St Mary’s House

North Wing
1^st Floor
St Martins View
Leeds
LS7 3LA
 
Tel: 0113 85 59772
Our Ref:  FOI-3978

Thank you for your correspondence received on 28^th July requesting information from our Trust.
 
Under the terms of the Freedom of Information Act 2000 we are able to provide you with the following information:
 
 Please provide 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.  * Investigation by the Trust or an external investigation - for 2020.

No such investigations in relation to ECT.
 
4. How many ECT in 2021 ?

The number of patients receiving ECT treatments during 2020 was 37.

The number of electroconvulsive therapy (ECT) treatments carried out by our Trust in 2020 was 420.
 
*Please note that all figures provided include data for Bradford District Care Trust, as our Trust provides ECT treatment for them under a contract.  Therefore figures provided are inclusive of these treatments.
 
5. What proportion of patients were men/women? *
 
6. How old were they? *
 
7. What proportion of patients were classified BAME? *
 
8. How many were receiving ECT for the first time? *
 
9. How many patients consented to ECT? *

*We can confirm that we have not treated anybody under 18
However, to calculate the ages of patients at the time of their ECT treatment, over a 12 month period, would take a manually labour intensive and time lengthy process; as would determining whether they were male or female, receiving ECT for the first time, classified BAME, consented, or whether they were receiving ECT for the first time.  To clarify; whilst personal data is recorded within a patient’s health care notes, this personal data, cannot be separately identified and reported from our electronic information system in a ‘numeric’ format.  As such, we would need to physically search through the health care notes of each individual patient over a 12 month period to establish this information – a manually labour intensive and time lengthy process.  Please refer to the footnote below on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).

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

None in relation to ECT.
 
11. How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
We have had nobody die during the procedure of ECT or immediately after, however, it would require a manual task to go through all of the patients to find out if people had died up to one month after, regardless of cause.  Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
12. How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
 
Please see our response above.
 
13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
Please see our response to question 11.
14. How many patients have suffered complications during and after ECT and what were those complications?
To establish whether patients had complications at the time of their treatment, or after treatment, we would need to physically search through the health care notes of every patient – a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).

15. Have there been any formal complaints from patients/relatives about ECT?
 
None in relation to ECT.
 
16. If so, what were their concerns?
 
Not applicable.
 
17. How many patients report memory loss/loss of cognitive function?
Again; such clinical data is recorded within a patient’s health care notes, and this detailed medical data, cannot be separately identified and reported from our electronic information system in an extractable ‘number’ format.  As such, we would need to physically search through the health care notes of every patient – a manually labour intensive and time lengthy process. Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
18. What tests are used to assess memory loss/loss of cognitive function?
Our Memory Assessment Service (MAS) work alongside other professionals and multi-disciplinary teams (MDTs), such as our Psychology and Psychotherapy Service which includes psychotherapists, clinical psychologists, consultant psychiatrists in psychotherapy and highly experienced counsellors, who undertake a variety of cognitive and neuropsychological assessments.
19. Have MRI or CT scans been used before and after ECT? *
 
20. If so what was the conclusion? *
 
Our Trust does not conduct MRI nor CT scans.
 
21. How does the Trust plan to prevent ECT in the future?
 
ECT is a medical treatment within mental health, therefore rules and legalities are at the forefront, and these must be adhered to.
We do not have plans to ‘prevent ECT’; however, we ensure that we work within set robust legal frameworks:
The Mental Health Act 2007.
The Mental Capacity Act, 2005.
 
Please provide SERIOUS INCIDENT information under the FOI act to the following questions: -
 
1. Please supply any serious incident reports/investigations.
 
With regards your request to be provided with serious incident investigation reports; having reviewed the matter against the Information Commissioners Office Anonymisation Code of Practice; available here:-
 
https://ico.org.uk/media/for-organisations/documents/1061/anonymisation-code.pdf
 
In essence, providing such detail has the potential that:-
 

 
In either scenario above, there would be a resultant data breach.
 
Therefore, under the terms of the Freedom of Information Act (2000), we would be unable to provide you with actual incident reports as they contain detail which relates to and has the potential to identify particular living individuals, therefore personal data which is exempt from disclosure under Section 40(2) of the Act by virtue of Section 40(3)(a)(i), as disclosure of such personal data would breach the data protection principles set out in the Data Protection Act (2018) and the EU General Data Protection Regulation.

2. How many SERIOUS INCIDENT REPORTS in 2020?

Our Trust reported 18 incidents as serious in 2020 (total).
 
3. What proportion of patients were men/women? *
 
4. How old were they? *
 
5. What proportion of patients were classified BAME? *
*Our incident reporting system (DATIX) is purposely designed to record incident data.  Details such the gender / ethnicity / diagnosis / age, may not be recorded in incident reporting, as there is no formal means of capturing this type of data in DATIX.  Such personal / medical details are recorded within each individual patient’s health care notes.  Furthermore, we report serious incidents externally via the Strategic Executive Information System (STEIS). As such, the above information is not data that we hold in a reportable ‘numeric’ format as we would need to cross reference each individual STEIS report, with the original DATIX report, and conduct a physical search of the records of each relevant service user’s health care notes – a manually labour intensive and time lengthy process. Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
6. How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?
 
None; however they are reported externally via STEIS.
 
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)?
 
The nature of a serious incident is that it is primarily in relation to deaths as STEIS captures all Serious Incidents which are defined as accidents or incidents when a patient, member of staff, or a member of public suffers injury or unexpected death, or the risk of death.
 
8. How many patients died within 6 months after SERIOUS INCIDENT REPORTS (within a year) and what was the cause (whether or not SERIOUS INCIDENT REPORTS was considered the cause)?
 
Please see our response above.
 
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)?
Such clinical data (up to 6 months after a serious incident) is recorded within a patient’s health care notes.  This detailed medical data, cannot be separately identified and reported from our electronic information system in an extractable ‘number’ format.  As such, we would need to physically search through the health care notes of every patient – a manually labour intensive and time lengthy process. Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
10. How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?
 
Please see our response above.
 
11. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
 
No.
 
12. If so, what was their concerns?
 
Not applicable.
 
13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
 
Our Trust is committed to continually improving the quality and safety of all of our services. We have previously provided our procedure “The Management of Incidents Including Serious Incidents Procedure, RM-0002”, which outlined our strategy to improve safety, systems and our services in order to protect our patients, visitors, staff and members of the public.
 
Please provide restraints information under the FOI act to the following questions: -
 
1. Please supply any Restraints/investigations.
 
With regards your request to be provided with restraint investigation reports; having reviewed the matter against the Information Commissioners Office Anonymisation Code of Practice; available here:-
 
https://ico.org.uk/media/for-organisations/documents/1061/anonymisation-code.pdf
 
In essence, providing such detail has the potential that:-
 

 
In either scenario above, there would be a resultant data breach.
 
Therefore, under the terms of the Freedom of Information Act (2000), we would be unable to provide you with actual incident reports as they contain detail which relates to and has the potential to identify particular living individuals, therefore personal data which is exempt from disclosure under Section 40(2) of the Act by virtue of Section 40(3)(a)(i), as disclosure of such personal data would breach the data protection principles set out in the Data Protection Act (2018) and the EU General Data Protection Regulation.
 
2. How many RESTRAINTS in 2020?
 
Our Trust reported 2,323 restraint incidents in 2020 (total).  (This could be anything from placing a hand on the back of a service users’ upper arm).
 
3. What proportion of patients were men/women? *
 
4. How old were they? *
 
5. What proportion of patients were classified BAME? *
To calculate the ages of patients at the time of their restraint, whether they were men or women, and the proportion of these patients who were classified as BAME - over a 12 month period, would take a manually labour intensive and time lengthy process; To clarify; our restraint incident reporting system (DATIX) is purposely designed to record incident data.  Details such as gender / ethnicity / age etc, are recorded within each individual service user’s health care notes.  As such, we would need to cross reference each individual DATIX report, with a physical search of the records of each relevant service users health care notes - a manually labour intensive and time lengthy process.  Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
6. How many RESTRAINTS were investigated outside the NHS and CCG ?
 
None.
 
7. How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
We have had nobody die during the process of restraint, and none that have died as an immediate result of restraint: however, to establish if people had died of other causes within months of a restraint incident would require a manual task as we would need to cross reference each individual DATIX report, with a physical search of the records of each relevant service users health care notes - a manually labour intensive and time lengthy process.  Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
8. How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
Please see our response above.
 
9. How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
 
Please see our response to question 7.
 
10. How many patients have suffered complications during and after RESTRAINTS and what were those complications?
To establish whether patients had complications up to 12 months after their restraint, we would need to physically search through the health care notes of every patient over a 12 month period – a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
11. Have there been any formal complaints from patients/relatives about RESTRAINTS?
 
No.
 
12. If so, what was their concerns?
 
Not applicable.
 
13. Are counts of forced injections available?
 
All incidents of rapid tranquillisation are reported to Risk Management, and recorded on Datix, in line with Trust Incident Reporting procedures.
 
14. How does the Trust plan to reduce restraints in the future?
 
Our Trust plans to reduce incidents of restrictive practice through learning lessons and post incident reviews Please see attached; “Procedure for the positive and safe support for people who may present with behaviour that challenges, C-0021”, specifically the section on; 1.5.2 Primary- Preventative strategies.
 
Please provide SECLUSION information under the FOI act to the following questions: -
 
1. Please supply any SECLUSION reports/investigations.
 
With regards your request to be provided with seclusion investigation reports; having reviewed the matter against the Information Commissioners Office Anonymisation Code of Practice; available here:-
 
https://ico.org.uk/media/for-organisations/documents/1061/anonymisation-code.pdf
 
In essence, providing such detail has the potential that:-
 

 
In either scenario above, there would be a resultant data breach.
 
Therefore, under the terms of the Freedom of Information Act (2000), we would be unable to provide you with actual incident reports as they contain detail which relates to and has the potential to identify particular living individuals, therefore personal data which is exempt from disclosure under Section 40(2) of the Act by virtue of Section 40(3)(a)(i), as disclosure of such personal data would breach the data protection principles set out in the Data Protection Act (2018) and the EU General Data Protection Regulation.
 
2. How many SECLUSIONS in 2020?
 
103.
 
3. What proportion of patients were men/women? *
 
4. How old were they? *
 
5. What proportion of patients were classified BAME? *
 
*To calculate the ages of patients at the time of their seclusion, over a 12 month period, would take a manually labour intensive and time lengthy process; as would calculating the proportion of patients classified BAME, or whether they were male or female. To clarify; details such as gender / ethnicity / age etc, are recorded within each individual service user’s health care notes.  As such, this is not information that we hold in a reportable ‘numeric’ format as we would need to conduct a physical search of the records to establish this information - a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
6. How many SECLUSIONS were investigated outside the NHS and CCG?
 
None.
 
7. How many patients died during or within 1 month of SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
We have had nobody die during the process of seclusion, and none that have died as an immediate result of seclusion: however, to establish if people had died after an incident of seclusion, regardless of the cause, would require a manual task as we would need to conduct a physical search of the records of each relevant service users health care notes, for a 12 month period - a manually labour intensive and time lengthy process.  Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
8. How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
 
Please see our response above.
 
9. How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
 
Please see our response to question 7.
 
10. How many patients have suffered complications during and after SECLUSION and what were those complications?
To establish whether patients had complications after their seclusion, we would need to physically search through the health care notes of every patient – a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
11. Have there been any formal complaints from patients/relatives about SECLUSION?
 
No.
 
12. If so, what was their concerns?
 
Not applicable.
 
13. How does the Trust plan to prevent SECLUSION in the future?
 
Our Trust plans to reduce incidents of seclusion through learning lessons and post incident reviews Please see attached; “Procedure for the positive and safe support for people who may present with behaviour that challenges, C-0021”, specifically the section on; 1.5.2 Primary- Preventative strategies.
 
Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
 
1. Please supply any MEDICATION ERRORS reports/investigations
 
With regards your request to be provided with medication error investigation reports; having reviewed the matter against the Information Commissioners Office Anonymisation Code of Practice; available here:-
 
https://ico.org.uk/media/for-organisations/documents/1061/anonymisation-code.pdf
 
In essence, providing such detail has the potential that:-
 

 
In either scenario above, there would be a resultant data breach.
 
Therefore, under the terms of the Freedom of Information Act (2000), we would be unable to provide you with actual incident reports as they contain detail which relates to and has the potential to identify particular living individuals, therefore personal data which is exempt from disclosure under Section 40(2) of the Act by virtue of Section 40(3)(a)(i), as disclosure of such personal data would breach the data protection principles set out in the Data Protection Act (2018) and the EU General Data Protection Regulation.
 
2. How many MEDICATION ERRORS in 2020?
 
There were 595 medication errors reported in 2020; this includes errors that were detected prior to administration of the medication (i.e. near misses) as our Trust encourages and supports a culture of reporting near misses so that we can learn and prevent future errors;
 

 
3. What proportion of patients were men/women? *
 
4. How old were they? *
 
5. What proportion of patients were classified BAME? *
*To calculate the ages of patients at the time of a reported medication error (which includes a near miss), over a 12 month period, would take a manually labour intensive and time lengthy process; as would calculating the proportion of patients classified BAME, or whether they were male or female. To clarify; details such as gender / ethnicity / age etc, are recorded within each individual service user’s health care notes.  As such, this is not information that we hold in a reportable ‘numeric’ format as we would need to conduct a physical search of their records to establish this information - a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
6. How many MEDICATION ERRORS were investigated outside the NHS and CCG?
 
None.
 
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)?
We have had nobody die as an immediate result of a medication error: however, to establish if people had died within a period of time after a medication error (or near miss), whether or not the medication error was considered the cause - would require a manual task as we would need to conduct a physical search of the records of each relevant service users health care notes, for a 12 month period, a manually labour intensive and time lengthy process.  Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
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)?
 
Please see our response above.
 
9. How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
 
Please see our response to question 7.
 
10. How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
To establish whether patients had complications up to a period after their medication error, we would need to physically search through the health care notes of every patient over a 12 month period – a manually labour intensive and time lengthy process.   Please refer to the footnote on the "appropriate limit" on the amount of time that can be spent on locating and extracting the information required to answer a Freedom of Information request (Section 12 exemption).
11. Have there been any formal complaints from patients/relatives about MEDICATION ERRORS in 2019?
 
No.
 
12. If so, what was their concerns?
 
Not applicable.
 
13. How does the Trust plan to prevent MEDICATION ERRORS in the future?
 
Our Trust adheres to Medicines Management processes and guidelines which ensure that medicines are managed and used appropriately and safely.
Medication errors have important implications for patient safety, and their identification is crucial in order to prevent adverse events.  Medication safety reports are produced for the Medicine Optimisation Group (MOG) and Trust wide Clinical Governance (TWCG) by our Medication Safety Officer on behalf of the Medicines Safety Committee. These reports are intended to provide an overview of all recorded medication related incidents/errors recorded on Datix across the organisation. 
We encourage the reporting of medication errors and near misses, to support learning and a better understanding of the root cause, so that we can develop policies and procedures to prevent further incidents.
* Please note: the Freedom of Information Act imposes a statutory limit, known as the "appropriate limit" on the amount that can be spent on locating and extracting the information required to answer a Freedom of Information request. This limit is currently set at £450, which the legislation deems to be equivalent to 18 hours of staff time. 
Section 12 of the Freedom of Information Act 2000 makes provision for public authorities to refuse requests for information where the cost of dealing with them would exceed the appropriate limit.
Where we receive a request which is estimated to be above this appropriate limit, we can apply relevant fees and charges attributable to the processing of that request.  In estimating whether a request will incur charges, we will take into account the retrieval process covering the entire request.  In view of our outlining that compliance with parts of your request would involve a wholly manual / labour intensive and time lengthy process, it is our estimation that compliance with these parts of your request will exceed this appropriate set limit.
If you are not satisfied with our decision regarding your request, you have the right to appeal and should in the first instance write to our Freedom of Information Officer, who will escalate your appeal to the Executive Team FoIA Lead. Our maximum response time to conduct our review of your appeal will be 40 working days.
 
If you are still not satisfied you can contact the Information Commissioner’s Office, who oversees Freedom of Information and Data Protection in the UK.

 

 
If there is anything that you need further clarification on, please do not hesitate to contact us.
 
Yours sincerely

 
Anne-Marie Field
Information Governance Support Officer
Email: foi.lypft@nhs.net