OXLEAS 2021

Name: Wendy Micklewright

Email: wmicklewright@yahoo.co.uk _{Bracken House}

Bracton Lane

Our ref: FOI 8137 Leyton Cross Road

Dartford

Date: 22 June 2022

Dear Wendy

FREEDOM OF INFORMATION ACT 2000 – SECTION 8 REQUEST

Thank you for your request for information dated 05/05/2022. 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 2021?

22 patients were seen in ECT between Jan - Dec 2021

5.What proportion of patients were men/women?

73% female

27% male

6.How old were they?

Ages at first appointment during 2021 were between 49-88 years: 40-49 Years (2)

50-59 Years (3)

60-69 Years (10)

70-79 Years (3) 80-89 Years (4)

7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Recorded ethnicity:

Asian or Asian British - Indian (1)

Black or Black British - African (2)

White - Any other background (1)

White - British (16)

White - Irish (2)

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

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 would not hold this information.

11.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?

During ECT: No patients died during ECT.

1 month after ECT:

Collating 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. We would not hold information for any patients that died outside of the Trust’s inpatient services.

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. Please note that we would not hold this information for any patients that died outside of the Trust’s inpatient services

13.How many patients died by suicide within 6 months of receiving ECT (whether or not ECT 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

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?

16.If so, what was their concerns?

N/A

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

Section 12 Exemption – 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.

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

Please see attached ECT Policy

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)

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: -

1.Please supply any serious incident reports/investigations?

Section 40 exemption - The information requested contains third party personal data and therefore, the disclosure of this information would breach the UK General Data Protection Regulation and Data Protection Act 2018. As a result, we are unable to provide you with the information you have requested.

Section 40(2) (personal information)

(2): (Where disclosure may contravene the General Data Protection Regulations)

2.How many SERIOUS INCIDENT REPORTS in 2021?

(Total number of level 4 and level 5 Serious incidents)

51 (including falls, excluding prisons)

3.What proportion of patients were men/women? Men 67%, Women 33%

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. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.

5.What proportion of patients were classified people of the global majority or racialised communities ("POC / 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.

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)?

42 serious incident reports were concerning patient deaths.

1 month after serious incident reports:

Collating this information would require manually accessing/reviewing the medical records. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000. We would not hold information for any patients that died outside of the Trust’s inpatient services.

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)?

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?

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 Restraints/investigations?

We do not write reports for individual restraints.

2.How many RESTRAINTS in 2021?

There were 648 restraints reported in the Trust in 2021.

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.

4.How old were they?

Section 12 Exemption – As above

5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Section 12 Exemption – As above

6.How many RESTRAINTS were investigated outside the NHS and CCG? 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)?

During restraint: We investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We can confirm that no patients died during restraint.

1 month after restraint:

8.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?

9.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?

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? 3

12.If so, what was their concerns?

Sustained injury due to restraint

13.Are counts of forced injections available?

As a Trust, we do not perform “forced injections”. Any injections are completed under a legal framework.

14.How does the Trust plan to reduce restraints in the future?

Separate the Reducing Restrictive Practice policy from the Prevention & Management of Violence & Aggression policy and update it to include requirements of section 4 MHU (Use of Force) Act
Develop and introduce annual training updates on reducing the restrictive practice for all staff
Introduce Trauma Informed Approaches in our practice
We will eliminate use of prone restraint in the Forensic units
Develop and publish the 2022 -2025 Reducing Restrictive Practice Strategy and work plan
We will scale up and embed the implementation of the See Think Act framework across all the wards.
We will report on all protected characteristics and on diagnosis of people who are restrained
We will continue to engage in Health Innovation Network workshops and Quality Improvement projects
We will complete and share ethnicity and restraint study.

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 2021?

There were 39 seclusions in 2021.

3.What proportion of patients were men/women?

4.How old were they?

Section 12 Exemption – As above

5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")? Section 12 Exemption – As above

6.How many SECLUSIONS were investigated outside the NHS and CCG? 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)?

During seclusion: We investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We can confirm that no patients died during seclusion.

1 month after seclusion:

Collating this information would require manually accessing/reviewing medical records. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000. We would not hold information for any patients that died outside of the Trust’s inpatient services.

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?

12.If so, what was their concerns?

N/A

13.How does the Trust plan to reduce SECLUSIONS in the future?

Please see restrictive practice reduction plan outlined in question 14 of Restraint.

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 2021?

There were 546 medication errors in 2021. Please note that due to changes in the way in which this information is recorded / extracted from our incident reporting system this figure may differ significantly from data provided previously.

3.What proportion of patients were men/women?

4.How old were they?

Section 12 Exemption – As above

5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?

Section 12 Exemption – As above

6.How many MEDICATION ERRORS were investigated outside the NHS and CCG? 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)?

We investigate any incident of unexplained, unexpected death or incidents relating to self harm that had the potential to cause significant harm. We can confirm that no patients died at the time of a medication error.

1 month after medication error:

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? No

12.If so, what was their concerns?

N/A

13.How does the Trust plan to prevent MEDICATION ERRORS in the future?

The Safer Use of Medicines Committee is responsible for quality improvements in medications

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