Thank you for your request for information under the Freedom of Information Act 2000.

I can confirm that our response is:

Request:

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

Response:

The Trust has now had the opportunity to fully consider your request and responds as follows:

ECT information:

Please see attached patient information leaflet.

Please see attached Consent Form 1 for informal patients or those consenting to treatment.

Consent Form 4 is for patient not consenting to treatment or lacking capacity.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust is unable to release any ECT reports/investigations into the public domain to avoid the potential risk of individual identification and disclosure of highly sensitive personal information (special category personal data).
 

Furthermore, local reports from the ECT Accreditation Service (ECTAS) are provided in confidence in line with their confidentiality statement (please see below), therefore we are also applying exemption 41 to your request. It is ECTAS's expectation that the obligation to maintain confidentiality will be complied with, as this is an important part of the process working effectively to help improve the quality of services and patient care.

ECT Accreditation Service Confidentiality Statement:
The data contained within this booklet are confidential and not to be disseminated to anyone outside the host team or peer review team named inside this booklet without the permission of the host team or ECTAS. Any copies, electronic or paper, of this booklet retained by members of the review team after the service has received accreditation, should be destroyed. There is a publication strategy allowing ECTAS to publish the anonymous aggregated data in national reports, on its website and in appropriate scientific journals.

There were 86 clinics in 2020.
 

There were eight male patients and 14 female patients for ECT in 2020.
 

The patient age group for 2020 ranges from being born in 1939 to 1996.
 

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 we are unable to provide the ages of each patient in order to avoid the potential risk of individual identification.  

<5.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.  

11 of the patients had not previously had ECT.

There were 14 patients consenting to treatment.

0.

0.
0.
0.

There are no patients identified as having complications during or after their ECT treatment.

No.

N/A.

 

2.5 working days locating, retrieving and extracting the required information).

The tool we would use is the MMSE.

Patients would not have a MRI or CT scan before and after ECT treatment unless there were concerns before or after treatment. There were <5 patients that had MRI's prior to treatment in 2021.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.  

The conclusion of the MRI's was that there were no concerns regarding the outcomes of the MRI's, and that they were fit for treatment.

ECT is used in line with NICE guidance N90 to gain fast and short-term improvement of severe symptoms of a depressive illness, a prolonged or severe episode of mania, or catatonia after all other treatment options have failed, or when the situation is thought to be life-threatening. Dorset HealthCare are exploring other alternative options such as the use of rTMS as a future treatment option.

SERIOUS INCIDENT information:

There have been no reported incidents that meet the criteria for a serious incident investigation.

There have been no reported incidents that meet the criteria for a serious incident investigation.

N/A.

N/A.
N/A.

The Trust only investigates incidents within Trust services; we are unable to answer for other providers.

We are only able to answer the question in relation to the number of patients who have died unexpectedly during 2020 that were investigated as a serious incident: 28 deaths This does not indicate that the serious incident was the cause of death. The cause of death is determined by HM Coroner.

We are only able to answer the question in relation to the number of patients who have died unexpectedly during 2020 that were investigated as a serious incident: 28 deaths. The cause of death is determined by HM Coroner and we have only been provided with this for 14 patients. Causes of death include hanging, drowning, subdural and brainstem haemorrhage, drug overdose, multiple drug toxicity, Hypoxic Ischaemic Encephalopathy.

A conclusion of suicide can only be given by HM Coroner; this is not something we have on record.

Complications have been defined as injury or death that had a serious incident investigation.

In 2020 there were 28 deaths, 7 fractures, <5 drug overdoses.
Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.

No.

N/A.

The Trust is working to the national Patent Safety Strategy.
 

1,479 incident forms which includes incidents where restraint was used to carry out essential care (physical intervention only.

Excludes incidents where there was seclusion and rapid tranquilisation as this data is provided in later questions).

1,571 individual restraints across 1,479 incidents (includes incidents where restraint was used to carry out essential care).

Female - 133 - 50%
Male - 131 - 50% 38 - Age:
Under 18 - 13
18-24 - 33
25-34 - 45
35-44 - 23
45-54 - 25
55 to 64 - 36
Over 65 - 89
Total Patients 2020 - 264.

Includes incidents where restraint was used to carry out essential care.

Using the incident reporting system for numbers of restraints occurring does not provide ethnicity data. This would involve review of each clinical record and exceed time allowed.
 

Consequently, under Section 12 (cost limit) of the Freedom of Information Act 2000 we are applying an exemption to your request. The information requested is not centrally recorded to the level of detail specified in your request. To collate this data would exceed the permitted cost limit of £450 (this represents the estimated cost of one person spending 2.5 working days locating, retrieving and extracting the required information).

We only investigate restraint which occur within Trust patients.

<5. Please note, all of these patients were aged 77+, the average age is 80. Cause of death unavailable.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.  

20. Please note, 19 of these patients were aged 70+ and the average age of these patients was 80. Cause of death unavailable.

No cases of suicide within six months of restraint.

Under Section 12 (cost limit) of the Freedom of Information Act 2000 we are applying an exemption to your request. The information requested is not centrally recorded to the level of detail specified in your request. To collate this data (manual trawl through medical records) would exceed the permitted cost limit of £450 (this represents the estimated cost of one person spending 2.5 working days locating, retrieving and extracting the required information).

No.

N/A.

292 incidences of rapid tranquilisation in 2020.
 

The Trust has a regular meeting which reviews all use of restraint and identifies any learning.
 

This includes good practice as well as learning from incidents.
We are looking at the following areas:
Safe wards implementation.
Staff induction including therapeutic engagement, PMVA.
Recruitment of staff.
Ward environment.
Risk assessment.
Training.
RRN self-assessment against standards.
NAPICU guidance.
Safe staffing and therapeutic offer.
We are piloting body worn cameras in our HBPoS suite.
We are part of a Wessex Patient Safety Collaborative.

Request:

1. - Please supply any SECLUSION reports/investigations
2. - How many SECLUSIONS in 2020?
3. - What proportion of patients were men/women?
4. - How old were they?
5. - What proportion of patients were classified BAME?
6. - How many SECLUSIONS were investigated outside the NHS and CCG?
7. - How many patients died during or 1 month after SECLUSION and what was the cause (whetheror not SECLUSION was considered the cause)?
8. - How many patients died within 6 months after SECLUSION and what was the cause (whether ornot SECLUSION was considered the cause)?
9. - How many patients died by suicide within 6 months of receiving SECLUSION (whether or notSECLUSION was considered the cause)?
10. - How many patients have suffered complications during and after SECLUSION and what werethose complications?
11. - Have there been any formal complaints from patients/relatives about SECLUSION?
12. - If so, what was their concerns?
13. - How does the Trust plan to prevent SECLUSION in the future?

1. - Please supply any MEDICATION ERRORS reports/investigations
2. - How many MEDICATION ERRORS in 2020?
3. - What proportion of patients were men/women?
4. - How old were they?
5. - What proportion of patients were classified BAME?
6. - How many MEDICATION ERRORS were investigated outside 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)?
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)?
9. - How many patients died by suicide within 6 months of receiving MEDICATION ERRORS(whether or not MEDICATION ERRORS was considered the cause)?
10. - How many patients have suffered complications during and after MEDICATION ERRORS andwhat were those complications?
11. - Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
12. - If so, what was their concerns?
13. - How does the Trust plan to prevent MEDICATION ERRORS in the future?

Response: SECLUSION

The Trust has now had the opportunity to fully consider your request and responds as follows:

1. - 81.
2. - 81.
3. - 2020: Female 28%,Male 73%.
4. - Age Range Total Individual Patients

18-24 = 8
25-34 =14
35-44 = 7
45-54 = <5
55-64 = <5
65+ = <5
Total Patients 2020 = 40

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying a partial exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.  

We are unable to answer this question as our records hold incomplete data in respect of BAMEclassification.

Episodes of seclusion are only investigated by the Trust when patients are in receipt of Trust care;we are unable to provide a response for other providers.

No cases of death within one month of seclusion.
<5. Not due to seclusion. No cause of death available on our incident reporting system.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification.  

No cases of suicide within six months of seclusion.

Under Section 12 (cost limit) of the Freedom of Information Act 2000 we are applying anexemption to your request. The information requested is not centrally recorded to the level of detail specified in your request. To collate this data (manual trawl through medical records) would exceed the permitted cost limit of £450 (this represents the estimated cost of one person spending 2.5 working days locating, retrieving and extracting the required information).

No.

N/A.

Medication errors information

551 incidents reported relating to medication. Excludes near miss and prevented incidents.

708 medication errors reported within the 551 incidents. Excludes near miss and preventedincidents.

2020: Female 52%,Male 48%. Excludes near miss and prevented incidents.

Under 18 = 9
18-24 = 20
25-34 = 32
35-44 = 34
45-54 = 35
55-64 = 36
65+ = 261

Total Patients 427. Excludes near miss and prevented incidents.

We are unable to answer this question as our records hold incomplete data in respect of BAMEclassification.

We are unable to provide details of investigations of medication errors outside of Trust patientsreceiving care.

42. No cause of death available.

82. No cause of death available.

None.

Under Section 12 (cost limit) of the Freedom of Information Act 2000 we are applying anexemption to your request. The information requested is not centrally recorded to the level of detail specified in your request. To collate this data (manual trawl through medical records) would exceed the permitted cost limit of £450 (this represents the estimated cost of one person spending 2.5 working days locating, retrieving and extracting the required information).

<5.

Under Section 40 (2) of the Freedom of Information Act 2000 we are applying an exemption to your request. In accordance with the General Data Protection Regulation (GDPR) 2018 Dorset Healthcare University NHS Foundation Trust does not release statistics below 5, or those which could result in the calculation of statistics below 5, in order to avoid the potential risk of individual identification. 

Please see response to Q24 above. We are unable to provide details in order to avoid the potential risk of individual identification.

Prevention and learning from errors is supported by the Medication Safety Officer andmanaged through the Medication Safety Group. EPMA will be implemented within the next 12 months and we are working towards a single medication record across Wessex which will reduce errors with regard to medicine reconciliation.

The information supplied to you in this communication, continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting.

If you wish to re-use the information supplied, in whole or in part, for any other purpose e.g. commercial publications, please write to me stating what information you wish to re-use, the purpose(s) you wish to re-use the information for. We will respond within 20 working days of receiving your request with any conditions and charges that relate to the re-use of the information in accordance with the Re-use of Public Section Information Regulations 2005.

If you wish to discuss any of the above, please contact me, quoting the reference above.

If you are unhappy with the way in which we have handled your request, please contact myself in the first instance. If you wish to make a formal complaint, you should write to our Complaints Manager at Dorset HealthCare University NHS Foundation Trust, Trust HQ, Sentinel House, 4-6
Nuffield Road, Poole, Dorset BH17 0RB

If you are not content with the outcome of your complaint or the internal review, you may apply directly to the Information Commissioner for a decision. Generally, the Information Commissioner will only make a decision once you have exhausted the complaints and/or internal review process provided by us. The Information Commissioner can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF.
 
Yours faithfully
Freedom of Information Coordinator http://www.dorsethealthcare.nhs.uk/ Email: dhc.foi.enquiries@nhs.net