT and what were those complications?
None
17.Have there been any formal complaints from patients/relatives about ECT?
Yes, 2
18.If so, what was their concerns?
1. Concerns about service user experiencing memory issues following historical ECT treatment.
2. Refusal to provide ECT to mental health inpatient.
19.How many patients report memory loss/loss of cognitive function?
It is common for temporary memory disruption after ECT.
We are unable to answer this question fully without manual review of patient records.
20.What tests are used to assess memory loss/loss of cognitive function?
The mini-ACE is used before the first session of ECT and then periodically throughout the course of ECT. It is also completed at the end of the course and then 3 months later.
21.Have MRI or CT scans been used before and after ECT?
The scans are completed routinely for patients who need them. They are not used specifically before and after ECT.
22.If so, what was the conclusion?
The scan results vary from patient to patient.
23.How does the Trust plan to prevent ECT in the future?
There are no plans to prevent ECT in the future.
I trust this information meets your needs. If you have any query or concern about the handling of your enquiry, then please contact the Trust’s Freedom of Information Lead at the address below.
You also have the right of appeal to the Information Commissioner at:
Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
Website: www.informationcommissioner.gov.uk
Yours sincerely,
Rachel Gomm
Interim Chief Nurse
19th August 2024
Reference number: CPFT FOI F25-223
SENT BY EMAIL
Dear Ms Micklewright
Thank you for your email requesting information under the Freedom of Information Act 2000. Please find our responses below (in bold).
Your Request
Please provide restraints information under the FOI act to the following questions: -
1.Please supply any Restraints/investigations
We are unable to release details of specific restraint incidents / investigations.
This is because we would consider this information to constitute personal data, and we have obligations under the Data Protection Act and in law generally to protect this information.
Your request has been considered in line with our obligations under the Freedom of Information Act and we have concluded that this information is exempt from disclosure under Section 40(2). This is because personal data (if disclosed) would breach any of the data protection principles.
2.How many RESTRAINTS in 2023?
1073 reports of ‘control and restraint’ were reported to our Trust incident reporting system in 2023.
This includes use of Clinical Holding, Physical Intervention, Chemical Restraint, Rapid Tranquilisation, Seclusion and Segregation, Safety Pods, Mechanical Restraint, Full Physical intervention, and Prone Restraint as defined in our Reducing Restrictive Practice / Use of Force Policy.
3.What proportion of patients were men/women?
|
Gender |
Total records |
Percentage |
|
Female |
704 |
66% |
|
Male |
279 |
26% |
|
Not Stated |
90 |
8% |
|
Grand Total |
1073 |
100% |
4.How old were they?
|
Age Range |
Count |
|
Under 18 |
354 |
|
18-29 |
285 |
|
30-39 |
122 |
|
40-49 |
67 |
|
50-59 |
74 |
|
60-69 |
40 |
|
70-79 |
106 |
|
80-89 |
17 |
|
Not stated |
8 |
|
Grand Total |
1073 |
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
Row Labels |
Total Records |
|
Any other Ethnic Category |
3 |
|
Asian or British Asian - Any other Asian background |
20 |
|
Asian or British Asian - Indian |
1 |
|
Asian or British Asian - Pakistani |
17 |
|
Black or Black British - African |
3 |
|
Mixed - Any other Mixed background |
11 |
|
White - Any other White background |
27 |
|
White - British |
259 |
|
White - Irish |
5 |
|
Not stated |
727 |
|
Grand Total |
1073 |
6.How many people covered by the equality act were restrained?
We are unsure what is meant by this question, as we are all covered by the Equalities Act. We believe you may mean to ask us about people with a specific protected characteristic under the Equalities Act. If so, please could you reword your question, as we are unclear what you are asking for.
7.How many RESTRAINTS were investigated outside the NHS and CCG?
No investigations regarding restraints have been referred to outside organisations.
8.How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
No patients were reported to have died during or within one month of restraint reported via our incident reporting system.
9.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
No patients were reported to have died within 6 months of restraint reported via our incident reporting system.
10.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
No patients were reported to have died by suicide, as confirmed by a coroner, within 6 months of restraint reported via our incident reporting system.
11.How many patients have suffered complications during and after RESTRAINTS and what were those complications?
We are unable to provide this information as it would require a wholly manual review of each record of restraint recorded on our incident reporting system, which we calculate would take more than 178 hours to complete.
The degree of harm recorded at the time of the restraint is outlined below:
|
Degree of Harm |
Count |
|
No Harm |
990 |
|
Low Harm |
79 |
|
Moderate Harm |
4 |
|
Grand Total |
1073 |
12.Have there been any formal complaints from patients/relatives about RESTRAINTS?
Yes, 4 in 2023
13.If so, what was their concerns?
- Concerns regarding excessive bruising which could be consistent with excessive force used for restraint while on inpatient ward.
- Patient felt they had been falsely detained under the Mental Health Act, advised that they had been restrained unnecessarily and were touched inappropriately by a staff member while being restrained.
- Patient unhappy with being restrained so that staff could administer medication via injection, patient felt they should not be on any medication.
- Relative felt that patient had been restrained unnecessarily and unlawfully, causing injuries to the patient.
14.Are counts of forced injections available?
168 counts of rapid tranquilisation were recorded within the required timeframe.
15.How does the Trust plan to reduce restraints in the future?
The Trust is taking a multifaceted approach :
Staff receive training which includes de-escalation or early intervention strategies in an attempt to avoid the use of restraint wherever possible
The Trust is engaged with quality improvement work as part of the national Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme.
Data related to restraints is monitored and reported on monthly within the Trust reporting structures
A copy of the Trust Reducing Restrictive Practice/ Use of Force Policy is also available on the Trust Website page , Documents that guide practice | CPFT NHS Trust
I trust this information meets your needs. If you have any query or concern about the handling of your enquiry, then please contact the Trust’s Freedom of Information Lead at the address below.
You also have the right of appeal to the Information Commissioner at:
Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
Website: www.informationcommissioner.gov.uk
1st October 2024
Reference number: CPFT FOI F25-373
SENT BY EMAIL
Dear Mrs Micklewright
Thank you for your email requesting information under the Freedom of Information Act 2000. Please find our responses below (in bold).
Your Request
1.Please supply any SECLUSION reports/investigations
We are unable to release details of specific seclusion reports / investigations.
This is because we would consider this information to constitute personal data, and we have obligations under the Data Protection Act and in law generally to protect this information.
Your request has been considered in line with our obligations under the Freedom of Information Act and we have concluded that this information is exempt from disclosure under Section 40(2). This is because personal data (if disclosed) would breach any of the data protection principles.
2.How many SECLUSIONS in 2023?
Use of seclusion was reported 187 times in 2023 via our incident reporting system.
3.What proportion of patients were men/women?
|
Gender |
Total |
Percentage |
|
Female |
70 |
37.43% |
|
Male |
97 |
51.87% |
|
Not stated |
20 |
10.70% |
|
Grand Total |
187 |
100.00% |
|
|
|
|
4.How old were they?
|
Age Range |
Count |
|
Under 18 |
71 |
|
18-29 |
30 |
|
30-39 |
47 |
|
40-49 |
23 |
|
50-59 |
7 |
|
60-69 |
7 |
|
Not stated |
2 |
|
Grand Total |
187 |
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
Ethnicity |
Count |
|
Asian or British Asian - Any other Asian background |
3 |
|
Asian or British Asian - Pakistani |
7 |
|
Black or Black British - African |
1 |
|
Mixed - Any other Mixed background |
5 |
|
Not stated |
123 |
|
White - Any other White background |
6 |
|
White - British |
22 |
|
White - Irish |
3 |
|
Not stated |
17 |
|
Grand Total |
187 |
6.How many people covered by the Equality Act were secluded?
We are unsure what is meant by this question, as we are all covered by the Equalities Act. We believe you may mean to ask us about people with a specific protected characteristic under the Equalities Act. If so, please could you reword your question, as we are unclear what you are asking for.
7.How many SECLUSIONS were investigated outside the NHS and CCG?
No investigations regarding seclusion have been referred to outside organisations.
8.How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
No patients were reported to have died during or within one month of seclusion via our incident reporting system.
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
No patients were reported to have died within 6 months of seclusion via our incident reporting system.
10.How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
No patients were reported to have died by suicide, as confirmed by a coroner, within 6 months of seclusion via our incident reporting system.
11.How many patients have suffered complications during and after SECLUSION and what were those complications?
We have reviewed this request, and unfortunately, we are unable to provide the data that you have asked for.
This is because to locate this information would involve a manual review of each record of restraint recorded on our incident reporting system within the timeframe you have stipulated (data for calendar year 2023). We estimate that to search for, locate and retrieve this information currently would take 44 hours of staff time, which exceeds the time limits as set out by the FOIA.
Section 12 of the FOIA allows a public authority to refuse a request where it estimates that it would exceed the appropriate limit to comply with the request.
The relevant section states:
12. (1) - Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit where the appropriate limit is equal to 18 hours of staff time as set by the Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004.
However, when we apply Section 12, we are required to provide advice and assistance (if possible) under Section 16 to help modify your request to an answerable standard.
Advice and Assistance provided under Section 16 of the FOIA
After careful consideration, we are unable to provide any further advice or assistance which would enable you to modify your request to an answerable standard.
12.Have there been any formal complaints from patients/relatives about SECLUSION?
Yes, 1 in 2023 which was not upheld following investigation
13.If so, what was their concerns?
We are unable to release details of specific concerns.
This is because we would consider this information to constitute personal data, and we have obligations under the Data Protection Act and in law generally to protect this information.
Your request has been considered in line with our obligations under the Freedom of Information Act and we have concluded that this information is exempt from disclosure under Section 40(2). This is because personal data (if disclosed) would breach any of the data protection principles.
14.How does the Trust plan to reduce SECLUSIONS in the future?
The Trust continues to adopt and support the three main domains under PCREF:
- Leadership and governance: trusts’ boards will be leading on establishing and monitoring concrete plans of action to reduce health inequalities
- Data: new data set on improvements in reducing health inequalities will need to be published, as well as details on ethnicity in all existing core data sets.
- Feedback mechanisms: visible and effective ways for patients and carers to feedback will be established, as well as clear processes to act and report on that feedback.
Additionally, we are focusing our learning through the MHLDA quality transformation Programme, which aims to improve positive patient outcomes through greater understanding. Ensuring greater knowledge around Ethnicity, Equality, Neuro Diversity, and Trauma Informed approaches, all that will actively influence least restrictive practice.
Finally, as a Trust we have recently reviewed the Governance surrounding Use of Force, Reducing Restrictive Practice, and Violence and Aggression providing a clearer and more accountable structure which is responsive to learning from incidents leading changes in practice.
I trust this information meets your needs. However, if you are dissatisfied with our response to your enquiry, you can ask for an internal review to be carried out into the handling / outcome of our response.
If you want us to carry out a review, please let us know within 40 working days.
If you are still dissatisfied after our internal review, you can complain to the Information Commissioner’s Office (ICO). You should make complaints to the ICO within six weeks of receiving the outcome of an internal review. The easiest way to lodge a complaint is through their website: www.ico.org.uk/foicomplaints.
Yours sincerely,
Rachel Gomm
Interim Chief Nurse