Oxleas NHS Foundation Trust
2nd June 2021
Our ref : FOI 7143
FREEDOM OF INFORMATION ACT 2000 – SECTION 8 REQUEST
Thank you for your request for information originally dated 27/04/2021. Your request has been managed under the terms of the Freedom of Information Act 2000.
You requested the following information under section 8 of the Act:
Please provide ECT information under the FOI act to the following questions:
1. Please supply patient’s information ECT leaflet.
See attached
2. Please supply patient ECT consent form.
See attached
3.Please supply any ECT reports/investigations
N/A
4. How many ECT in 2020?
During 2020 19 individuals received ECT therapy
5. What proportion of patients were men/women?
68% female
32% male
32% male
6. How old were they?
Ages at first appointment during 2020:
28, 34, 50, 56, 62, 63, 67, 68, 69, 69, 70, 72, 73, 73, 73, 75, 76, 77, 83
28, 34, 50, 56, 62, 63, 67, 68, 69, 69, 70, 72, 73, 73, 73, 75, 76, 77, 83
7. What proportion of patients were classified BAME?Recorded ethnicity:
Asian or Asian British - Any other background = 1
Black or Black British – African = 1
Mixed - White & Black Caribbean = 1
Not Known = 1
Other Ethnic Groups - Any Other Group = 1
White - Any other background = 4
White – British = 10
Black or Black British – African = 1
Mixed - White & Black Caribbean = 1
Not Known = 1
Other Ethnic Groups - Any Other Group = 1
White - Any other background = 4
White – British = 10
8. How many were receiving ECT for the first time?
9
9. How many patients consented to ECT?
All informal patients who have capacity are asked to give consent to treatment
10. How many ECT complaints were investigated outside the NHS and CCG?
We have not received any complaints regarding 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)?
Section 12 Exemption – No patients died during ECT. We would not hold information for any patients that died outside of the Trust’s inpatient services. Collating any information we do hold would require manually accessing/reviewing the medical records for every patient referred for ECT. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
12. How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
Section 12 Exemption
13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
Section 12 Exemption
14. How many patients have suffered complications during and after ECT and what were those complications?
Section 12 Exemption – We would only hold this information if reported by the patient. Collating this information would require manually accessing/reviewing the medical records for every patient referred for ECT and would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
15. Have there been any formal complaints from patients/relatives about ECT?
We have not received any complaints regarding ECT
We have not received any complaints regarding ECT
16. If so, what was their concerns?
N/A
17. How many patients report memory loss/loss of cognitive function?
Section 12 Exemption – To collate this information would require manually accessing/reviewing the medical records for every patient referred for ECT. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
18. What tests are used to assess memory loss/loss of cognitive function?
See attached Clinical Guidelines and Procedures for ECT
See attached Clinical Guidelines and Procedures for ECT
19. Have MRI or CT scans been used before and after ECT?
Section 12 Exemption – To collate this information would require manually accessing/reviewing the medical records for every patient referred for ECT. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
20. If so what was the conclusion?
Section 40(2) (personal information)
(2): (Where disclosure may contravene the General Data Protection Regulations)
(2): (Where disclosure may contravene the General Data Protection Regulations)
21. How does the Trust plan to prevent ECT in the future?
See attached Clinical Guidelines and Procedures for ECT
Please provide SERIOUS INCIDENT information under the FOI act to the following questions:
See attached Clinical Guidelines and Procedures for ECT
Please provide SERIOUS INCIDENT information under the FOI act to the following questions:
1. Please supply any serious incident reports/investigations
Section 12 exemption – collating this information would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
2. How many SERIOUS INCIDENT REPORTS in 2020?
The total number of level 4 and level 5 Serious incidents was 66.
3. What proportion of patients were men/women?
Section 12 Exemption – We do not record patient demographic information (age, sex, ethnicity) on our incident reporting system (Datix). To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
4. How old were they?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident.
5. What proportion of patients were classified BAME?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident.
6. How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?
We would not hold this information.
We would not hold this information.
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)?
We investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We are unable to provide information relating to deaths as part of an SI until the Coroner has held the inquest and delivered a conclusion. Due to the Covid19 pandemic, inquests relating to deaths in 2020 are significantly delayed and we would not be able to give an accurate figure for this question.
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)?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
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)?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
10. How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?
We would not have access to this information, we do not collect this data.
11. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
No
No
12. If so, what was their concerns?
N/A
13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
We complete a full investigation into the incident and formulate a recommendation plan that is implemented by the Services involved.
Please provide restraints information under the FOI act to the following questions:
1. Please supply any Restraint reports/investigations
We do not write reports for individual restraints.
Please provide restraints information under the FOI act to the following questions:
1. Please supply any Restraint reports/investigations
We do not write reports for individual restraints.
2. How many RESTRAINTS in 2020?
There were 582 “restraints”, the areas that we class as restraint are:
Prone, Supine, Side, Standing, Seated, Kneeling, Restricted escort, Belts, Handcuffs, S Bed, Safety Pod, Mechanical restraint other, Chemical restraint: Oral, Rapid Tranquilisation, Injection other and Chemical Restraint other, Seclusion and Segregation.
Prone, Supine, Side, Standing, Seated, Kneeling, Restricted escort, Belts, Handcuffs, S Bed, Safety Pod, Mechanical restraint other, Chemical restraint: Oral, Rapid Tranquilisation, Injection other and Chemical Restraint other, Seclusion and Segregation.
3. What proportion of patients were men/women?
Section 12 Exemption – We do not record patient demographic information (age, sex, ethnicity) on our incident reporting system (Datix). To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
4. How old were they?
Section 12 Exemption
5. What proportion of patients were classified BAME?
Section 12 Exemption
Section 12 Exemption
6. How many RESTRAINTS were investigated outside the NHS and CCG?
We would not hold this information.
We would not hold this information.
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 investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We are unable to provide information relating to deaths as part of an SI until the Coroner has held the inquest and delivered a conclusion. Due to the Covid19 pandemic, inquests relating to deaths in 2020 are significantly delayed and we would not be able to give an accurate figure for this question.
8.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
9. How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
Section 12 Exemption. To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
10. How many patients have suffered complications during and after RESTRAINTS and what were those complications?
We would not collect this information in relation to a restraint.
11. Have there been any formal complaints from patients/relatives about RESTRAINTS?
There were 4 complaints where restraint was mentioned.
There were 4 complaints where restraint was mentioned.
12. If so, what was their concerns?
- Following a restraint, patient's food was returned which had further metal hidden in it undetected.
- Staff did not listen to patient's explanation for why her blood pressure had dipped and they forcibly restrained her and took her to A&E against her will citing the MCA.
- Unnecessary amount of force was used when they restrained and administered patient with injection.
- Patients are being abused by physical restraints from staff
13. Are counts of forced injections available?
We as a Trust do not complete “forced injections”. Any injections are completed under a legal framework.
14. How does the Trust plan to reduce restraints in the future?
A Reducing Restrictive Practice workplan has been rolled out to all wards and this is being monitored.
Desktop reviews are completed for all prone restraints to reduce the number of prone restraints in the Trust.
Please provide SECLUSION information under the FOI act to the following questions:
1. Please supply any SECLUSION reports/investigations
We do not write reports for individual seclusions.
Desktop reviews are completed for all prone restraints to reduce the number of prone restraints in the Trust.
Please provide SECLUSION information under the FOI act to the following questions:
1. Please supply any SECLUSION reports/investigations
We do not write reports for individual seclusions.
2. How many SECLUSIONS in 2020?
23
3. What proportion of patients were men/women?
Section 12 Exemption – We do not record patient demographic information (age, sex, ethnicity) on our incident reporting system (Datix). To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
4. How old were they?
Section 12 Exemption
5. What proportion of patients were classified BAME?
Section 12 Exemption
6. How many SECLUSIONS were investigated outside the NHS and CCG?
We would not hold this information.
We would not hold this information.
7. How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
We investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We are unable to provide information relating to deaths as part of an SI until the Coroner has held the inquest and delivered a conclusion. Due to the Covid19 pandemic, inquests relating to deaths in 2020 are significantly delayed and we would not be able to give an accurate figure for this question.
8. How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
Section 12 Exemption. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
9. How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
Section 12 Exemption. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
10. How many patients have suffered complications during and after SECLUSION and what were those complications?
We would not hold this information.
11. Have there been any formal complaints from patients/relatives about SECLUSION?
No
12. If so, what was their concerns?
12. If so, what was their concerns?
N/A
13. How does the Trust plan to prevent SECLUSION in the future?
A Reducing Restrictive Practice workplan has been rolled out to all wards and this is being monitored.
Please provide MEDICATION ERRORS information under the FOI act to the following questions:
Please provide MEDICATION ERRORS information under the FOI act to the following questions:
1. Please supply any MEDICATION ERRORS reports/investigations
We do not write reports on Medication Errors
2. How many MEDICATION ERRORS in 2020?
77
3. What proportion of patients were men/women?
Section 12 Exemption – We do not record patient demographic information (age, sex, ethnicity) on our incident reporting system (Datix). To collate this information would require manually accessing/reviewing the patient’s medical records for every incident. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
12 Exemption where cost of compliance exceeds appropriate limit
(1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.
4. How old were they?
Section 12 Exemption
5. What proportion of patients were classified BAME?
Section 12 Exemption
Section 12 Exemption
6. How many MEDICATION ERRORS were investigated outside the NHS and CCG?
We would not hold this information.
We would not hold this information.
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)?
There were no immediate deaths reported, however, we would not hold this information for any patients that died outside of the Trust’s premises.
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)?
Section 12 Exemption. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
9. How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
Section 12 Exemption. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services
10. How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
Section 12 Exemption – We would only hold this information if reported by the patient. Collating this information would require manually accessing/reviewing the medical records for every incident and would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.
11. Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
9
12. If so, what was their concerns?
9
12. If so, what was their concerns?
- Patient is being overmedicated unnecessarily; they are on a depot and only needs medication for insomnia.
- Medication was Incorrect when transferred to XXXXX and why was patient stopped from receiving rTMS.
- The patient had been taking 125mg but the Doctor advised the dosage should have been 275mg
- District Nurse administered an injection of a triple overdose of the prescribed medication which was witnessed by personal assistant and confirmed by the district nurse.
- Given another patient's medication. Patient's medication went missing.
- Lack of medication reviews - supposed to be quarterly, last one March 2019.
- Did not monitor medication or provide adequate support for long enough which resulted in a further A&E admission.
- Failure to monitor - Medication had not been stabilised.
- Failure to monitor medication on numerous occasions, the amount of medication patient was on and the changes made to medication and side effects resulting in changes of behaviour and gaps in memory.
13. How does the Trust plan to prevent MEDICATION ERRORS in the future?
There are Quality Improvement projects actively being completed in the Trust to reduce the amount of medication errors.
If you have any queries or concerns or are dissatisfied with the service you have received in relation to your request, please do not hesitate to contact us. If you wish to request a review of the decision, you should write to the Information Governance Manager, Julie Lucas via email at julie.lucas9@nhs.net in the first instance. If you remain unsatisfied with the outcome of your review and wish to make a formal complaint, please address this to: Complaints, Oxleas NHS Foundation
Trust, Pinewood House, Pinewood Place, Dartford, DA2 7WG - Email: oxl-tr.complaints@nhs.net
In addition if you are not satisfied with the outcome of your complaint or review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Trust. The Information Commissioner can be contacted at: Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF (Telephone: 0303 123 1113 or 01625 545 745 - www.ico.org.uk).
Kind regards,
Paul Bransgrove
Information Governance Officer
E: oxl-tr.FOI@nhs.net
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF
If you have any queries or concerns or are dissatisfied with the service you have received in relation to your request, please do not hesitate to contact us. If you wish to request a review of the decision, you should write to the Information Governance Manager, Julie Lucas via email at julie.lucas9@nhs.net in the first instance. If you remain unsatisfied with the outcome of your review and wish to make a formal complaint, please address this to: Complaints, Oxleas NHS Foundation
Trust, Pinewood House, Pinewood Place, Dartford, DA2 7WG - Email: oxl-tr.complaints@nhs.net
In addition if you are not satisfied with the outcome of your complaint or review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Trust. The Information Commissioner can be contacted at: Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF (Telephone: 0303 123 1113 or 01625 545 745 - www.ico.org.uk).
Kind regards,
Paul Bransgrove
Information Governance Officer
E: oxl-tr.FOI@nhs.net
Oxleas NHS Foundation Trust | Bracken House | Bracton Lane | Leyton Cross Road | Dartford | Kent | DA2 7AF