Coventry + Warwickshire partnership NHS trust 2020 data - Friendship group affiliated to HVN

Coventry + Warwickshire partnership NHS trust 2020 data

Our Ref: FOI - 2163

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

Request	Trust Response
1. Please supply patient’s information ECT leaflet.	Attached
2. Please supply patient ECT consent form.	Attached
3. Please supply any ECT reports/investigations	No patient safety investigations have been required to take place that involved the ECT suite.
4. How many ECT in 2020?	44 patients / 497 treatments
5. What proportion of patients were men/women?	Men – 16 / Women – 28
6. How old were they?	Age 19 x 2 Age 32 x 1 Age 38 x 2 Age 39 x 2 Age 43 x 3 Age 45 x 1 Age 47 x 2 Age 50 x 1 Age 51 x 3 Age 52 x 1 Age 53 x 1 Age 55 x 1 Age 57 x 1 Age 58 x 3 Age 59 x 1 Age 60 x 1 Age 61 x 2 Age 62 x 1 Age 63 x 1 Age 64 x 1 Age 68 x 1 Age 70 x 1 Age 71 x 2 Age 77 x 3 Age 78 x 1 Age 79 x 2 Age 82 x 1 Age 84 x 1 Age 89 x 1
7. What proportion of patients were classified BAME?	9 patients
8. How many were receiving ECT for the first time?	43 patients
9. How many patients consented to ECT?	27 patients
10. How many ECT complaints were investigated outside the NHS and CCG?	None
11. How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?	None
12. How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?	None
13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?	None
14. How many patients have suffered complications during and after ECT and what were those complications?	None
15. Have there been any formal complaints from patients/relatives about ECT?	No
16. If so, what was their concerns?	N/A
17. How many patients report memory loss/loss of cognitive function?	Follow up tests are carried out by the Consultant 14 days, 4 weeks, 8 weeks and 12 weeks after treatment However, following careful consideration, the Trust has estimated that the cost of complying with this part of your request would exceed the appropriate limit costs under Section 12 of the Freedom of Information Act 2000 and, therefore, the Trust is not obliged to comply with your request. The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 currently sets the appropriate costs limit at £450. This represents the estimated cost of one person spending 2½ (18 hours) working days in determining whether the Department holds the information and locating, retrieving and extracting the information. Under Section 12 of the Freedom of Information Act, the Trust is not obliged to comply with your request if this appropriate limit is exceeded. In summary, there are 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 this will therefore require manual searching. With this search requirement in mind please note that the Trust does not have capacity to fulfil this question and have applied the above exemption. Therefore, in accordance with Section 17 of the Freedom of Information Act 2000, please treat this response as a Refusal Notice in respect of the information that you have asked for in this question.
18. What tests are used to assess memory loss/loss of cognitive function?	MMSE / HAM-D (previously HADS) / Patient Experience of ECT
19. Have MRI or CT scans been used before and after ECT?	MRI and CT scans are not specifically undertaken before or after ECT treatment in all cases.
20. If so what was the conclusion?	N/A
21. 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.

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

Request

Trust Response

1. Please supply any serious incident reports/investigations

Following careful consideration, the Trust has estimated that the cost of complying with this part of your request would exceed the appropriate limit costs under Section 12 of the Freedom of Information Act 2000 and, therefore, the Trust is not obliged to comply with your request. The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 currently sets the appropriate costs limit at £450. This represents the estimated cost of one person spending 2½ (18 hours) working days in determining whether the Department holds the information and locating, retrieving and extracting the information. Under Section 12 of the Freedom of Information Act, the Trust is not obliged to comply with your request if this appropriate limit is exceeded.

In summary, serious incident reports that have been used as source data to support the coroner to conduct his or her review are already in the public domain and can be requested from the coroner’s office.

For Serious Incident investigations that focus on other issues than death, we would need to obtain consent from patients to support release.

Therefore, in accordance with Section 17 of the Freedom of Information Act 2000, please treat this response as a Refusal Notice in respect of the information that you have asked for in this question.

2. How many SERIOUS INCIDENT REPORTS in 2020?

3. What proportion of patients were men/women?

33 Female, 36 Male, 11 related to Organisational issue(s); i.e. ward closure due to infection.

4. How old were they?

Age bracket	Number of SIRI
Under 21	2
21 - 39	17
40 - 64	23
65+	27
Organisational issue	11
Total	80

5. What proportion of patients were classified BAME?

10 classified as BAME.

(4 other SIRI relate to patients where ethnic background is unknown).

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

None

7. 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)?

2 patients had died within 1 month of the SIRI.

Patient 1: Covid related death, patient on end of life pathway.

Patient 2: Congestive Heart Failure was recorded on the death certificate

8. 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)?

2 as above, and one more patient.

Patient 3: Patient who was being seen by the district nursing team. Patient was admitted to hospital due to deterioration in physical health and subsequently passed away.

9. How many patients died by suicide within 6 months of receiving SERIOUS INCIDENT REPORTS (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?

Zero

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

Please note that the Trust has provided this response in the absence of a definition of “complication”.

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

None in 2020 that focussed on a Serious Incident Report.

12. If so, what was their concerns?

N/A

13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?

The Trust takes action, where identified, to prevent future serious incidents occurring. Action taken is reported through the Trust’s governance structures.

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

Request

Trust Response

1. Please supply any Restraints/investigations

The Trust does not hold any specific investigation reports that focus solely on restraint.

2. How many RESTRAINTS in 2020?

1524

3. What proportion of patients were men/women?

Female: 759

Male: 765

4. How old were they?

Age Bracket	Number of restraints
Under 21	449
21 - 39	593
40 - 64	352
65+	69
Not Stated	61
Total	1524

5. What proportion of patients were classified BAME?

Ethnicity	Number of restraints
BAME	468
Not Stated	143
White	913
Total	1524

6. How many RESTRAINTS were investigated outside the NHS and CCG?

None

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

2 patients.

Patient 1: Covid-19

Patient 2: Discharged from Mental Health Inpatient Services to the Acute Sector following deterioration in physical health, cause of death unknown.

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

2 patients as above.

Patient 3: Cause of death unknown, client was on end of life care.

Patient 4: Cause of death awaited.

Patient 5: Suicide.

Patient 6: Cause of death unknown.

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

1 patient (patient 5 as above).

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

1524 restraints in period. To answer this question will require a review of Carenotes. 15 minutes each restraint equates to 381 hours.

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

1 complaint

12. If so, what was their concerns?

Number of times physical restraint was used.

13. Are counts of forced injections available?

The Trust does not use the terminology forced injection and therefore does not hold information that supports responding to this request.

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

Following national guidance, clinical risk assessments and formulation, use of positive behaviour support plans, involving patients in care planning, therapeutic engagement, training including de-escalation and debrief post restraint events.

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

Request

Trust Response

1. Please supply any SECLUSION reports / investigations

The Trust does not hold any specific investigation reports that focus solely on restraint.

2. How many SECLUSIONS in 2020?

312

3. What proportion of patients were men/women?

Female: 170

Male: 142

4. How old were they?

Age Bracket	number of seclusions
Under 21	19
21 - 39	150
40 - 64	114
Not Stated	29
Total	312

5. What proportion of patients were classified BAME?

Ethnicity	number of seclusions
BAME	68
Not Stated	24
White	220
Total	312

6. How many SECLUSIONS were investigated outside the NHS and CCG?

None

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

Zero

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

None

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

None

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

In summary, the Trust is unable to provide any information regarding this question as we are unable to review seclusions in the period. To obtain the answer we need to review Carenotes for each incident. 15 minutes per seclusion equates to 78 hours.

Therefore, in accordance with Section 17 of the Freedom of Information Act 2000, please treat this response as a Refusal Notice in respect of the information that you have asked for in this question.

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

12. If so, what was their concerns?

n/a

13. How does the Trust plan to prevent SECLUSION in the future?

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

Request

Trust Response

1. Please supply any MEDICATION ERRORS reports/investigations

2. How many MEDICATION ERRORS in 2020?

296

3. What proportion of patients were men/women?

Female: 145

Male: 123

Not stated/ not patient related: 28

4. How old were they?

Age bracket	Number of incidents
Under 21	30
21 - 39	61
40 - 64	67
65+	90
not stated/ not patient related	48
Total	296

5. What proportion of patients were classified BAME?

Ethnicity	Number
BAME	39
White	183
Not stated / not patient related	74
Total	296

6. How many MEDICATION ERRORS were investigated outside the NHS and CCG?

No medication errors have been investigated outside of the NHS and CCG

7. 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)?

None

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

None

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

None

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

The majority of the trust’s reported medication errors were classed as either no harm, or low harm. Therefore these patients did not experience complications. Of the year’s medication errors, 7 were rated as having a moderate (short term harm – further treatment).

A summary of the impact is described below:

Morning and evening doses of insulin inadvertently switched. Patient had hypoglycaemia requiring hospital treatment. Recovered with no issues

Missed evening dose of their medications given via feeding tube. No observed impact on patient, but rated as moderate as needed to observe

Missed evening dose of a blood thinning injection. No observed impact on patient, but rated as moderate as needed to observe

Patient pregnant whilst on depot contraception. However wanted a termination in any case, and was referred for appropriate counselling

Received over sedation with lorazepam as 4mg given rather than 1mg, no lasting impact

Patient's pain relief syringe drive was not infusing, meaning that they did not receive their pain relief for 24 hours. Patient did not report any breakthrough pain, but classed as moderate impact as could have had potential for greater impact

Syringe driver had been set up with only half the required diluent. This resulted in the syringe drive occluding approximately 12-13 hours into the 24 hour dosing. Patient only received half their dose. No reported impact on the patient but rated as moderate and required observation.

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

12. If so, what was their concerns?

The concern raised was in respect of an incorrect dosage of medication (Depixol injection) that was administered as a result of conflicting information provided by mental health services to patients GP.

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

The trust structures support the safe use medication in a number of ways, and these will continue to help prevent medication errors in the future. These include

All medication errors are reviewed, and Learning Alerts and key lessons learnt are shared with clinical services
The Medicines Management Team provides pharmaceutical oversight and review to clinical services. This includes advice on safe use of medication
The Medicines Management Team reviews the safe and secure medicines handling processes within in-patient units and community teams
Drugs and therapeutics groups are in place for physical and mental health
Clinical services undergo targeted reviews of use of medication
Medicines Management Guidance is in place, guiding services on safe use of medications
Training is provided to nursing and care staff on safe and effective use of medication
Regular Medicines Management Newsletters are issued to clinical services