The Freedom of Information Team
Information Governance Team Office
1st Floor Haylock House
Kettering Venture Park
Kettering NN15 6EY
📞 0300 0111133 (voicemail only)
15 July 2024
mrs.wendy.micklewright
Sent by email only to: mrs.wendy.micklewright@proton.me
Dear Requester,
Freedom of Information Act 2000 request:
With reference to your request for information made under section 1(1) of the Freedom of Information Act: we set out below your request as it was received by Northamptonshire Healthcare (NHFT) together with the Trust’s response(s):
You asked:
Please provide Electro Convulsive Treatment (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 2023?
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 people covered by the equality act received ECT ?
9.How many people were offered talking therapy prior to ECT ?
10.How many were receiving ECT for the first time?
11.How many patients consented to ECT?
12.How many ECT complaints were investigated outside the NHS and CCG?
13.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
14.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
15.How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
16.How many patients have suffered complications during and after ECT and what were those complications?
17.Have there been any formal complaints from patients/relatives about ECT?
18.If so, what was their concerns?
19.How many patients report memory loss/loss of cognitive function?
20.What tests are used to assess memory loss/loss of cognitive function?
21.Have MRI or CT scans been used before and after ECT?
22.If so, what was the conclusion?
23.How does the Trust plan to prevent ECT in the future?
Please provide restraints information under the FOI act to the following questions: -
1.Please supply any Restraints/investigations
2.How many RESTRAINTS in 2023?
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 people covered by the equality act were restrained?
7.How many RESTRAINTS were investigated outside the NHS and CCG?
8.How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
9.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
10.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
11.How many patients have suffered complications during and after RESTRAINTS and what were those complications?
12.Have there been any formal complaints from patients/relatives about RESTRAINTS?
13.If so, what was their concerns?
14.Are counts of forced injections available?
15.How does the Trust plan to reduce restraints in the future?
Please provide SECLUSION information under the FOI act to the following questions: -
1.Please supply any SECLUSION reports/investigations
2.How many SECLUSIONS in 2023?
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 people covered by the Equality Act were secluded ?
7.How many SECLUSIONS were investigated outside the NHS and CCG?
8.How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
10.How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
11.How many patients have suffered complications during and after SECLUSION and what were those complications?
12.Have there been any formal complaints from patients/relatives about SECLUSION?
13.If so, what was their concerns?
14.How does the Trust plan to reduce SECLUSIONS in the future?
14.How does the Trust plan to prevent MEDICATION ERRORS in the future?
Our response:
ECT
1.Please supply patient’s information ECT leaflet. See attachment ‘ElectroConvulsive-Therapy-Information-Resource- 3-March 2022’
2.Please supply patient ECT consent form See attachment ‘NHFT consent form (ECT)’
3.Please supply any ECT reports/investigations n/a
4.How many ECT in 2023? 23
5.What proportion of patients were men/women? Men 10 Women 13
6.How old were they? 18-85
7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")? Not a mandatory field of capture therefore unable to report.
8.How many were receiving ECT for the first time? 22
9.How many patients consented to ECT? All patients are consented prior to the procedure; where a patient is under Section and does not have capacity, a MCA capacity is completed by the treating clinician.
10.How many ECT complaints were investigated outside the NHS and CCG? None received.
11.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
12.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
13.How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
14.How many patients have suffered complications during and after ECT and what were those complications? None, each patient receives an anaesthetic review at the start of ECT and is seen by their Responsible Clinician /Consultant after every two sessions.
15.Have there been any formal complaints from patients/relatives about ECT? No
16.If so, what was their concerns? n/a
17.How many patients report memory loss/loss of cognitive function? Short-term memory impairment is a recognised side effect of ECT. No patients reported this as a long-term side effect.
18.What tests are used to assess memory loss/loss of cognitive function? MOCA and Hamilton prior to commencement of ECT and thereafter at treatments 4, 8 and 12.
19.Have MRI or CT scans been used before and after ECT? MRI and CT scans are not routinely undertaken at this Trust.
20.If so, what was the conclusion? n/a
21.How does the Trust plan to prevent ECT in the future? The Trust has no such plans since it considers ECT a valuable treatment; around 70% of those suffering from psychiatric disorders that undergo the treatment, achieve improvement and/or subsequent recovery.
Seclusion
1.Please supply any SECLUSION reports/investigations
All episodes are routinely reviewed internally, on a monthly basis; there have been no formal investigations
2.How many SECLUSIONS in 2023?
227 incidents (110 service users)
3.What proportion of patients were men/women?
61.8% Male
37.3% Female
0.9% Not Known
4.How old were they?
|
Age Group |
Count |
|
0-17 |
6 |
|
18-24 |
21 |
|
25-34 |
26 |
|
35-44 |
29 |
|
45-54 |
16 |
|
55-64 |
8 |
|
65+ |
3 |
|
NOT KNOWN |
1 |
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
Ethnicity National Code |
Count |
|
White - British |
38 |
|
White - Irish |
4 |
|
White - Any other White background |
10 |
|
Mixed - White and Black Caribbean |
2 |
|
Mixed - White and Black African |
1 |
|
Mixed - White and Asian |
0 |
|
Mixed - Any other mixed background |
11 |
6.How many people covered by the Equality Act were secluded ?
The Equalities Act covers all patients as such the figure will be the same as in question 2 for Seclusions.
7.How many SECLUSIONS were investigated outside the NHS and CCG? - Nil
8.How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
10.How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
11.How many patients have suffered complications during and after SECLUSION and what were those complications? Northamptonshire Healthcare NHS Foundation Trust does not capture this information in a reportable format.
12.Have there been any formal complaints from patients/relatives about SECLUSION? ZERO
13.If so, what was their concerns? n/a
14.How does the Trust plan to reduce SECLUSIONS in the future?
Please see the Trust’s public-facing website for our Seclusion Policy CLP007
Restraints
1.Please supply any Restraints/investigations All restraints are discussed and reviewed within the PMVA monitoring group monthly. Any incidents of particular concern are discussed more in depth and possibly further discussed outside of the meeting with the ward manager and LRRP.
2.How many RESTRAINTS in 2023?
|
Incidents |
1758 |
|
Patients |
189 |
3.What proportion of patients were men/women?
|
Gender |
Records |
|
Male |
86 |
|
Female |
101 |
|
Not Known (Not Recorded) |
2 |
4.How old were they?
|
Age Group |
Records |
|
0-17 |
22 |
|
18-24 |
32 |
|
25-34 |
33 |
|
35-44 |
36 |
|
45-54 |
23 |
|
55-64 |
16 |
|
65+ |
31 |
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Not a mandatory field of capture therefore unable to report.
6.How many people covered by the equality act were restrained?
The Equalities Act covers all patients as such the figure will be the same as in question 2 for Restraints.
7.How many RESTRAINTS were investigated outside the NHS and CCG? - 0
8.How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
9.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
10.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
11.How many patients have suffered complications during and after RESTRAINTS and what were those complications? <10 have been recorded as being injured during restraint.
12.Have there been any formal complaints from patients/relatives about RESTRAINTS? <10
13.If so, what was their concerns? We are unable to provide this without risk of identifying the individuals involved, as such the Trust is applying a Section 40(2) exemption. Full details of this exemption can be found below.
14.Are counts of forced injections available? 0
15.How does the Trust plan to reduce restraints in the future?
There is a continued drive to reduce the number of all restrictive practices not just restraint. The Lead for Reducing Restrictive Practices continually monitors any use of restrictive practices within the trust. The LRRP also works directly with the wards to support on and implement QI projects on the reduction of all restrictive practices. Currently there is a three-year strategy in place, for reducing restrictive practices that will be reviewed in 2025.
All incidences of restraint and seclusion are continually reviewed to ensure best practice and that the use of those practices are the least restrictive option. The LRRP provides training on staff development days to ensure there is a focus on the reduction of restrictive practices. Staff are encouraged to conduct debriefs with patients following restraint in order to learn from incidents and reflect.
The trust employs a blended approach of PBS, PBS style care plans, Trauma Informed Care and Safe wards to ensure that all care plans are person centred and promote the recovery of a person in our care and improve their quality of life. The LRR also promotes visiting other services and providers in order share and learn from best practice. There is also an annual report generated for the board on the use of restraint and seclusion to ensure that there is clarity and openness on the use of all the restrictive physical interventions. The policies are reviewed and updated as the national legislation, guidance, best practices and lessons learned evidence.
Medication Errors
Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
1.Please supply any MEDICATION ERRORS reports/investigations - n/a
2.How many MEDICATION ERRORS in 2023? - 1337
3.What proportion of patients were men/women?
1039 of the 1337 incidents were patient related the proportional breakdown of which is in the table below
|
Gender |
Records |
|
Female |
442 |
|
Male |
562 |
|
Other / Not recorded |
35 |
|
Grand Total |
1039 |
Please note duplicate values have been removed.
4.How old were they?
|
Age Group |
Records |
|
Under 18 |
42 |
|
18-40 |
216 |
|
40-65
|
251 |
|
Over 65
|
440
|
|
Unknown |
90 |
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
Not a mandatory field of capture therefore unable to report
6.How many people covered by the equality act endured medication errors ?
The Equalities Act covers all patients as such the figure will be the same as in question 2 for Medication Errors.
7.How many MEDICATION ERRORS were investigated outside the NHS and CCG? N/A
8.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)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
9.How many patients died within 6 months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
10.How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)? This information is not recorded in a reportable format at Trust level - enquiries regarding deaths should be directed to the coroner’s office.
11.How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications? None recorded.
12.Have there been any formal complaints from patients/relatives about MEDICATION ERRORS? - 3
13.If so, what was their concerns?
1 – Concerned about an adverse reaction of 2 separate medications.
1 – Concerned about medication not being suitable for a relative’s condition.
1- Prescription had wrong name on.
14.How does the Trust plan to prevent MEDICATION ERRORS in the future?
The Trust has a multidisciplinary Medicine’s Safety Group that monitors all medication incidents ( both actual incidents and near misses) and shares learning from these incident reports across the organisation, advising on changes to practice and policy should these be required. Ongoing implementation of Electronic Prescribing and Medicines Administration is part of the Trust’s strategy to continuously improve medicines safety.
Exemption Note:
Whilst Northamptonshire Healthcare can confirm it holds all requested data, it has been determined that further detail should not be released since to do so might risk potential identification of the individuals involved, thereby contravening data protection legislation.
In accordance with the Freedom of Information Act Section 40(2) therefore, the Trust is refusing this part of the request since this is the personal data of another person. Section 40(2) of the FOIA states that the personal data of a third party is exempt from disclosure under the FOIA if to do so would contravene any of the data protection principles. The Act states:
“ Any information to which a request for information relates is also exempt information if—
(a) it constitutes personal data which does not fall within subsection (1), and
(b) the first, second or third condition below is satisfied.
The first condition is that the disclosure of the information to a member of the public otherwise than under this Act—
(a) would contravene any of the data protection principles, or
(b) would do so if the exemptions in section 24(1) of the DPA2018 (manual unstructured data held by public authorities) were disregarded.
The second condition is that the disclosure of the information to a member of the public otherwise than under this Act would contravene Article 21 of the GDPR (general processing: right to object to processing).”
Article 5 (a) states that personal data must be processed lawfully, fairly and in a transparent manner in relation to the data subject. To release data linked to an individual into the public domain would run contrary to the individual’s expectations of how their data is used and hence would breach the Trusts responsibility under Article 5 (a).
This concludes our response to your request for information. If you are unhappy with the reply, please forward your concerns to the address below to request an Internal Review, detailing your reasons for dis-satisfaction and these will be addressed accordingly.
Head of Data Privacy/Group Data Protection Officer
NHFT Information Governance Team Office
1st Floor Haylock House, Kettering Venture Park
Kettering
NN15 6EY
Alternatively, you may email your request to dpo@nhft.nhs.uk. Please note that any such request should be made within forty working-days of the date of this response; requests received after this period will not be considered.
If you are still not content with the outcome, you may apply directly to the Information Commissioner for a decision. Generally, the Information Commissioner cannot make a decision unless you have exhausted the complaints procedure provided by the Trust. The Information Commissioner can be contacted at:
The Information Commissioner's Office
Wycliffe House Water Lane
Wilmslow
SK9 5AF
Yours faithfully,
The Freedom of Information Team
Northamptonshire Healthcare NHS Foundation Trust
Email: foi@nhft.nhs.uk | Web: Northamptonshire Healthcare Home
Information Governance Team Office
1st Floor Haylock House | Kettering Venture Park | Kettering | NN15 6EY