Friendship group affiliated to HVN

You asked us

Our reply

Please provide ECT information under the FOI act to the following questions: -

The Trust is exempt from providing the information requested as to do so 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. 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’. However, on this occasion the Trust has provided some of the information as a gesture of goodwill

Please supply patient’s information ECT leaflet

The information you have requested is exempt under Section 21 of the Freedom of Information Act 2000 - the requested information is already reasonably accessible to the applicant by other means.

The Trust’s ECT leaflet can be found within Cornwall Partnership NHS Foundation Trust’s website via the following links: https://www.cornwallft.nhs.uk/electro-convulsive-therapy-ect

Please supply patient ECT consent form

The consent form used is the standard form issued by the Department of Health

Please supply any ECT reports/investigations within your organisation or reports your organisation were involved with regarding ECT

Following your clarification that the information sought relates to 2021 the Trust can confirm that it is not aware of any internal or external ECT reports of investigations for this period of time.

However, if you are seeking a specific report, please submit a further FOI

How many ECT in 2021

461 sessions

What proportion of patients were men/women

Fifteen patients were female, and six patients were male.

How old were they

Age

1 – 49 - 1 person

50 – 59 - 7 people

60 – 69 - 3 people

70 – 79 - 6 people

80 – 89 - 4 people

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

none

How many were receiving ECT for the first time

15

How many patients consented to ECT

All patients consent to ECT treatment

How many ECT complaints were investigated outside the NHS and CCG

The Trust does not hold this information as the system does not record complaints investigated outside the NHS and CCG

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

The Trust does not hold this information as not all deaths will be known to the Trust For example, if a patient is no longer a current patient or where the death is expected and is not required to be reported to the coroner

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

See answer above

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

The Trust has not recorded any reports relating to the death by suicide of any patient within 6 months of receiving ECT. This response is based on information relating to 2021

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

Two patients suffered complications during and after ECT in 2021. The Trust is unable to release details of the complications as to do so may identify an individual

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

The Trust does not hold this information as the systems do not record formal complaints about specific treatments

If so, what was their concerns

How many patients report memory loss/loss of cognitive function

Of the twenty-one records reviewed five patient records identify reported memory loss

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

Mini Addenbrookes cognitive test self reporting scale

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

The Trust does not routinely use MRI or CT scans before or after ECT. These tests would only be conducted if a doctor felt there was a clinical indication

If so, what was the conclusion

See answer above

How does the Trust plan to prevent ECT in the future

The Trust does not plan to prevent ECT. ECT is provided to patients for whom it is clinically indicated and in line with NICE guidelines

Please supply any serious incident reports/investigations

The Trust is exempt from providing this information in accordance with section 40 of the Freedom of Information Act (FOI); as releasing any internal investigation reports will contain information that may make individuals personally identifiable

How many SERIOUS INCIDENT REPORTS in 2021

Sixty-three incidents were reported as serious incidents during 2021. One serious incident involved multiple patients and staff and related to covid nosocomial transmission and has, therefore, not been included in the data below

What proportion of patients were men/women

42 were male, 20 were female

How old were they

Age

1 – 19 - 2 people

20 – 29 - 8 people

30 – 39 - 4 people

40 - 49 - 9 people

50 – 59 - 7 people

60 – 69 - 4 people

70 – 79 - 5 people

80 – 89 - 13 people

90 – 100+ - 10 people

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

48 patients identified as white British and 14 records do not have ethnicity recorded

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

The Trust does not hold this information as the systems do not record serious incident reports investigated outside the NHS or to the CCG

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)

The Trust does not hold this information as not all deaths will be known to the Trust. For example, if a patient is no longer a current patient or where the death is expected and is not required to be reported to the coroner.

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)

Please see answer above

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

Please see answer above

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

The Trust does not capture data relating to how many patients have suffered complications during and after a serious incident report

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

The Trust does not hold this information

If so, what was their concerns

Please see answer above

How does the Trust plan to prevent SERIOUS INCIDENTS in the future

The Trust has adopted the NHS England Patient Safety Incident Investigation Framework which provides a more systematic approach to identifying, learning and implementing appropriate actions. For more information, please see the following link on the Trust’s website:

https://www.cornwallft.nhs.uk/patient-safety-incident-response-framework-psirf

Please supply any Restraints/investigations

The Trust is exempt from providing this information in accordance with section 40 of the Freedom of Information Act (FOI); as releasing any internal investigation reports will contain information may make individuals personally identifiable.

How many RESTRAINTS in 2021

1,054

What proportion of patients were men/women

Men 70%, Women 29% *Other 1%. Please note *other – patients did not identify as male or female.

How old were they

Age

11 – 20 - 283 people

21 – 30 - 279 people

31 – 40 - 133 people

41 – 50 - 63 people

51 – 60 - 73 people

61 – 70 - 52 people

71 – 80 - 95 people

81 – 91 - 76 people

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

1.14%

How many RESTRAINTS were investigated outside the NHS and CCG

The Trust does not hold this information as the systems do not record this data

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 have died during restraint. The response is based on data for 2021 as per Q4 in the initial section of the response. The Trust does not hold information relating to deaths one month, or more, after restraint as the Trust is not routinely advised of patient deaths.

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

Please see answer above

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

Please see answer above

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

The Trust does not hold information in a reportable format relating to whether a patient experienced harm under restraint. This would be expected to be reported as an incident, but this is not an incident category. To collate this information would require manually checking 1,054 restraint incidents taking approximately two minutes per restraint. Therefore, 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. 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’

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

The Trust does not hold this information as the systems do not record this data

If so, what was their concerns

Not applicable

Are counts of forced injections available

There are 172 counts of rapid tranquiliser injections recorded for 2021.

Please note ‘Forced’ injections are not recorded separately. To identify which of these injections were forced would entail manually reviewing each individual record taking approximately 8 minutes per record.

Therefore, 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. 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’

How does the Trust plan to reduce restraints in the future

The Trust promotes trauma informed care and this enables the creation of individualised, least restrictive interventions.Learning from experience aids the development of staff understanding of proactive measures to avoid a restraint. The Trust is part of The National Mental Health Improvement programme for reducing the incidence of restrictive practice in inpatient mental health and learning disability services.

Please supply any SECLUSION reports/investigations

The Trust is exempt from providing this information in accordance with section 40 of the Freedom of Information Act (FOI); as releasing any internal investigation reports will contain information that may make individuals personally identifiable

How many SECLUSIONS in 2021

76

What proportion of patients were men/women

Male 65.8%, Female 31.6% Other 2.6%

How old were they

Age Amount

11 - 20 17

21 – 30 16

31 – 40 17

41 – 50 5

51 – 60 13

61 – 80 8

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

1.32%

How many SECLUSIONS were investigated outside the NHS and CCG

The Trust does not hold this information as the systems do not record this data

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 died during seclusion in 2021/ The Trust does not hold information relating to how many patients died 1 month, or later,after seclusion as not all deaths will be known to the Trust eg. where the patient is no longer a current patient or where the death is expected and has not been reported to the coroner.

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

Please see answer above

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

Please see answer above

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

The Trust does not hold information in a reportable format relating to how many patients have suffered complications during and after seclusion. To collate this information would require manually checking 135 restraints taking approximately ten minutes per record. Therefore, 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. 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’

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

The Trust does not hold this information as the systems do not capture this data

If so, what was their concerns

Not applicable

How does the Trust plan to reduce SECLUSIONS in the future

The Trust adopts a least restrictive practice approach when it comes to delivering care. Staff utilise proactive measures to avoid the use of seclusion where possible. By using positive behaviour support staff can identify triggers and put measures in place to help support the individual in crisis. The Trust has adopted the good practice promoted by the Mental health improvement programme

Please supply any MEDICATION ERRORS reports/investigations

The Trust is exempt from providing this information in accordance with section 40 of the Freedom of Information Act (FOI); as releasing any internal investigation reports will contain information that may make individuals personally identifiable

How many MEDICATION ERRORS in 2021

931

What proportion of patients were men/women

Female 53%, Male 46%, Other 1%

How old were they

Age

01 - 10 17 people

11 – 20 58 people

21 – 30 66 people

31 – 40 77 people

41 – 50 76 people

51 – 60 97 people

61 – 70 85 people

71 – 80 187 people

81 – 90 216 people

91 – 100 52 people

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

1.72%

How many MEDICATION ERRORS were investigated outside the NHS and CCG

The Trust does not hold this information as the systems do not record this data

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)

No patients died during medication errors in 2021. The Trust does not hold information relating to how many patients died 1 month, or more, after medication errors as not all deaths will be known to the Trust eg. where the patient is no longer a current patient or where the death is expected and has not been reported to the coroner

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

Please see answer above

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

Please see answer above

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

The Trust does not hold this information in a reportable format if a patient had suffered complications during and after a medication

error. This would be expected to be reported as an incident, but we do not have a particular category to enable us to identify the information requested. To collate this information would required manually checking 931 medication errors taking approximately two minutes per medication

error. Therefore, 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. The limit for this organisation is £450 calculated at a rate of £25 per hour to a maximum of 18 hours.

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

The Trust does not hold this information as systems do not record this data

If so, what was their concerns

Not applicable

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

The Trust holds learning from experience meetings, discussions are held at regular forums and staff training is accessible. The Trust also has a designated medications safety officer who reviews incidents and supports the identification of learning.