FOI Reference number: 90746
Freedom of Information Team
Suite 6, Carew House
Beacon Technology Park
Dunmere Road
Bodmin
PL31 2QN
Call 01208 834 496
Email cpn-tr.freedomofinformation@nhs.net
Date: 16 May 2024
Emailed to: Wendy Micklewright
mrs.wendy.micklewright@proton.me
To whom it may concern
Freedom Of Information Act 2000
Thank you for your request for information as detailed below, together with our reply.
Date range for all questions 1 January 2023 – 31 December 2023.
- Please supply patient’s information ECT leaflet.
Answer: This information has already been provided – in response to FOI 90174.
- Please supply patient ECT consent form.
Answer: This information has already been provided – in response to FOI 90174.
- Please supply any ECT reports/investigations.
Answer: The Trust is exempt from providing the requested information in accordance with section 40 of the Freedom of Information Act as internal reports may contain information from which individuals may be identified. However, if you are aware of a certain report that you would like to receive, please submit a further freedom of information request and the Trust will determine if it is able to provide it.
- How many ECT in 2023?
Answer: From 1 January 2023 to 31 December 2023 there were 396 ECT treatments in total. 20 patients were treated.
- What proportion of patients were men/women?
Answer:
- Men = 4
- women = 16
- How old were they?
Answer: The age range was between 33 years old and 81 years old.
- What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Answer: Out of the 20 patients that received ECT between 1 Jan 23 and 31 Dec 23, 2 patients were of POC / BAME.
- How many people covered by the equality act received ECT?
Answer: Of the 20 patients treated with ECT between 1 January 2023 and 31 December 2023, all were covered by the Equality Act.
- How many people were offered talking therapy prior to ECT?
Answer: All patients are offered talking therapy, unless too unwell and require emergency treatment.
- How many were receiving ECT for the first time?
Answer: This information is not collected in a reportable format. To collate the information requested would require the review of all the 396 treatment records of ECT Services during this time frame and cross reference with patient records which would be 30 minutes per record and exceed the appropriate time limit. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
- How many patients consented to ECT?
Answer: All 20 patients either consented to ECT or were treated under the Mental Health Act with a second opinion in place.
12.How many ECT complaints were investigated outside the NHS and CCG?
Answer: The Trust does not hold information on the number of complaints investigated outside of the NHS/CCG. Please note that Clinical Commissioning Groups have been replaced by Integrated Care Boards.
- How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
Answer: To collate the information requested would require the review of all incidents and cross reference with patient records and inquest reports during this time frame which would be 30 minutes per record and exceed the appropriate time limit. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
The Trust is not always advised of the death of a patient and hence the information, if collected, may not provide the information requested.
- How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
Answer: Please see answer provided to question 13.
- How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
Answer: The coroner determines how an individual has died. The Trust is not always made aware of the outcome of an inquest.
- How many patients have suffered complications during and after ECT and what were those complications?
Answer: There were nil complications reported on the Trust incident system for the period 1 January 2023 to 31 December 2023.
- Have there been any formal complaints from patients / relatives about ECT?
Answer: The Trust does not record ‘seclusion’ as a category from which it can report.
- If so, what was their concerns?
Answer: Not applicable, please see answer to question 17.
- How many patients report memory loss/loss of cognitive function?
Answer: The full information that you have requested is not held in an easily reportable format and would require the checking of individual patient records.
Collating this information would exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244. Under Section 12(1) of the Freedom of Information Act 2000, this information is exempt as a public authority is not obliged to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
- What tests are used to assess memory loss/loss of cognitive function?
Answer: Mini Ace and Part 17 of the Comprehensive Psychopathological Rating Scale (CPRS).
- Have MRI or CT scans been used before and after ECT?
Answer: MRI or CT scans would only be requested, before treatment, if a history of neurological/physiological problems had been identified. MRI and CT scans are not usually required following a course of treatment.
- If so, what was the conclusion?
Answer: Not applicable.
- How does the Trust plan to prevent ECT in the future?
Answer: Cornwall Partnership NHS Foundation Trust does not plan to prevent ECT.
- Please supply any restraints/investigations.
Answer: The Trust is exempt from disclosure under Section 40 of the Freedom of Information Act 2000, as releasing any internal investigation reports will contain information that constitutes personal information and may make individuals personally identifiable.
- How many restraints in 2023?
Answer: 1,057.
- What proportion of patients were men/women?
Answer:
- Males: 46.63%
- Females: 51.53%
- Other: 1.84%
- How old were they?
Answer:
- Under 17: 6.75%
- 18-19: 4.91%
- 20-29: 12.88%
- 30-39: 12.88%
- 40-49: 9.82%
- 50-59: 13.50%
- 60-69: 11.04%
- 70+: 26.38%
- What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Answer: 1.84%.
- How many people covered by the equality act were restrained?
Answer: Of the 1,057 restraints between 1 January 2023 and 31 December 2023, all people were covered by the Equality Act.
- How many restraints were investigated outside the NHS and CCG? 1 January 2023 – 31 December 2023.
Answer: The Trust does not hold information on the number of restraints investigated outside of the NHS/CCG. Please note that Clinical Commissioning Groups have been replaced by Integrated Care Boards.
- How many patients died during or 1 month after restraints and what was the cause (whether or not restraints were considered the cause)?
Answer: To collate the information requested would require the review of all incidents and cross reference with patient records and inquest reports during this time frame which would be 30 minutes per record and exceed the appropriate time limit. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
The Trust is not always advised of the death of a patient and hence the information, if collected, may not provide the information requested.
- How many patients died within 6 months after restraints and what was the cause (whether or not restraints were considered the cause)?
Answer: Please see the answer provided for question 31.
- How many patients died by suicide within 6 months of receiving restraints (whether or not restraints were considered the cause)?
Answer: Please see the answer provided for question 31.
- How many patients have suffered complications during and after restraints and what were those complications?
Answer: Please see the answer provided for question 31.
- Have there been any formal complaints from patients/relatives about restraints?
Answer: One.
- If so, what was their concerns?
Answer: The Trust is exempt from providing this information in accordance with section 40 of the Freedom of Information Act (FOI) where to reveal a low number could make the individuals personally identifiable, therefore breaching confidentiality.
- Are counts of forced injections available?
Answer: There are 231 incidents reported on the incident and reporting system where rapid tranquilisation is being used.
- How does the Trust plan to reduce restraints in the future?
Answer: The Trust was part of the National Patient Safety Improvement programme for reducing the incidence of restrictive practice in inpatient mental health and learning disability services by 50% by March 2024. Further information about the programme is available via this link https://www.england.nhs.uk/patient-safety/patient-safety-improvement-programmes/#MHSIP
Following on from the quality safety programme, the Trust maintains safety cross-monitoring of data regarding restrictive intervention and have also invested in management of aggression and violence (MAV) links on each of our inpatient units. These members of the team support patients and staff with learning from incidents and the development of Positive Behavioural Support plans.
39.Please supply any seclusion reports/investigations.
Answer: The Trust is exempt from disclosure under Section 40 of the Freedom of Information Act 2000, as releasing any internal investigation reports will contain information that constitutes personal information and may make individuals personally identifiable.
- How many seclusions in 2023?
Answer: 59.
- What proportion of patients were men/women?
Answer:
- Males: 46.15%
- Females: 53.85%
- How old were they?
Answer:
- Under 17: 15.38%
- 18-19: 0.00%
- 20-29: 15.38%
- 30-39: 15.38%
- 40-49: 30.77%
- 50-59: 23.08%
- 60-69: 7.69%
- 70+: 7.69%
- What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Answer: 0%.
- How many people covered by the Equality Act were secluded?
Answer: Of the 59 seclusions between 1 January 2023 and 31 December 2023, all people were covered by the Equality Act.
- How many seclusions were investigated outside the NHS and CCG?
Answer: The Trust does not hold information on the number of seclusions investigated outside of the NHS/CCG. Please note that Clinical Commissioning Groups have been replaced by Integrated Care Boards.
- How many patients died during or 1 month after seclusion and what was the cause (whether or not seclusion was considered the cause)?
Answer: To collate the information requested would require the review of all incidents and cross reference with patient records and inquest reports during this time frame which would be 30 minutes per record and exceed the appropriate time limit. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
The Trust is not always advised of the death of a patient and hence the information, if collected, may not provide the information requested.
- How many patients died within 6 months after seclusion and what was the cause (whether or not seclusion was considered the cause)?
Answer: Please see the answer provided for question 46.
- How many patients died by suicide within 6 months of receiving seclusion (whether or not seclusion was considered the cause)?
Answer: Please see the answer provided for question 46.
- How many patients have suffered complications during and after seclusion and what were those complications?
Answer: Please see the answer provided for question 46.
- Have there been any formal complaints from patients/relatives about seclusion?
Answer: The Trust does not record ‘seclusion’ as a category from which it can report.
- If so, what was their concerns?
Answer: Please see the answer provided for question 50.
- How does the Trust plan to reduce seclusions in the future?
Answer: The Trust was part of the National Patient Safety Improvement programme for reducing the incidence of restrictive practice in inpatient mental health and learning disability services by 50% by March 2024. Further information about the programme is available via this link https://www.england.nhs
Seclusions have reduced within the organisation, with much work gone into the amount of time someone is in seclusion and the monitoring and support from the wider multi-disciplinary team (MDT), and executive team is well embedded to support and challenge.
- Please supply any medication errors reports/investigations.
Answer: The Trust is exempt from disclosure under Section 40 of the Freedom of Information Act 2000. Internal investigation reports will contain information that constitutes personal information and may make individuals personally identifiable.
- How many medication errors in 2023?
Answer: 1,206.
- What proportion of patients were men/women?
Answer:
- Males: 46.67%
- Females: 51.70%
- Other: 1.63%
- How old were they?
Answer:
- Under 17: 3.95%
- 18-19: 1.77%
- 20-29: 4.49%
- 30-39: 4.49%
- 40-49: 7.76%
- 50-59: 8.44%
- 60-69: 12.11%
- 70+: 55.51%
- What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Answer: 0.41%.
- How many people covered by the Equality Act endured medication errors?
Answer: Of the 1,206 medication errors between 1 January 2023 and 31 December 2023, all people were covered by the Equality Act.
- How many medication errors were investigated outside the NHS and CCG?
Answer: The Trust does not hold information on the number of medication errors investigated outside of the NHS/CCG. Please note that clinical commissioning groups have been replaced by integrated care boards.
- How many patients died during or 1 month after medication errors and what was the cause (whether or not medication errors were considered the cause)?
Answer: To collate the information requested would require the review of all incidents and cross reference with patient records and inquest reports. during this time frame which would be 30 minutes per record and exceed the appropriate time limit. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
The Trust is not always advised of the death of a patient and hence the information, if collected, may not provide the information requested.
- How many patients died within 6 months after medication errors and what was the cause (whether or not medication errors were considered the cause)?
Answer: Please see the answer provided for question 60.
- How many patients died by suicide within 6 months of receiving medication errors (whether or not medication errors were considered the cause)?
Answer: Please see the answer provided for question 60.
- How many patients have suffered complications during and after medication errors and what were those complications?
Answer: To collate the information requested would require the review of all incidents and cross reference with patient records and inquest reports during this time frame which would be 30 minutes per record and exceed the appropriate time limit. The
limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours. The time to extract the information would exceed 18 hours and would, therefore, exceed the ‘appropriate limit’ as defined in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244.
- Have there been any formal complaints from patients/relatives about medication errors?
Answer: One.
- If so, what was their concerns?
Answer: The Trust is exempt from providing specific information in accordance with section 40 of the Freedom of Information Act (FOI) where to reveal the numbers less than 10 could constitute personal information more likely than not to make the individuals personally identifiable.
- How does the Trust plan to prevent medication errors in the future?
Answer: The Trust has moved to Electronic Medications Prescribing. Medication incidents are identified as a local priority within the Trust’s 2023/24 patient safety incident response plan. The Trust has a medications safety officer who works within the pharmacy team to review safety concerns.
If you have any further queries, please contact me.
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If you are not satisfied with the response to your request, you have the right to an internal review. The handling of your request will be looked at by someone who was not responsible for the original case, and they will decide as to whether your request was managed correctly.
If you would like to request a review, write to: Head of Information Governance, Cornwall Partnership NHS Foundation Trust, Suite 6, Carew House, Beacon Technology Park, Dunmere Road, Bodmin, PL31 2QN.
If you remain dissatisfied, after an internal review decision, you have the right to apply to the Information Commissioner’s Office. The commissioner is an independent regulator who has the power to direct the Trust to respond to your request differently, if it is considered that your request was managed incorrectly. Write to: Information Commissioners, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF.
The Trust continually strives to provide the best possible service to people who request information using the Freedom of Information Act 2000 legislation. To help achieve this, the Trust would be most grateful if you would complete and return a satisfaction survey via this link: https://forms.office.com/e/Xtj5e98Xs4
Yours sincerely
Sarah James
Chief Governance and Improvement Officer