MIDLANDS 2019

Dear Ms. Micklewright,
Further to your recent request made under the Freedom of Information Act 2000, please see detailed below the Trust’s response:

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

Investigations are only carried out by the Investigation Team following a Serious Incident.

4. How many ECT in 2019?

550.

5. What proportion of patients were men/women?

5. What proportion of patients were men/women?

Sex	Number of ECT's
Female	372
Male	178
Grand Total	550

6. How old were they?

6. How old were they?

Age	Number of ECT's
25	7
26	5
30	13
39	13
47	6
48	<5
49	19
53	16
54	<5
55	<5
58	9
59	46
60	24
61	11
62	7
63	7
64	26
66	42
67	30
68	12
69	<5
70	10
71	14
72	<5
73	8
74	49
75	24
76	11
77	14
78	10
79	6
80	16
81	37
82	<5
83	6
85	13
86	7
88	10
91	11
Grand Total	550

7. What were the diagnoses and in what proportions?

We do not routinely record the diagnoses of every patient treated with ECT. The only way of obtaining the information would be to manually check through all Patient records. Given that there are 550 patients which even at 2 minutes per client, would take 18 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.

8. What proportion of patients were classified BAME?

8. What proportion of patients were classified BAME?

Ethnicity	Number of ECT's
Asian or Asian British - Indian	18
Asian or Asian British - Pakistani	13
Black or Black British - Caribbean	<5
Not Stated	19
White - Any other background	14
White - British	485
Grand Total	550

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

39 Patients.

10.How many patients consented to ECT?

We do not record this information. The only way of obtaining the information would be to manually check through all Patient records. Given that there are 550 patients which even at 2 minutes per client, would take 18 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.
11. How many ECT complaints were investigated outside the NHS and CCG?
None.
12. How many patients died a few months after ECT and what was the cause (whether or not ECT was considered the cause)?

None.

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

None.

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

We do not record this information. The only way of obtaining the information would be to manually check through all Patient records. Given that there are 550 patients which even at 2 minutes per client, would take 18 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.

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

We do not record this information. The only way of obtaining the information would be to manually check through all Patient records. Given that there are 550 patients which even at 2 minutes per client, would take 18 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.

16. Have there been any formal complaints from patients/relatives about ECT?
No.
17. If so, what was their concerns?
Not applicable.
18.How many patients report memory loss/loss of cognitive function?
We do not record this information. The only way of obtaining the information would be to manually check through all Patient records. Given that there are 550 patients which even at 2 minutes per client, would take 18 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.

19.What tests are used to assess memory loss/loss of cognitive function?
Cognitive function tests are carried out 3 months and 6 months post treatment.
20.Have MRI or CT scans been used before and after ECT?
No, the request for MRI or CT scans would be carried out prior to referral for ECT.

21. If so what was the conclusion?

Not applicable

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

There are currently no plans to prevent ECT.

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

1.     Please supply SERIOUS INCIDENT REPORTS patient’s information leaflet.
We have no such document.

2.     Please supply patient SERIOUS INCIDENT REPORTS consent form.

We do not need patient’s consent to carry out Serious Incident Investigations it is a requirement from NHS England.

3.     Please supply any serious incident reports/investigations

I can confirm that the Trust holds the information requested, but in this case we will not be providing it to you as it is exempt from disclosure.

We will not be providing this information under both section 12 and section 40 (2) of the Freedom of Information Act.

The only way of obtaining the information would be to manually check through all Serious Incident Reports and redact all personal information. Given that there are 87 reports which even at 15 minutes per report, would take 21 hours. The provision of this information is therefore exempt under Section 12 of the FOI act which states that this exemption will apply “where the cost of compliance is estimated to exceed the appropriate limit”. This is based on a cost limit of £450 with a calculation of £25 per hour.

We are not obliged, under section 40(2) of the Act, to provide information that is the personal information of another person if releasing would contravene any of the provisions in the Data Protection Act 1998 (DPA). In this instance we believe that the release of this information would contravene the first data protection principle and therefore section 40 (2) is engaged. The terms of this exemption in the Freedom of Information Act mean that we do not have to consider whether or not it would be in the public interest for you to have the information.

4.     How many SERIOUS INCIDENT REPORTS in 2019?

87

5.     What proportion of patients were men/women?

40 women/47 men.

6.     How old were they?

Age	Female Patients
14	<5
18	<5
25	<5
27	<5
31	<5
32	<5
33	<5
34	<5
35	<5
36	<5
39	<5
43	<5
46	<5
47	<5
50	<5
55	<5
56	<5
58	<5
62	<5
66	<5
68	<5
71	<5
72	<5
73	<5
75	<5
76	<5
80	<5
83	<5
85	<5
88	<5
(blank)	<5
Total	40

Age	Male Patients
3	<5
17	<5
19	<5
21	<5
22	<5
23	<5
25	<5
26	<5
27	<5
29	<5
32	<5
33	<5
34	<5
35	<5
38	<5
40	<5
41	<5
42	<5
43	<5
44	<5
46	<5
47	<5
48	<5
50	<5
51	<5
55	<5
56	<5
57	<5
60	<5
62	<5
64	<5
67	<5
68	<5
80	<5
84	<5
89	<5
(blank)	<5
Total	47

Gender and Age Unknown	6

7.     What were the diagnoses and in what proportions?

We do not record this information.

8.     What proportion of patients were classified BAME?
We do not record this information.

9.     How many were receiving SERIOUS INCIDENT REPORTS for the first time?
We do not record this information.

10.How many patients consented to SERIOUS INCIDENT REPORTS?
We do not need patient’s consent to carry out Serious Incident Investigations it is a requirement from NHS England.

11. How many SERIUOS INCIDENT REPORTS were investigated outside the NHS and CCG?

None.

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)?
We do not record this information. Serious Incidents are carried out after a patient has died.

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)?

We do not record this information. Serious Incidents are carried out after a patient has died.

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)?

We do not record this information.

15. How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?

We do not record this information.

16. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
Yes.

17.If so, what was their concerns?

              The complainants were unhappy with RCA findings and other complainants had further concerns following the outcome of the RCA which were not part      of the original investigation.

18.How many patients report memory loss/loss of cognitive function?
We do not record this information.

19.What tests are used to assess memory loss/loss of cognitive function?
Any patient with memory loss is tested with Cognitive Function Tests

20. Have MRI or CT scans been used before and after SERIOUS INCIDENT REPORTS?
We do not record this information.

21.If so what was the conclusion?
We do not record this information.

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

              Incident management underpins a basic part of the risk management framework for Midlands Partnership NHS Foundation Trust. It is important that incidents are reported and investigated in a consistent way and that lessons learnt are shared within the organisation to reduce the likelihood of similar          incidents occurring within our services.

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

1.     Please supply RESTRAINTS patient’s information leaflet.
We have no such document.

2.     Please supply patient RESTRAINTS consent form.
We have no such document. A patient would not consent to restraint, restraint would be used only if it was deemed in the patients best interests.

3.     Please supply any Restraints/investigations

Investigations are only carried out by the Investigation Team following a Serious Incident.

4.     How many RESTRAINTS in 2019?
1294

5.     What proportion of patients were men/women?

579 women/715 men

6.     How old were they?

Age	Female Patients
17	<5
18	27
19	<5
20	15
21	<5
24	7
25	7
26	<5
27	5
28	<5
29	6
31	21
32	6
33	5
34	22
35	11
36	18
37	<5
38	8
39	8
41	27
42	17
43	<5
45	7
46	<5
47	8
48	7
49	7
50	9
51	14
52	<5
53	8
54	<5
55	7
56	9
57	38
58	11
59	5
60	10
62	55
64	9
65	<5
66	12
67	<5
68	<5
69	8
70	<5
71	<5
72	23
73	<5
74	11
75	17
76	<5
77	8
78	14
79	6
80	5
81	<5
83	<5
85	<5
93	<5
94	<5
(blank)	7
Total	579

Age	Male Patients
18	<5
19	12
20	<5
21	12
22	8
23	16
24	29
25	21
26	10
27	12
28	6
29	7
30	8
31	<5
32	28
33	17
34	18
35	8
36	9
37	12
38	14
39	78
40	13
41	19
43	<5
44	19
45	79
46	42
47	<5
48	<5
49	13
50	8
51	<5
52	5
53	9
54	<5
58	7
59	7
60	<5
61	<5
62	7
63	6
64	16
65	<5
66	<5
67	39
68	<5
69	<5
70	<5
72	13
77	<5
78	<5
80	<5
81	6
82	<5
83	21
84	6
85	<5
87	<5
88	<5
89	7
92	5
Total	715

7. What were the diagnoses and in what proportions?

We do not record this information.

8. What proportion of patients were classified BAME?

Ethnic Origin	Patients
Asian or Asian British - Any other background	15
Asian or Asian British - Indian	9
Asian or Asian British - Pakistani	6
Black African - Black Or Black British	<5
Black Caribbean - Black Or Black British	<5
Black or Black British - African	<5
Black or Black British - Any other background	<5
Black or Black British - Caribbean	28
British - White	139
Irish – White	<5
Not Known	20
Not Stated / Unknown	79
Other Ethnic Groups - Any Other Group	<5
Other White - White	<5
White - Any other background	29
White – British	831
White & Black Caribbean	<5
White & Black Caribbean - Mixed	11
(blank)	108
Total	1294

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

We do not record this information.

10.How many patients consented to RESTRAINTS?
As above, patients do not consent to restraint, restraint is used in a patients best interests.

11. How many RESTRAINTS were investigated outside the NHS and CCG ?
None.
12. .How many patients died during or soon after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
None.

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

None.

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

None.

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

None.

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

No.

17. If so, what was their concerns?

Not applicable.

18. How many patients report memory loss/loss of cognitive function?
We do not record this information.

19. What tests are used to assess memory loss/loss of cognitive function?
Any patient with memory loss is tested with Cognitive Function Tests

20.Have MRI or CT scans been used before and after RESTRAINTS?
We do not record this information.
21. If so what was the conclusion?

We do not record this information.

22. How does the Trust plan to reduce restraints in the future?
Restraint is not a standard method of managing patients within the Trust. However, in rare and exceptional circumstances in order to protect the patient, other patients, staff and the general public it may be necessary to restrain patients.

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

1.       Please supply patient’s information SECLUSION leaflet.

         We have no such document.

2.       Please supply patient SECLUSION consent form.

Patients do not consent to seclusion. Patients detained under the Mental Health Act are secluded for their own safety and the safety of other patients and staff and in the patients best interests.

3.       Please supply any SECLUSION reports/investigations

Investigations are only carried out by the Investigation Team following a Serious Incident

4.       How many SECLUSION in 2019?

107

5.       What proportion of patients were men/women?

47 women/60 men

6.       How old were they?

Age	Female Patients
24	<5
25	<5
31	<5
34	<5
35	<5
36	<5
41	<5
42	<5
43	<5
45	<5
47	<5
51	<5
53	<5
56	<5
57	9
58	<5
60	<5
62	<5
65	<5
(blank)	<5
Total	47

Age	Male Patients
18	<5
19	<5
20	<5
21	<5
22	<5
23	5
24	<5
25	<5
26	<5
28	<5
29	<5
31	<5
33	<5
35	<5
36	<5
37	<5
38	<5
40	<5
41	<5
43	<5
44	<5
45	<5
49	<5
50	<5
62	<5
63	<5
64	<5
Total	60

7. What were the diagnoses and in what proportions?
We do not record this information.

8. What proportion of patients were classified BAME?

Ethnic Group	Patients
Asian or Asian British - Any other background	5
Asian or Asian British - Pakistani	<5
Black or Black British - Any other background	<5
British - White	10
Not Known	<5
Not Stated / Unknown	<5
Other Ethnic Groups - Any Other Group	<5
White - Any other background	<5
White – British	68
White & Black Carribbean - Mixed	<5
(blank)	9
Total	107

9.       How many were receiving SECLUSION for the first time?
We do not record this information.

10. How many patients consented to SECLUSION?

         As above patients do not consent to seclusion, seclusion is used in a patients best interests.

11. How many SECLUSIONS were investigated outside the NHS and CCG ?
None.

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

None.

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

   None.

14. How many patients died by suicide within a few months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
   None.

15. How many patients have suffered complications during and after SECLUSION and what were those complications?
   None.

16. Have there been any formal complaints from patients/relatives about SECLUSION?
No.

17. If so, what was their concerns?

Not applicable.

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

We do not record this information.

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

Any patient with memory loss is tested with Cognitive Function Tests

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

         We do not record this information.

21. If so what was the conclusion?

          We do not record this information.

22. How does the Trust plan to prevent SECLUSION in the future?
Seclusion is not a standard method of managing patients within the Trust. However, in rare and exceptional circumstances in order to protect other patients, staff and the general public it may be necessary to seclude patients. Seclusion is only used for patients detained under the Mental Health Act and is only used when patients display highly and severely disturbed behaviour.

Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
1.     Please supply patient’s information MEDICATION ERRORS leaflet.
We have no such document.

2.     Please supply patient MEDICATION ERRORS consent form.
We have no such document.

3.     Please supply any MEDICATION ERRORS reports/investigations

         Investigations are only carried out by the Investigation Team following a Serious Incident

4.     How many MEDICATION ERRORS in 2019?
593

5.     What proportion of patients were men/women?

221 women/257men/115 unknown

6.     How old were they?

Age	Female Patients
16	<5
19	<5
20	<5
21	<5
23	<5
24	<5
25	<5
26	<5
27	<5
28	<5
30	<5
31	6
32	<5
33	<5
34	6
35	<5
37	<5
38	6
39	<5
41	<5
42	6
43	<5
44	<5
45	<5
46	<5
49	8
50	<5
51	<5
52	<5
54	<5
55	11
56	<5
57	8
58	<5
60	5
61	<5
62	28
63	<5
64	<5
65	<5
66	5
67	5
68	<5
70	<5
71	6
72	<5
73	5
75	<5
76	5
77	<5
78	6
79	<5
81	<5
84	<5
85	5
88	<5
93	<5
94	<5
95	<5
(blank)	<5
Total	221

Age	Male Patients
19	7
21	<5
22	<5
23	<5
24	7
25	5
26	<5
27	<5
28	<5
29	8
30	5
31	8
32	15
33	5
34	10
35	7
36	5
37	8
38	<5
39	17
40	7
41	5
42	<5
43	<5
44	<5
45	9
46	<5
47	<5
48	<5
49	10
50	12
51	<5
53	<5
54	6
55	<5
58	<5
59	<5
60	<5
61	<5
62	<5
63	<5
64	<5
65	<5
66	<5
67	6
68	<5
69	<5
70	<5
71	<5
73	<5
74	<5
75	<5
76	<5
77	<5
78	<5
79	<5
80	<5
82	<5
84	<5
89	<5
91	<5
94	<5
(blank)	<5
Total	257

Unknown Age and Gender	115

7.     What were the diagnoses and in what proportions?

          We do not record this information

8.     What proportion of patients were classified BAME?

Ethnic Group	Patients
Asian or Asian British - Any other background	<5
Asian or Asian British - Pakistani	7
Black or Black British - African	<5
Black or Black British - Any other background	5
Black or Black British - Caribbean	5
British - White	55
Irish - White	<5
Mixed - Any other mixed background	<5
Not Known	5
Not Stated / Unknown	34
Other Ethnic Groups - Any Other Group	9
Pakistani - Asian Or Asian British	<5
White - Any other background	9
White - British	275
White - Irish	<5
White & Black Caribbean	7
(blank)	172
Total	593

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

          We do not record this information

10.How many patients consented to MEDICATION ERRORS?

None.

11.How many MEDICATION ERRORS S 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)?

None.

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)?
None.

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.

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

None.

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

Yes

17.If so, what was their concerns?

The incorrect dose of medication was administered.

18. How many patients report memory loss/loss of cognitive function?
      We do not record this information
19. What tests are used to assess memory loss/loss of cognitive function?
Any patient with memory loss is tested with Cognitive Function Tests

20. Have MRI or CT scans been used before and after MEDICATION ERRORS?
We do not record this information
21. If so what was the conclusion?
We do not record this information
22.How does the Trust plan to prevent MEDICATION ERRORS in the future?

Staff MUST follow the basic principles of safe administration of medication as listed below at

ALL times: RIGHT PATIENT	Ask patient to confirm their name Check name of patient on administration record
RIGHT MEDICATION	Check name on medication label corresponds with MARs chart
RIGHT DOSE	Check dose on medication label corresponds with MARs chart
RIGHT TIME	Check the frequency of medication Check medication is been given / taken at the correct time Confirm when last dose was given
RIGHT ROUTE	Confirm that patient can take/ receive medication by specified route
RIGHT DOCUMENTATION	Record signature, and any relevant information after giving specified medication Observe patient taking medication Document time of administration and any relevant information in care record
RIGHT CONSENT	Ensure that you have gained patient consent to administer medication
RIGHT EDUCATION	All staff involved in the administration of medication must have received appropriate medicines management training

We would be grateful if you could take a minute to fill out our Freedom of Information Customer Satisfaction Survey (attached) and let us know about your experience.
Please contact me (Aled Evans) in the first instance if you have any queries or questions regarding the Trust's response. However, if you have any complaints about the handling of your enquiry, please contact:

Ms Lian Stibbs
Head of Information Governance and Records Access Management
Midlands Partnership Foundation Trust
Trust Headquarters St George's Hospital Corporation Street Stafford
ST16 3SR
Email: lian.stibbs@mpft.nhs.uk

You also have a right of appeal to the Information Commissioner at:

Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545700
Website: www.informationcommissioner.gov.ukPLEASE NOTE: As of 1^st June 2018 South Staffordshire and Shropshire Healthcare NHS Foundation Trust has merged with Staffordshire and Stoke-on-Trent Partnership NHS Trust to become Midlands Partnership Foundation Trust.
Yours sincerely

Aled Evans

FOI Officer
Midlands Partnership Foundation Trust
Trust HQ, St George’s Hospital
Corporation Street
Stafford
ST16 3AG
Tel: 01785 221104 Extension: 7128998
Skype: 01785 301314 Extenstion: 301314
Email: FOI@mpft.nhs.uk