Our ref: HWHCT-037
27 May 2022
By email
Wendy Micklewright
Dear Wendy,
Re: Request for information under Freedom of Information Act 2000
Thank you for your request under the Freedom of Information Act 2000, which was received on
05 May 2022. You requested the following information:
FOI request:
Please provide ECT information under the FOI act to the following questions: -
1. Please supply patient’s information ECT leaflet
2. Please supply patient ECT consent form
3. Please supply any ECT reports/investigations
4. How many ECT in 2021?
5. What proportion of patients were men/women?
6. How old were they?
7. What proportion of patients were classified people of the global majority or racialised
communities ("POC / BAME")?
8. How many were receiving ECT for the first time?
9. How many patients consented to ECT?
10. How many ECT complaints were investigated outside the NHS and CCG?
11. How many patients died during or 1 month after ECT and what was the cause (whether or
not ECT was considered the cause)?
12. How many patients died within 6 months after ECT and what was the cause (whether or not
ECT was considered the cause)?
13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT
was considered the cause)?
14. How many patients have suffered complications during and after ECT and what were those
complications?
15. Have there been any formal complaints from patients/relatives about ECT?
16. If so, what was their concerns?
17. How many patients report memory loss/loss of cognitive function?
18. What tests are used to assess memory loss/loss of cognitive function?
19. Have MRI or CT scans been used before and after ECT?
20. If so, what was the conclusion?
21. How does the Trust plan to prevent ECT in the future?
Trust response:
1. See attached ( 1 x RCPsych leaflet & 3 x local leaflets for Grafton Worcester).
Also refer to RCPSYCH, ECT leaflet, March 2022 Electroconvulsive therapy (ECT) | Royal
College of Psychiatrists (rcpsych.ac.uk) and also CQC 2012 August 2012
20120821_mha_ect_booklet_final.pdf (cqc.org.uk)
2. See attached (ECT consent form 1 and ECT consent form 4).
3.There were no reports or investigations to report in 2021.
4. 15 patients received ECT at the Grafton Suite, Worcester in 2021. This totals 124 treatments
of ECT.
15 patients received treatments at SBU, Hereford in 2021 which totalled 151 treatments of ECT.
5. 19 women, 11 men
6. Age 21 - 30, 4 patients. 31-40, 2 patients. 41-50, 4 patients. 51-60, 4 patients. 61-70, 9
patients, 71-80, 3 patients. 81-90, 4 patients.
7. None.
8.18 patients received ECT for the first time.
9. 11 patients consented to ECT.
10. None.
11. 1 - Bowel obstruction.
12. None.
13. None. No patients who received ECT died by suicide within 6 months of receiving ECT
14. There were no complications reported for patients during or after ECT.
15. None.
16. N/A.
17. There have been no reports of memory loss or cognitive function reported.
18.Montreal Cognitive Assessment (MoCA) - at baseline, then every 4 treatments and at end of
course.
Comprehensive Psychopathological Rating Scale (CPRS) - before every single ECT treatment
Autobiographical Questions - at baseline, then every 4 treatments and at end of course
Mental Capacity Assessments (MCA) before each ECT
Mental state examinations during weekly ward reviews including cognition / memory
Consultation with family members to assess changes in functioning / cognition
Occupational therapy assessments to assess cognition
Direct patient questioning about their memory and any changes they may perceive
Post ECT follow up for 3 months after ECT which includes further MoCA testing at 2 months.
19.Yes where applicable and clinically indicated.
20. MRI/CT scan have been used to rule out any organic causes for mental health issues/
injuries of the brain whilst having ECT.
21.Please refer to Trust Board papers for reports relating to Trust future plans for all Trust
services. Papers can be accessed via the following link: Board Papers - Herefordshire and
Worcestershire Health and Care NHS Trust | Herefordshire and Worcestershire Health and
Care NHS Trust (hacw.nhs.uk)
Please provide SERIOUS INCIDENT information under the FOI act to the following questions: -
1. Please supply any serious incident reports/investigations?
2. How many SERIOUS INCIDENT REPORTS in 2021?
3. What proportion of patients were men/women?
4. How old were they?
5. What proportion of patients were classified people of the global majority or racialised
communities ("POC / BAME")?
6. How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?
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)?
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)?
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)?
10. How many patients have suffered complications during and after SERIOUS INCIDENT
REPORTS and what were those complications?
11. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT
REPORTS?
12. If so, what was their concerns?
13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
Trust response:
1. See below*.
2. From January 1st to December 31st 2021, 89 serious incidents were reported on the STEIS
system (national SI database).
3. 46 Male, 32 Female, 11 N/A (as related to ward closures due to COVID-19 outbreaks).
4. Out of the 78 patients (male/female).
0-18 – 0
19-30 –10
31-40 –10
41-50 – 7
51-60 – 12
61-70 – 8
71-80 –13
81-90- 9
91-100 – 9
5. See question 1 response.
6. None.
7-10. See question 1 response.
11. 1.
12. Patient's family raised concerns in regard to the findings the patient's Serious Incident
investigation and have further concerns following the details that have been provided around
unexpected deaths.
13. Please refer to Trust Board papers for reports relating to future plans for all Trust services.
Papers can be accessed via the following link: Board Papers - Herefordshire and
Worcestershire Health and Care NHS Trust | Herefordshire and Worcestershire Health and
Care NHS Trust (hacw.nhs.uk)
Please provide restraints information under the FOI act to the following questions: -
1. Please supply any Restraints/investigations?
2. How many RESTRAINTS in 2021?
3. What proportion of patients were men/women?
4. How old were they?
5. What proportion of patients were classified people of the global majority or racialised
communities ("POC / BAME")?
6. How many RESTRAINTS were investigated outside the NHS and CCG?
7. How many patients died during or 1 month after RESTRAINTS and what was the cause
(whether or not RESTRAINTS was considered the cause)?
8. How many patients died within 6 months after RESTRAINTS and what was the cause
(whether or not RESTRAINTS was considered the cause)?
9. How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or
not RESTRAINTS was considered the cause)?
10. How many patients have suffered complications during and after RESTRAINTS and what
were those complications?
11. Have there been any formal complaints from patients/relatives about RESTRAINTS?
12. If so, what was their concerns?
13. Are counts of forced injections available?
14. How does the Trust plan to reduce restraints in the future?
Trust response:
1. See below*.
2. A total of 576 restraint incidents were reported in 2021.
3. Female 312 and Male 264.
4.
0-18 – 71
19-30 – 163
31-40 – 81
41-50 - 54
51-60 – 67
61-70 – 84
71-80 – 31
81-90- 16
91-100 – 9
5. 8.3% (48 patients).
6. None.
7-10. See question 1 response.
11. 1.
12. Patient raised a number of concerns in regards to the care they were receiving whilst an
inpatient on a mental health ward. These included Covid-19 restrictions and having to isolate
for 14 days, the ward environment being inadequate, care planning and co-ordinating were not
in place, that their physical health problems were ignored and about information provided by a
nurse about restraint and administering medication.
13. N/A.
14. Please refer to Trust Board papers for reports relating to future plans for all Trust services.
Papers can be accessed via the following link: Board Papers - Herefordshire and
Worcestershire Health and Care NHS Trust | Herefordshire and Worcestershire Health and
Care NHS Trust (hacw.nhs.uk)
Please provide SECLUSION information under the FOI act to the following questions: -
1. Please supply any SECLUSION reports/investigations
2 .How many SECLUSIONS in 2021?
3. What proportion of patients were men/women?
4. How old were they?
5. What proportion of patients were classified people of the global majority or racialised
communities ("POC / 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
(whether or not SECLUSION was considered the cause)?
8. How many patients died within 6 months after SECLUSION and what was the cause (whether
or not SECLUSION was considered the cause)?
9. How many patients died by suicide within 6 months of receiving SECLUSION (whether or not
SECLUSION was considered the cause)?
10. How many patients have suffered complications during and after SECLUSION and what
were those 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 reduce SECLUSIONS in the future?
Trust response:
1-13. NIL as the Trust does not use seclusion.
Please provide MEDICATION ERRORS information under the FOI act to the following questions:
1. Please supply any MEDICATION ERRORS reports/investigations
2. How many MEDICATION ERRORS in 2021?
3. What proportion of patients were men/women?
4. How old were they?
5. What proportion of patients were classified people of the global majority or racialised
communities ("POC / 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
and what 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?
Trust response:
This data relates to Patient Safety Incident (PSI) Medication Errors only
1. See below*.
2. A total of 603 PSI medication error incidents were reported in 2021.
3. Female 286 and Male 265 and Not Specified 52.
4.
0-18 – 16
19-30 – 47
31-40 – 28
41-50 - 32
51-60 – 43
61-70 – 54
71-80 – 134
81-90- 147
91-100 – 41
Not Specified - 61
5. 3% (18 patients).
6. None.
7-10. See question 1 response.
11. 3.
12.
▪ Patient's son raised concerns that their father was prescribed incorrect medication, and
this was administered by one of the community nurses.
▪ Patient's mother raised concern in relation to a phone call they had with a psychologist in
relation to their daughter and also a medication error that the clinician made that was
noted by the patient's mother.
▪ Deceased patient's wife raised further concerns in relation to the care her husband
received, following receipt of the Chief Executive's response to their complaint. They
also raised concern that their husband was administered medication that they should not
have been given due to their COPD.
13. Please refer to Trust Board papers for reports relating to future plans for all Trust services.
Papers can be accessed via the following link: Board Papers - Herefordshire and
Worcestershire Health and Care NHS Trust | Herefordshire and Worcestershire Health and
Care NHS Trust (hacw.nhs.uk)
*Section 12 – Exemption where cost of compliance exceeds appropriate limit. Section 12
of the Act makes provision for public authorities to refuse requests for information where the
cost of dealing with them would exceed the appropriate limit, which for local authorities is set at
£450. This represents the estimated cost of one person spending 2.5 working days in
determining whether the department holds the information, locating, retrieving and extracting the
information. We estimate that it will take us in excess of 2.5 working days to determine
appropriate material and locate, retrieve and extract the information in reference to your
request. Therefore, your request will not be processed further.
Please be aware that although this information is accurate at the time it is provided, it may not
be in the future and should not be relied upon.
In line with the Information Commissioner’s directive on the disclosure of information under the
Freedom of Information Act 2000, your request will form part of our disclosure log within our
Publication Scheme. Therefore, a version of our response, which will protect your identity, will be
posted on the Herefordshire and Worcestershire Health and Care Trust website.
Please note that any information we provide following your request under the Freedom of
Information Act will not confer an automatic right for you to re-use that information, for example
to publish it.
If you wish to re-use the information you have requested, in whole or in part,
please write to me stating 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 or charges that relate to the
re-use of the information. These will be determined in line with the Re-use of Public Sector
Information Regulations.
I trust this matter has been dealt with to your satisfaction but if there is anything on which you
need further clarification, please do not hesitate to contact us at the email address above.
Please remember to quote the reference number above in any future communications.
If you are unhappy with the service you have received in relation to your request and wish to
make a complaint or request a review of our decision, you should write to: Head of Information
Governance, Herefordshire and Worcestershire Health and Care NHS Trust, 2 Kings
Court, Charles Hastings Way, Worcester, WR5 1JR.
Any request for an internal review should be made within 40 working days of the initial response.
The Trust is not obliged to provide a review if it is requested after more than 40 days.
If you are still unhappy following an internal review, you may take your complaint to the Information
Commissioner under the provisions of Section 50 of the Freedom of Information Act.
Please note that the Information Commissioner will not investigate your case until the Trust’s internal review
process has been completed. Further details of the role and powers of Information Commissioner
can be found on the Commissioner’s website, www.informationcommissioner.gov.uk.
The Information Commissioner’s address is: Information Commissioner's Office, Wycliffe House,
Water Lane, Wilmslow, Cheshire SK9 5AF.
Yours sincerely,
FOI Team
FOI Team
Herefordshire and Worcestershire Health and Care NHS Trust