Freedom of Information Request
Reference Number: EPUT.FOI.20.1514
Date Received: 16 April 2020
Information Requested:
FOI request for Mental Health institutions in the UK – for 2019
Please provide ECT information under the FOI act to the following questions:
Please supply patient’s information ECT leaflet
Basildon – Please see attached
Colchester – Please see attached
The Linden Centre – Please see attached
Please supply patient ECT consent for
Basildon – Please see attached
Colchester – Please see attached
The Linden Centre – Please see attached
Please supply any ECT reports/investigations
Basildon – Non
Colchester – None
The Linden Centre – None
How many ECT in 2019?
Basildon – 468 Treatments
Colchester – 163 Treatments
The Linden Centre – 241 Treatments
What proportion of patients were men/women?
Basildon – Men 7 and Women 28
Colchester – Men 6 and Women 8
The Linden Centre – Men 11 and Women 13
How old were they?
Basildon – Between 25 – 75+
Colchester – Between 27 - 88
The Linden Centre – Between 26 - 84
What were the diagnoses and in what proportions?
Basildon – 31 Severe Depressive Disorder, 1 Catanoic, 1 Bipolar Affection Disorder, 1 Paranoid Schizophrenia, 1 Schizo Affective Disorder
Colchester – This information for Colchester is not held in the ECT records. Patients will be diagnosed by the Patient’s Registered Consultant
The Linden Centre – 1 anxiety disorder; 3 depression with psychosis and 20 severe depression
What proportion of patients were classified BAME?
Basildon – 2
Colchester – 0
The Linden Centre – 2
How many were receiving ECT for the first time?
Basildon – 8
Colchester – 8
The Linden Centre – 10
How many patients consented to ECT?
Basildon – 31
Colchester – 8
The Linden Centre – 17
How many ECT complaints were investigated outside the NHS and CCG?
Basildon – None
Colchester – None
The Linden Centre – None
How many patients died during or soon after ECT and what was the cause (whether or not ECT was considered the cause)?
Basildon – None
Colchester – None
The Linden Centre – None
How many patients died a few months after ECT and what was the cause (whether or not ECT was considered the cause)?
Basildon – None
Colchester – None
The Linden Centre – None
How many patients died by suicide within a few months of receiving ECT (whether or not ECT was considered the cause)?
Basildon – None
Colchester – None
The Linden Centre – None
How many patients have suffered complications during and after ECT and what were those complications?
Basildon – None
Colchester – One acute bradycardia after treatment
The Linden Centre – None
Have there been any formal complaints from patients/relatives about ECT?
Basildon – No
Colchester – No
The Linden Centre – No
If so, what was their concerns?
Basildon – N/A
Colchester – N/A
The Linden Centre – N/A
How many patients report memory loss/loss of cognitive function?
Basildon – 2
Colchester – Clinical documentation are on inpatient record keeping
The Linden Centre – None
What tests are used to assess memory loss/loss of cognitive function?
Basildon – The Montgomery–Åsberg Depression Rating Scale
(MADRS The Montreal Cognitive Assessment (MOCA)
Colchester – MMSE and MADRS
The Linden Centre – Mimi ACE and MADRS
Have MRI or CT scans been used before and after ECT?
Basildon – None
Colchester – None
The Linden Centre – None
If so what was the conclusion?
Basildon – N/A
Colchester – N/A
The Linden Centre – N/A
How does the Trust plan to prevent ECT in the future?
Basildon – ECT is an effective and lifesaving treatment for people with severe Mental Health Conditions. There are no plans to prevent ECT in the future.
Colchester – N/A
The Linden Centre – Through giving ECT to patients as a last resort. Currently, the Trust gives ECT to patients as a last resort and other treatment options are always considered first before ECT is given.
Please provide SERIOUS INCIDENT information under the FOI act to the following questions: -
Please Note – For the above questions relating to Serious Incident:
In order to provide context to these answers, the Trust feels it may be useful to clarify the term “serious incident report(s)”. A serious incident is defined by NHS England as “an event in health care where the potential for learning is so great, or the consequences to patients, families and carers, staff or organisations are so significant, that they warrant using additional resources to mount a comprehensive response. Serious incidents can extend beyond incidents which affect patients directly and include incidents which may indirectly impact patient safety or an organisation’s ability to deliver ongoing healthcare”. Following the identification of a serious incident, an investigation into the incident is carried out and a comprehensive investigation report is produced which identifies contributory factors and lessons learnt. The findings of investigations are shared with patients/families and within the Trust to share the learning identified.
Please supply SERIOUS INCIDENT REPORTS patient’s information leaflet. EPUT does not have a Serious Incident Reports information leaflet. Following a serious incident, the Trust allocates a Family Liaison Officer who provides information and support to the patient/family. The attached leaflets are provided as appropriate.
Please supply patient SERIOUS INCIDENT REPORTS consent form. No consent form is required for the serious incident investigation to take place
Please supply any serious incident reports/investigations
The Trust is unable to provide completed SI reports as they contain person identifiable information which is exempt under Section 40 (Personal Information) of the Act.
How many SERIOUS INCIDENT REPORTS in 2019?
111
What proportion of patients were men/women?
37 Females
74 Males
How old were they?
Females aged between 14yrs -89yrs
Males aged between 20yrs -89yrs
What were the diagnoses and in what proportions?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each individual report and then cross reference with the patient’s electronic records. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
What proportion of patients were classified BAME?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each patient record. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
How many were receiving SERIOUS INCIDENT REPORTS for the first time? The Trust is unable to answer this question as people do not receive a serious incident report.
How many patients consented to SERIOUS INCIDENT REPORTS?
A serious incident investigation is undertaken by the Trust in line with the NHS Serious Incident Framework for the purposes of learning to prevent a reoccurrence. NHS Trusts are not required to gain patients’ consent to carry out a serious incident investigation, however issues of consent are considered during the investigation process and prior to finalisation of the report. Reports are anonymised to protect confidentiality.
How many SERIUOS INCIDENT REPORTS were investigated outside the NHS and CCG?
2
How many patients died during or soon after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
A serious incident is in response to an incident that covers a range of incidents not necessarily death
How many patients died a few months after SERIOUS INCIDENT REPORTS and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
As above
How many patients died by suicide within a few months of receiving SERIOUS INCIDENT REPORTS (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
As above
How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?
As above
Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
1 complaint following a SI report
If so, what was their concerns?
Questions related to Custom and Practice with in the trust
How many patients report memory loss/loss of cognitive function?
Please see response to Question 2g
What tests are used to assess memory loss/loss of cognitive function? EPUT has a variety of services that may employ cognitive testing. All services utilise clinically validated, approved tools, following the best practice guidelines for that service, such as NICE Guideline NG97 for Dementia, which is followed by Memory Assessment Services. There are many evidence based cognitive assessment tools available to the clinicians in EPUT and appropriate tools are selected for assessing each person based the environment of test, requirement of testing and on individual presentation, amongst other factors. Some of the tools used within EPUT include Montreal
Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination (ACEIII), The Informant Questionnaire on Cognitive Decline in the Elderly
(IQCODE), Dementia Screening Questionnaire for Individuals with
Intellectuals Disabilities (DSQIID ) and many others. Memory is a domain of cognitive function, with the others being attention, orientation, fluency, language and visuospatial skills. Individual domains are not normally tested independently. Cognitive testing may be used for many reasons, such as to identify possible dementia or learning difficulty and in recovery from illness where cognition has been impacted.
Have MRI or CT scans been used before and after SERIOUS INCIDENT REPORTS?
No
If so what was the conclusion?
N/A
How does the Trust plan to prevent SERIOUS INCIDENTS in the future? The Trust continues to work in line with the NHS Serious Incident Framework, identifying learning to prevent reoccurrences.
3. Please provide restraints information under the FOI act to the following questions: -
Please supply RESTRAINTS patient’s information leaflet.
Not available
Please supply patient RESTRAINTS consent form.
Not available
Please supply any Restraints/investigations
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many RESTRAINTS in 2019?
1947
What proportion of patients were men/women?
Female - 66%
Male - 34%
How old were they?
<18 - 39%
19 – 64 - 51%
65+ - 10%
What were the diagnoses and in what proportions?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each patient record. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
What proportion of patients were classified BAME?
10.5%
How many were receiving RESTRAINTS for the first time?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each patient record. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
How many patients consented to RESTRAINTS?
Not recorded
How many RESTRAINTS were investigated outside the NHS and CCG? Not recorded
How many patients died during or soon after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
No patients died during restraints or as a result of restraints.
How many patients died a few months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many patients died by suicide within a few months of receiving
RESTRAINTS (whether or not RESTRAINTS was considered the cause)? The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many patients have suffered complications during and after RESTRAINTS and what were those complications?
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
Have there been any formal complaints from patients/relatives about RESTRAINTS?
Yes - 5
If so, what was their concerns?
4 complaints related to allegation of excessive force used
1 complaint related to an allegation that restraint was not used in line with the agreed care plan
How many patients report memory loss/loss of cognitive function? Not recorded
What tests are used to assess memory loss/loss of cognitive function? Not recorded
Have MRI or CT scans been used before and after RESTRAINTS?
No
If so what was the conclusion?
N/A
How does the Trust plan to reduce restraints in the future?
In 2019 the Trust refreshed its reducing restrictive practice Framework. The framework sets out how the Trust is planning to reduce coercive and restrictive practices across all services. This includes the use of restraint, seclusion and long term segregation.
The Trust recognises that restrictions may be necessary in emergencies. However we know that such interventions can create anxiety, fear, anger and mistrust which generate further stress.
To achieve a reduction in restrictions a number of key actions are set out in the framework . These include the following but not exhaustive list;
The use of data to drive improvement
Implementation of restraint reduction tools
Conducting debriefs for staff and patients
De-escalation resources and skills
Developing the workforce in relation to preventative measures which focus on conflict avoidance and resolution.
Taking a collaborative approach to positive behaviour support planning with staff and patients.
Restraints are all reportable incidents. They are subject to local team and corporate monitoring on a regular basis.
4. Please provide SECLUSION information under the FOI act to the following questions:
Please supply patient’s information SECLUSION leaflet.
Not available
Please supply patient SECLUSION consent form.
Not available
Please supply any SECLUSION reports/investigations
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many SECLUSION in 2019?
198 (155 Seclusion; 43 Long Term Segregation)
What proportion of patients were men/women?
Female – 41%
Male – 59%
How old were they?
<18 - 29%
19 – 64 - 66%
65+ - 5%
What were the diagnoses and in what proportions?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each individual report and then cross reference with the patient’s electronic records. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
What proportion of patients were classified BAME?
15.1%
How many were receiving SECLUSION for the first time?
The Trust is unable to provide this information as it is not recorded centrally. To collate this information would require a manual trawl of each individual report and then cross reference with the patient’s electronic records. This would exceed the time and cost limits as set out in the Act. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).
How many patients consented to SECLUSION?
Not recorded
How many SECLUSIONS were investigated outside the NHS and CCG?
Not recorded
How many patients died during or soon after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
No patients died whilst in seclusion
How many patients died a few months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many patients died by suicide within a few months of receiving SECLUSION (whether or not SECLUSION was considered the cause)? The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
How many patients have suffered complications during and after SECLUSION and what were those complications?
The Trust is unsure what is required for this question and is therefore unable to provide a response without clarification or additional information
Have there been any formal complaints from patients/relatives about SECLUSION?
No
If so, what was their concerns?
N/A
How many patients report memory loss/loss of cognitive function?
Not recorded
What tests are used to assess memory loss/loss of cognitive function?
N/A
Have MRI or CT scans been used before and after SECLUSION?
Not recorded
If so what was the conclusion?
N/A
How does the Trust plan to prevent SECLUSION in the future?
In 2019 the Trust refreshed its reducing restrictive practice Framework. The framework sets out how the Trust is planning to reduce coercive and restrictive practices across all services. This includes the use of restraint, seclusion and long term segregation.
The Trust recognises that restrictions may be necessary in emergencies. However we know that such interventions can create anxiety, fear, anger and mistrust which generate further stress.
To achieve a reduction in restrictions a number of key actions are set out in the framework . These include the following but not exhaustive list;
The use of data to drive improvement
Implementation of restraint reduction tools
Conducting debriefs for staff and patients
De-escalation resources and skills
Developing the workforce in relation to preventative measures which focus on conflict avoidance and resolution.
Taking a collaborative approach to positive behaviour support planning with staff and patients.
Incidents of seclusion and long term segregation are all reportable incidents. They are subject to local team and corporate monitoring on a regular basis.
5. Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
Please supply patient’s information MEDICATION ERRORS leaflet.
None available
Please supply patient MEDICATION ERRORS consent form.
None available
Please supply any MEDICATION ERRORS reports/investigations
Not available
How many MEDICATION ERRORS in 2019? 1230
What proportion of patients were men/women?
Data not collected
How old were they?
Data not collected
What were the diagnoses and in what proportions?
Data not collected
What proportion of patients were classified BAME?
Data not collected
How many were receiving MEDICATION ERRORS for the first time?
Data not collected
How many patients consented to MEDICATION ERRORS?
Not applicable
How many MEDICATION ERRORS S were investigated outside the NHS and CCG?
Nil
How many patients died during or soon after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?
Nil
How many patients died a few months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)? Data not collected
How many patients died by suicide within a few months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)? Data not collected
How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
Data not collected
Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
Yes - 11
If so, what was their concerns?
Various relating to individuals private medication, including time to prescribe, dosage, side effects.
How many patients report memory loss/loss of cognitive function?
Data not collected
What tests are used to assess memory loss/loss of cognitive function? Not applicable
Have MRI or CT scans been used before and after MEDICATION ERRORS? Data not collected
If so what was the conclusion?
Not applicable
How does the Trust plan to prevent MEDICATION ERRORS in the future? We have a Medication Safety Officer in post who leads work on medication errors.
Applied Exemption:
Section 12 (Exemption where cost of compliance exceeds appropriate limit):
(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.
(2) Subsection (1) does not exempt the public authority from its obligation to comply with paragraph (a) of section 1(1) unless the estimated cost of complying with that paragraph alone would exceed the appropriate limit.
(3) In subsections (1) and (2) “the appropriate limit” means such amount as may be prescribed, and different amounts may be prescribed in relation to different cases.
(4) The Secretary of State may by regulations provide that, in such circumstances as may be prescribed, where two or more requests for information are made to a public authority—
(a) by one person, or
(b) by different persons who appear to the public authority to be acting in concert or in pursuance of a campaign, the estimated cost of complying with any of the requests is to be taken to be the estimated total cost of complying with all of them.
(5) The Secretary of State may by regulations make provision for the purposes of this section as to the costs to be estimated and as to the manner in which they are to be estimated
Section 40 (Personal information):
(1) Any information to which a request for information relates is exempt information if it constitutes personal data of which the applicant is the data subject.
(2) Any information to which a request for information relates is also exempt information if—
(a) it constitutes personal data which do not fall within subsection (1), and
(b) either the first or the second condition below is satisfied.
(3) The first condition is—
(a) in a case where the information falls within any of paragraphs (a) to (d) of the definition of “data” in section 1(1) of the Data Protection Act 2018, that the disclosure of the information to a member of the public otherwise than under this Act would contravene—
(i) any of the data protection principles, or
(ii) section 10 of that Act (right to prevent processing likely to cause damage or distress), and
(b) in any other case, that the disclosure of the information to a member of the public otherwise than under this Act would contravene any of the data protection principles if the exemptions in section 33A(1) of the Data Protection Act 2018 (which relate to manual data held by public authorities) were disregarded.
(4) The second condition is that by virtue of any provision of Part IV of the Data Protection Act 2018 the information is exempt from section 7(1)(c) of that Act (data subject’s right of access to personal data).
(5) The duty to confirm or deny—
(a) does not arise in relation to information which is (or if it were held by the public authority would be) exempt information by virtue of subsection (1), and
(b) does not arise in relation to other information if or to the extent that either—
(i) the giving to a member of the public of the confirmation or denial that would have to be given to comply with section 1(1)(a) would (apart from this Act) contravene any of the data protection principles or section 10 of the Data Protection Act 2018 or would do so if the exemptions in section 33A(1) of that Act were disregarded, or
(ii) by virtue of any provision of Part IV of the Data Protection Act 2018 the information is exempt from section 7(1)(a) of that Act (data subject’s right to be informed whether personal data being processed).
(6) In determining for the purposes of this section whether anything done before 24th October 2007 would contravene any of the data protection principles, the exemptions in Part III of Schedule 8 to the Data Protection Act 2018 shall be disregarded.
(7) In this section— “the data protection principles” means the principles set out in Part I of Schedule 1 to the Data Protection Act 2018, as read subject to Part II of that Schedule and section 27(1) of that Act;
“data subject” has the same meaning as in section 1(1) of that Act;
“personal data” has the same meaning as in section 1(1) of that Act.
Publication Scheme:
As part of the Freedom of Information Act all public organisations are required to proactively publish certain classes of information on a Publication Scheme. A publication scheme is a guide to the information that is held by the organisation. EPUT’s Publication Scheme is located on its Website at the following link https://eput.nhs.uk
