FOI 2020/140
FOI 2020/140 (1)
Lancashire & South Cumbria NHS Foundation Trust
Please provide ECT information under the FOI act to the following questions: -
1. Please supply patient’s information ECT leaflet. Leaflet attached to the response email (ECT leaflet)
2. Please supply patient ECT consent form. Leaflet attached to the response email (Consent leaflet)
3. Please supply any ECT reports/investigations The Trust cannot supply this information on the grounds of patient confidentiality (S40 exemption applied)
4. How many ECT in 2019?
Number of sessions=98
Number of patients=40
Number of treatments=397
Number of planned treatments=432
Number of LCFT ECT units=2
5. What proportion of patients were men/women? In 2018 -13 men 27 women
6. How old were they? In 2018 - Ages 25-82
7. What were the diagnoses and in what proportions? In 2018 - 100% Severe depression.
8. What proportion of patients were classified BAME? In 2018 – 8%
9. How many were receiving ECT for the first time?
28 of those who started ECT in 2019
33 including those who had ECT in 2019 but did not start ECT in 2019.
10. How many patients consented to ECT?
Total number of consents=263
Patients who on at least one occasion consented=32
11. How many ECT complaints were investigated outside the NHS and CCG? None
12. How many patients died during or soon after ECT and what was the cause (whether or not ECT was considered the cause)? None (but the term soon is not quantifiable).
13. How many patients died a few months after ECT and what was the cause (whether or not ECT was considered the cause)? None (but the term few is not quantifiable).
14. How many patients died by suicide within a few months of receiving ECT (whether or not ECT was considered the cause)? None (but the term few is not quantifiable).
15. How many patients have suffered complications during and after ECT and what were those complications? 20- Memory loss
16. Have there been any formal complaints from patients/relatives about ECT? We do not currently code information aligned to specific treatments. However, a search in the description field has identified that we received two complaints in the past financial year regarding ECT. This data cannot be considered wholly reliable.
17. If so, what was their concerns? One requested that he be given the option to consent to ECT before he has another psychotic break. The other is regarding a clinical decision to discontinue ECT.
18. How many patients report memory loss/loss of cognitive function? 20
19. What tests are used to assess memory loss/loss of cognitive function?
MOCA
6-CIT
Patient Orientation Assessment
20. Have MRI or CT scans been used before and after ECT? None that have been recorded
21. If so what was the conclusion? N/A
22. How does the Trust plan to prevent ECT in the future? It doesn’t
FOI 2020/140 (2)
Please provide SERIOUS INCIDENT information under the FOI act to the following questions: -
1. Please supply SERIOUS INCIDENT REPORTS patient’s information leaflet. The Trust does not have a leaflet for this.
2. Please supply patient SERIOUS INCIDENT REPORTS consent form. Patients are not asked for consent as part of the serious incident process.
3. Please supply any serious incident reports/investigations The Trust cannot supply this information on the grounds of patient confidentiality (S40 exemption applied)
4. How many SERIOUS INCIDENT REPORTS in 2019?
• 155 serious incidents were reported on StEIS in 2019 – some investigations are still underway
• 103 serious incident reports were completed in 2019 – this incudes serious incidents reported in 2018
5. What proportion of patients were men/women? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
6. How old were they? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
7. What were the diagnoses and in what proportions? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
8. What proportion of patients were classified BAME? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
9. How many were receiving SERIOUS INCIDENT REPORTS for the first time? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
10. How many patients consented to SERIOUS INCIDENT REPORTS? Please see response to Q2
11. How many SERIUOS INCIDENT REPORTS were investigated outside the NHS and CCG? None as we comply with the DH Serious incident framework.
12. 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)? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
13. 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)? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
14. 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)? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
15. How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
16. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS? For 2019 – 1
17. If so, what was their concerns? In 2019 there were no complaints about serious incident investigation reports formally raised with the Trust.
18. How many patients report memory loss/loss of cognitive function? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
19. What tests are used to assess memory loss/loss of cognitive function? AC063 MAS Standard Operating Procedure May 2018 (attached to response email)
20. Have MRI or CT scans been used before and after SERIOUS INCIDENT REPORTS? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
21. If so what was the conclusion? The Trust is unable to provide this information, as it is not collected in a way that is reportable in that way and take too much staff time to deal with the request (more than the recommended 18hrs).
22. How does the Trust plan to prevent SERIOUS INCIDENTS in the future? The majority of serious incident investigations relate to suicide or pressure ulcers. The Trust has a pressure ulcer action plan that has seen a reduction in the number of serious pressure ulcers reported that are attributable to care provided by the trust. The Trust is working with the Integrated Care Organisation on a suicide prevention plan that involves a range of agencies and stakeholders.
FOI 2020/140 (3)
Please provide restraints information under the FOI act to the following questions: -
1. Please supply RESTRAINTS patient’s information leaflet. The Trust does not have a patient’s restraint leaflet
2. Please supply patient RESTRAINTS consent form. Restraint is undertaken as last resort under common law and where applicable under the MHA or MCA consent is not needed.
3. Please supply any Restraints/investigations The number of restraint investigations can be supplied if a date range is provided, but individual reports will not be disclosable due to patient confidentiality (S40 exemption applied).
4. How many RESTRAINTS in 2019? There were 3972 incidents of restraint during 2019
5. What proportion of patients were men/women? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
6. How old were they? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
7. What were the diagnoses and in what proportions? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
8. What proportion of patients were classified BAME? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
9. How many were receiving RESTRAINTS for the first time? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
10. How many patients consented to RESTRAINTS? Consent does not need to be obtained, however it is only undertaken as a last resort
11. How many RESTRAINTS were investigated outside the NHS and CCG? 0
12. How many patients died during or soon after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)? 0
13. How many patients died a few months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)? There have been no incidents of patient deaths linked to restraints
14. How many patients died by suicide within a few months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)? There have been no incidents of patient deaths linked to restraints
15. How many patients have suffered complications during and after RESTRAINTS and what were those complications? There have been no incidents of patients suffering complications during or after restraints
16. Have there been any formal complaints from patients/relatives about RESTRAINTS? The Trust does not code complaints against specific interventions such as restraint however a review of the description fields has revealed no complaints where the word ‘restraint’ forms part of the description.
17. If so, what was their concerns? Not applicable
18. How many patients report memory loss/loss of cognitive function? There have been no incidents of memory loss being recorded as linked to restraint
19. What tests are used to assess memory loss/loss of cognitive function? This would not be tested unless clinically indicated and there have been no incidents linked to restraint where this was clinically indicated
20. Have MRI or CT scans been used before and after RESTRAINTS? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we’re unable to report on it.
21. If so what was the conclusion? As above
22. How does the Trust plan to reduce restraints in the future? LSCFT has a reducing restrictive practice programme that is being delivered to all inpatient areas. Each inpatient area also has their own Violence Reduction Nurse specialist who is working to reduce all episodes of restraint.
FOI 2020/140 (4)
Please provide SECLUSION information under the FOI act to the following questions: -
1. Please supply patient’s information SECLUSION leaflet. No seclusion leaflet
2. Please supply patient SECLUSION consent form. Consent is not required to use seclusion, however there is a robust framework relating to seclusion and it is implemented as a last resort.
3. Please supply any SECLUSION reports/investigations Individual reports will not be disclosable due to patient confidentiality (S40 exemption applied).
4. How many SECLUSION in 2019? 1087 incidents of seclusion
5. What proportion of patients were men/women? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
6. How old were they? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
7. What were the diagnoses and in what proportions? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
8. What proportion of patients were classified BAME? The Trust is unable to provide this information as it is not collected on our incident reporting system, therefore we are unable to report on it.
9. How many were receiving SECLUSION for the first time? Information is not recorded in this way, so we are unable to report.
10. How many patients consented to SECLUSION? Consent does not need to be obtained, however it is used as a last resort.
11. How many SECLUSIONS were investigated outside the NHS and CCG ? 0
12. How many patients died during or soon after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? 0
13. How many patients died a few months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? There have been no incidents of patient deaths linked to seclusion
14. How many patients died by suicide within a few months of receiving SECLUSION (whether or not SECLUSION was considered the cause)? The Trust is unable to provide this information as it is not collected in a way that is reportable and cannot be gathered within the FOI timescale thresholds.
15. How many patients have suffered complications during and after SECLUSION and what were those complications? There have been no record of patients suffering complications during or after seclusion
16. Have there been any formal complaints from patients/relatives about SECLUSION? There have been 7
17. If so, what was their concerns?
• The complainant was concerned regarding access to services whilst in seclusion.
• The complaint alleges that they were forced into seclusion
• The complainant alleges they lost property during transfer to seclusion
• The complainant is concerned that they remain in seclusion whilst awaiting a PICU bed
• The complainant alleges that they were punished with the use of seclusion
• The complaint raises concerns about the personal self-care of the patient whilst in seclusion
18. How many patients report memory loss/loss of cognitive function? There were no incidents of this being recorded as linked to seclusion
19. What tests are used to assess memory loss/loss of cognitive function? This would not be tested unless clinically indicated, and there have been no incidents linked to restraint where this was clinically indicated.
20. Have MRI or CT scans been used before and after SECLUSION? This information is not recorded centrally and therefore cannot be reported upon
21. If so what was the conclusion? As above
22. How does the Trust plan to prevent SECLUSION in the future? LSCFT has a reducing restrictive practice programme that will be delivered to all inpatient areas. Each inpatient area also has their own Violence Reduction Nurse specialist who is working to reduce all episodes of seclusion.
FOI 2020/140 (5)
Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
1. Please supply patient’s information MEDICATION ERRORS leaflet. The Trust does not provide a specific leaflet regarding medication errors. In line with duty of candour, we inform patients where an error has occurred and ensure we maintain communication with regards to outcome where appropriate. Should a patient wish to submit a formal complaint, they are supported and directed to the complaints department.
2. Please supply patient MEDICATION ERRORS consent form. The Trust does not provide consent forms for medication errors.
3. Please supply any MEDICATION ERRORS reports/investigations The Trust is unable to provide these because of identifiable information contained within them (exemption S40 applied).
4. How many MEDICATION ERRORS in 2019? In 2019, across the Trust, we received 482 medication incident reports. We have previously been recognised as a good reporter of medication incidents and near misses. We promote reporting of near misses so that we also learn from these.
5. What proportion of patients were men/women? Of the 482 incident reports received, 240 occurred with female patients, 190 occurred with male patients and 52 reports did not provide a response within this data field.
6. How old were they?
|
Age range |
Number of incidents |
|
14 – 18 years |
5 |
|
19 – 30 |
55 |
|
31 - 40 |
47 |
|
41 - 50 |
54 |
|
51 - 60 |
54 |
|
61 - 70 |
37 |
|
71 - 80 |
63 |
|
81 - 90 |
46 |
|
91 - 97 |
12 |
|
None reported |
109 |
|
Total |
482 |
7. What were the diagnoses and in what proportions? At present, our incident reporting system does not link to patient clinical systems, therefore we are unable to establish this level of detail.
8. What proportion of patients were classified BAME?
|
Ethnic Group |
Number of incidents |
|
White British |
271 |
|
White – other white |
7 |
|
Other Asian |
4 |
|
Indian |
3 |
|
Pakistani |
3 |
|
Black African |
3 |
|
Mixed White and Black African |
2 |
|
Other mixed |
2 |
|
White Irish |
2 |
|
Mixed White and Asian |
1 |
|
Other Black |
1 |
|
None stated/classified |
183 |
|
Total |
482 |
9. How many were receiving MEDICATION ERRORS for the first time? At present, our incident reporting system does not link to patient clinical systems, therefore we are unable to establish this level of detail.
10. How many patients consented to MEDICATION ERRORS? None
11. How many MEDICATION ERRORS were investigated outside the NHS and CCG? None
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)? 5 deaths occurred post incident. 4 patients were receiving End of Life care, medication errors not considered the cause in any patient.
13. How many patients died a few months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)? 3 deaths occurred months following medication errors, all of these were within Later Life services and medication errors were not 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)? The Trust is unable to ascertain this information through the system we have.
15. How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications? 2 patients experienced an allergic reaction to a medicine prescribed. 4 reported minor complications post incident.
16. Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
Of the formal complaints received, 43 complaints included medication related issues.
17. If so, what was their concerns?
|
Complaint category |
Number of complaints received |
|
Access to treatment or drugs |
25 |
|
Clinical Treatment |
14 |
|
Prescribing issues |
4 |
|
Total |
43 |
18. How many patients report memory loss/loss of cognitive function? None
19. What tests are used to assess memory loss/loss of cognitive function? Mental state examinations and mini-mental state examinations would be completed as routine, with more detailed testing and neuropsychological assessments occurring where impairment identified.
20. Have MRI or CT scans been used before and after MEDICATION ERRORS? None completed as routine before or following a medication error.
21. If so what was the conclusion? N/A
22. How does the Trust plan to prevent MEDICATION ERRORS in the future? Trust Medication Safety Group meets bi-monthly to review themes and lessons to be shared across organisation. This meeting is attended by professions and key post holders across our services.
- Medication Management Nurses are an integral part of the Trust-wide Pharmacy team, who work to investigate incidents, support training needs and work alongside the front line multi-disciplinary team to proactively provide safe and effective medicines management services.
- Trust guidance is in place to support incident investigation, ensuring staff reflect and explore factors that led to incident. This allows for the medicines management team to ensure that wherever possible, we provide training, systems, guidance and processes to support safe prescribing, dispensing and administration of medicines to our patients.
- Monthly communications from the Pharmacy team ensure sharing of key issues raised through our various forums and signpost staff to resources where required.