Please find out response for ECT

1. Please supply patient’s information ECT leaflet.

Please see attached as a separate PDF document.

2. Please supply patient ECT consent form.

Please see attached as a separate PDF document.

3. Please supply any ECT reports/investigations

These would contain patient identifiable information and therefore cannot be supplied.

4. How many ECT in 2019?

16 patients received ECT

5. What proportion of patients were men/women?  

11 - Female  

5 - Male

6. How old were they?

67yrs, 53yrs, 63yrs, 58yrs, 55yrs, 57yrs, 74yrs, 23yrs, 78yrs, 61yrs, 68yrs, 51yrs, 47yrs, 64yrs, 72yrs.

7. What were the diagnoses and in what proportions?

Life Threatening depressive illness [7]

Prolonged or severe manic episode [3]

Non severe depressive illness/inadequate drug response [4] Catatonia [1]

Acute schizophrenia 4th line treatment after clozapine

[1]

8. What proportion of patients were classified BAME?

None.

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

[15]

10. How many patients consented to ECT?

[5]

11. How many ECT complaints were investigated outside the NHS and CCG?

Not informed of any formal complaint.

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

No service users have died during a course of ECT.

13. How many patients died a few months after ECT and what was the cause (whether or not ECT was considered the cause)?

Two Patients died - ECT team have not been made aware that deaths were linked to ECT.

14. How many patients died by suicide within a few months of receiving ECT (whether or not ECT

None.

was considered the cause)?

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

None.

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

ECT not notified of any formal complaints.

17. If so, what was their concerns?

N/A

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

Subjectively one patient complained Objectively through psycho neurological testing analysis found no deterioration.

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

MoCA

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

Not routinely required ECT department do not keep data on this.

21. If so what was the conclusion?  

N/A

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

There are no plans to stop ECT as it is an evidence based treatment for Mental Disorder supported by NICE for specified conditions.

Please find our response for RESTRAINTS

1. Please supply RESTRAINTS patient’s information leaflet.

Please see attached as a separate PDF document.

2. Please supply patient RESTRAINTS consent form.

Gloucestershire Health & Care NHS Foundation Trust do not have a consent form. Service users are encouraged to be involved with and sign up to their care plans where possible as a matter of course. Where a service user doesn’t have capacity a Best Interest decision is made and recorded, with the input from advocacy services where appropriate.

3. Please supply any Restraints/investigations.

These would contain patient identifiable information and therefore cannot be supplied.

4. How many RESTRAINTS in 2019?

2172 Restraints during 2019, involving 317 individual patients.

5. What proportion of patients were men/women?

171 (53.9%) Male

146 (46.1%) Female

6. How old were they?

Age under 12     =     9

12-17 years old   = 10

18-24 years old   = 46

25-34 years old   = 42

35-44 years old   = 40

45-54 years old   = 66

55-64 years old   = 43

65-74 years old   = 28

75 years or older = 33

7. What were the diagnoses and in what proportions

Please see separate PDF document attached.

8. What proportion of patients were classified

BAME?

Please see separate PDF document attached.

9. How many were receiving RESTRAINTS for the first time?

We don't capture this information within the current dataset. To provide this would require longer than the 18 hour limit for FOI Requests.

10. How many patients consented to RESTRAINTS?

Service users are encouraged to be involved with and sign up to their care plans where possible as a matter of course. Where a service user doesn’t have capacity a Best Interest decision is made and recorded, with the input from advocacy services where appropriate.

11. How many RESTRAINTS were investigated outside the NHS and CCG

Unfortunately we don’t capture this information.

12. How many patients died during or soon after

RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?

We have had no deaths of patients during a restraint. One patient died within 1 week of their last recorded restraint. We don't capture information on cause of death within the current dataset. To provide this would

require longer than the 18 hour limit for FOI Requests.

13. How many patients died a few months after

RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?

18 patients died after more than 1 week but within 6 months of their last recorded restraint. We don't capture information on cause of death within the current dataset. To provide this would require longer than the 18 hour limit for FOI Requests.

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

We don't capture this information within the current dataset. To provide this would require longer than the

18 hour limit for FOI Requests.

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

We don't capture this information within the current dataset. To provide this would require longer than the

18 hour limit for FOI Requests.

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

Yes, seven. Four partly upheld, two not withheld and one withdrawn.

17. If so, what was their concerns?

This information is unfortunately not available without accessing each individual complaint.

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

We don't capture this information within the current dataset. To provide this would require longer than the

18 hour limit for FOI Requests.

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

Standard Memory Assessments are used to diagnose

memory loss/loss of cognitive function but not specifically related to restraint.

20. Have MRI or CT scans been used before and after RESTRAINTS?

We don't capture this information within the current dataset. To provide this would require longer than the

18 hour limit for FOI Requests.

21. If so what was the conclusion?

We don't capture this information within the current dataset. To provide this would require longer than the

18 hour limit for FOI Requests.

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

Reducing Restrictive Intervention Action Plans are currently under review and are due to be co-revised with Service Users as soon as relaxation of Covid-19 restrictions allow.

Please find our response for MEDICATION ERRORS

1. Please supply patient’s information MEDICATION ERRORS leaflet.

Gloucestershire Health & Care NHS Foundation Trust does not have one.

2. Please supply patient MEDICATION ERRORS consent form.

Gloucestershire Health & Care NHS Foundation Trust does not have a form specifically for consent around medication error. Consent would be recorded in the patient record.

3. Please supply any MEDICATION ERRORS

reports/investigations

These would contain patient identifiable information and therefore cannot be supplied.

4. How many MEDICATION ERRORS in 2019?  

86

5. What proportion of patients were men/women?

This information is unfortunately not available without accessing each individual report.

6. How old were they?

This information is unfortunately not available without accessing each individual report.

7. What were the diagnoses and in what proportions?

This information is unfortunately not available without accessing each patient’s clinical record.

8. What proportion of patients were classified BAME?

This information is unfortunately not available without accessing each patient’s clinical record.

9. How many were receiving MEDICATION ERRORS for the first time?

This information is unfortunately not available without accessing each patient’s clinical record.

10. How many patients consented to MEDICATION ERRORS?

We would not ask a patient to consent to medication errors.

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

Unfortunately we don’t capture this information.

12. How many patients died during or soon after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?

None known in our care.

13. How many patients died a few months after

None known in our care.

MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?

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

None known in our care.

15. How many patients have suffered complications during and after MEDICATION

ERRORS and what were those complications?

None known in our care.

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

ERRORS?

In the last 6 months there have been none.

17. If so, what was their concerns?  

This information is unfortunately not available without accessing each individual complaint.

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

This information is unfortunately not available without accessing individual patient clinical records.

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

Standard Memory Assessments are used to diagnose

memory loss/loss of cognitive function but not specifically related to medication errors.  

20. Have MRI or CT scans been used before and after MEDICATION ERRORS?

This information is unfortunately not available without accessing individual patient clinical records.

21. If so what was the conclusion? See above

This information is unfortunately not available without accessing individual patient clinical records.

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

All medication errors are reviewed as part of the Trust’s incident management process. Themes and trends are identified and training/resources made available to support colleagues to get medicines right. Individual training, support and supervision around managing medicines is available for colleagues. Learning from incidents is also shared across the Trust.

Primary Diagnosis

Number of patients

Proportion %

Acute and transient psychotic disorder, unspecified

5

1.58%

Acute polymorphic psychotic disorder without symptoms of schizophrenia

1

0.32%

Adjustment disorders

2

0.63%

Bipolar affective disorder

36

11.36%

Childhood autism

7

2.21%

Delirium not superimposed on dementia

1

0.32%

Delirium, unspecified

1

0.32%

Delusional disorder

1

0.32%

Dementia in Alzheimer disease with early onset

3

0.95%

Dementia in Alzheimer disease with late onset

10

3.15%

Dementia in Alzheimer disease, atypical or mixed type

12

3.79%

Dementia in Alzheimer disease, unspecified

5

1.58%

Dementia in Parkinson disease

2

0.63%

Dementia in Pick disease

1

0.32%

Dementia, multi-infarct

1

0.32%

Dementia, unspecified

2

0.63%

Dementia, vascular

12

3.79%

Diagnosis unspecified in clinical system*

30

9.46%

Dissociative convulsions

1

0.32%

Dissociative stupor

1

0.32%

Emotionally unstable personality disorder

30

9.46%

Mania with psychotic symptoms

4

1.26%

Manic episode, unspecified

1

0.32%

Mental and behavioural disorders due to use of alcohol, amnesic syndrome

1

0.32%

Mild cognitive disorder

1

0.32%

Mild mental retardation, disturbance of activity and attention

1

0.32%

Mild mental retardation, significant impairment of behaviour requiring attention or treatment

3

0.95%

Mild mental retardation, with the statement of no, or minimal, impairment of behaviour

1

0.32%

Mild mental retardation, without mention of impairment of behaviour

7

2.21%

Mixed and other personality disorders

2

0.63%

Moderate mental retardation, other impairments of behaviour

2

0.63%

Moderate mental retardation, significant impairment of behaviour requiring attention or treatment

7

2.21%

Moderate mental retardation, with the statement of no, or minimal, impairment of behaviour

3

0.95%

Moderate mental retardation, without mention of impairment of behaviour

11

3.47%

Observation for suspected mental and behavioural disorders

1

0.32%

Organic delusional, schizophrenia-like, disorder

1

0.32%

Other acute predominantly delusional psychotic disorders

1

0.32%

Post-traumatic stress disorder

2

0.63%

Profound mental retardation, without mention of impairment of behaviour

2

0.63%

Reactive attachment disorder of childhood

1

0.32%

Recurrent depressive disorder

1

0.32%

Schizoaffective disorder, depressive type

2

0.63%

Schizoaffective disorder, manic type

9

2.84%

Schizoaffective disorder, mixed type

2

0.63%

Schizoaffective disorder, unspecified

3

0.95%

Schizophrenia, hebephrenic

1

0.32%

Schizophrenia, paranoid

37

11.67%

Schizophrenia, unspecified

1

0.32%

Schizotypal disorder

1

0.32%

Severe depressive episode with psychotic symptoms

4

1.26%

Severe depressive episode without psychotic symptoms

2

0.63%

Severe mental and behavioural disorders associated with the puerperium, not elsewhere classified

1

0.32%

Severe mental retardation associated with spastic paraplegic cerebral palsy

1

0.32%

Severe mental retardation with Down syndrome

1

0.32%

Severe mental retardation, disturbance of activity and attention

1

0.32%

Severe mental retardation, other impairments of behaviour

1

0.32%

Severe mental retardation, significant impairment of behaviour requiring attention or treatment

5

1.58%

Severe mental retardation, with the statement of no, or minimal, impairment of behaviour

5

1.58%

Severe mental retardation, without mention of impairment of behaviour

15

4.73%

Unspecified mental disorder due to brain damage and dysfunction and to physical disease

1

0.32%

Unspecified nonorganic psychosis

7

2.21%