ESSEX 2024

Dear Wendy 

Please see below as requested.

 

Please provide Electro Convulsive Treatment (ECT) information under the FOI act to the following questions: -

1.     Please supply patient’s information ECT leaflet

Please see attached

 

2.     Please supply patient ECT consent form

    Please see attached    

 

3.     Please supply any ECT reports/investigations

 

None

 

4.     How many ECT in 2024?

   783

5.     What proportion of patients were men/women?

44 Female and 23 males (67 Patients)

6.     How old were they?

Female

Male

18-65 Years

Over 65 Years

18-65 Years

Over 65 Years

11

22

14

20

 

7.     What proportion of patients were classified people of the global majority or racialized communities ("POC / BAME")? 3 Patients

Female

Male

2

1

 

8.     How many people covered by the equality act - specific protected characteristics - excluding age + gender - received ECT?

3

9.     How many people were offered talking therapy prior to ECT?

67

10.  How many were receiving ECT for the first time?

Female

Male

12

6

 

11.  How many patients consented to ECT?

Female

Male

21

14

 

12.  How many ECT complaints were investigated outside the NHS?

None

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

None

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

None

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

None

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

3 Patient experienced Tachycardia

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

None

18.  If so, what was their concerns?

Not Applicable

19.  How many patients report memory loss/loss of cognitive function?

Deterioration of memory following ECT comparison of pre ECT memory to memory monitored at final review

Female

Male

6

2

 

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

CPRS, MOCA and Mini Ace

21.  Have MRI or CT scans been used before and after ECT? None

22.  If so, what was the conclusion?

N/A

23.  How does the Trust plan to prevent ECT in the future?

 

The Trust has expanded its Neuromodulation treatment service, which includes: Repetitive Transcranial Magnetic Stimulation and Esketamine treatment. ECT is only considered as a last resort.

 

 

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

1.     Please supply any Restraints/investigations

The Trust does not hold this data centrally, to determine this would require a manual trawl of each individual restraint incident and relating patient records, therefore the Trust is unable to provide all of the information requested as 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.

2.     How many RESTRAINTS in 2024?

2490

3.     What proportion of patients were men/women?

 

Male

Female

Other

Not Stated

Gender

72.6%

24.2%

1.3%

1.9%

*Other is an available option on the internal form that can be chosen

4.     How old were they?

 

0-17

18-65

65+

Not stated

Age

844

1795

125

274

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

19%

9% of incidents do not have ethnicity recorded.

6.     How many people covered by the equality act - specific protected characteristics - excluding age + gender - were restrainted?

All Service Users are covered by the Equality Act 2010

7.     How many RESTRAINTS were investigated outside the NHS?

There are no (zero) complaints investigated outside of the NHS and CCG.

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

Exempt under section 12

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

Exempt under section 12

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

Exempt under section 12

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

The Trust does not hold this data centrally, to determine this would require a manual trawl of each individual restraint incident and relating patient records, therefore the Trust is unable to provide all of the information requested as 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.

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

There have been 2 formal complaints.

13.  If so, what was their concerns?

Exempt under section 40

14.  Are counts of forced injections available? if so how many people were forcible injected ?

Counts of Rapid Tranquillisation are kept.

194 patients

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

National guidance on reducing restrictive practices in mental health has emphasised the need for a shift towards more person-centred, trauma-informed care approach. As a Trust we have focused on minimising the use of physical restraint, seclusion, and other coercive interventions, promoting alternatives that prioritise patient dignity, safety and empowerment. We have adopted proactive de-escalation techniques, improved staff training, and increased patient involvement in care planning. The overarching goal is to foster a culture of respect, aiming to reduce reliance on restrictive practices and improve therapeutic outcomes.

 

 

As a Trust, we continue to be part of the national working group focused on the creation of national guidance regarding therapeutic engagement and observation, and working towards patient led competency sign-off with wider multi-disciplinary involvement, including senior nursing and allied health professionals.

 

 

Our year 1 ambition is to implement SafeWards to support restrictive practice reduction and has been monitored as a rolling agenda item at our Trust-wide Reducing Restrictive Practices Quality Priority Steering Group. In line with our year 1 priorities, we continue to support the introduction of local change ideas. EPUT have 4 wards engaged in the National Culture of Care Programme who are working with their own ideas for change. The Culture of Care Programme is part of NHS England's Quality Transformation Programme to improve patient experience, reduce restrictive practice, and improve staff experience. This programme includes a suite of measures that include patient feedback, staff feelings of burnout and proxy measures that are indicators of culture on a ward.

16.  How many of these restraints were face down restraints?

17

 

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

1.     Please supply any SECLUSION reports/investigations

The Trust does not hold this data centrally, to determine this would require a manual trawl of each individual seclusion incident and relating patient records, therefore the Trust is unable to provide all of the information requested as 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.

2.     How many SECLUSIONS in 2024?

252

3.     What proportion of patients were men/women?

 

 

Male

Female

Other

Not Stated

Gender

48%

49%

0%

3%

 

4.     How old were they?

 

0-17

18-65

65+

Not stated

Age

90

151

8

3

 

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

18%

6% of incidents do not have ethnicity recorded.

6.     How many people covered by the equality act - specific protected characteristics - excluding age + gender - were secluded ?

All Service Users are covered by the Equality Act 2010

7.     How many SECLUSIONS were investigated outside the NHS?

There are no (zero) complaints investigated outside of the NHS and CCG.

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

Exempt under section 12

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

Exempt under section 12

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

Exempt under section 12

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

The Trust does not hold this data centrally, to determine this would require a manual trawl of each individual restraint incident and relating patient records, therefore the Trust is unable to provide all of the information requested as 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.

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

0

13.  If so, what was their concerns?

N/A

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

National guidance on reducing restrictive practices in mental health has emphasised the need for a shift towards more person-centred, trauma-informed care approach. As a Trust we have focused on minimising the use of physical restraint, seclusion, and other coercive interventions, promoting alternatives that prioritise patient dignity, safety and empowerment. We have adopted proactive de-escalation techniques, improved staff training, and increased patient involvement in care planning. The overarching goal is to foster a culture of respect, aiming to reduce reliance on restrictive practices and improve therapeutic outcomes.

 

 

As a Trust, we continue to be part of the national working group focused on the creation of national guidance regarding therapeutic engagement and observation, and working towards patient led competency sign-off with wider multi-disciplinary involvement, including senior nursing and allied health professionals.

 

 

Our year 1 ambition is to implement SafeWards to support restrictive practice reduction and has been monitored as a rolling agenda item at our Trust-wide Reducing Restrictive Practices Quality Priority Steering Group. In line with our year 1 priorities, we continue to support the introduction of local change ideas. EPUT have 4 wards engaged in the National Culture of Care Programme who are working with their own ideas for change. The Culture of Care Programme is part of NHS England's Quality Transformation Programme to improve patient experience, reduce restrictive practice, and improve staff experience. This programme includes a suite of measures that include patient feedback, staff feelings of burnout and proxy measures that are indicators of culture on a ward.

 

 

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

1.     Please supply any MEDICATION ERRORS reports/investigations

The Trust does not hold this data centrally, to determine this would require a manual trawl of individual records for every patient who had a reported medication error of any type. The Trust is therefore applying Section 12 of the Act (where cost of compliance exceeds appropriate limit).

2.     How many MEDICATION ERRORS in 2024?

632

3.     What proportion of patients were men/women?

 

Male

Female

Other

Not Stated

Gender

46%

50%

1%

3%

 

4.     How old were they?

 

0-17

18-65

65+

Not stated

Age

33

342

249

8

 

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

11%

10% of incidents do not have ethnicity recorded.

 

6.     How many people covered by the equality act - specific protected characteristics - excluding age + gender - endured medication errors ?

All Service Users are covered by the Equality Act 2010

7.     How many MEDICATION ERRORS were investigated outside the NHS ?

There are no (zero) complaints investigated outside of the NHS and CCG.

8.     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)?

Exempt under section 12

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

Exempt under section 12

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

Exempt under section 12

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

The Trust does not hold this data centrally, to determine this would require a manual trawl of each individual restraint incident and relating patient records, therefore the Trust is unable to provide all of the information requested as 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.

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

There have been 24 formal complaints.

13.  If so, what was their concerns?

Exempt under section 40

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

Medication incidents reported via the Trust adverse incident reporting system (DATIX) are analysed for trends and lessons learned. These are discussed at the Medication Management Group and incorporated into medicines management training for staff.