OXLEAS 2023

Dear Wendy,

FREEDOM OF INFORMATION ACT 2000 – SECTION 8 REQUEST

Further to your email dated 01/06/2024, please find below a copy of the response originally sent to you on 29/05/2024 (please note that we are unable to copy the contents of the attached Trust policies into the body of an email). 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 Electro Convulsive Treatment (ECT) information under the FOI act to the following questions: -

1.Please supply patient’s information ECT leaflet

See attached “ECT policy and pack”

2.Please supply patient ECT consent form

See attached “ECT policy and pack”

3.Please supply any ECT reports/investigations

Section 40 Exemption

Section 40(2) (personal information)

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

4.How many ECT in 2023? (Both number of people + number of "treatments")

Number of Treatments	Number of Unique Patients
403	32

5.What proportion of patients were men/women?

Gender	Number of Patients
Female	28
Male	4
Grand Total	32

6.How old were they?

Age group	Number of Patients
20-29 Years	1
30-39 Years	2
40-49 Years	6
50-59 Years	4
60-69 Years	11
70-79 Years	5
80-89 Years	3
Grand Total	32

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

Ethnicity	Number of patients	Number of patients (%)
No	21	65.63%
White - British	21	65.63%

Yes (BAME)	11	34.38%
Asian or Asian British - Any other background	2	6.25%
Asian or Asian British - Indian	1	3.13%
Black or Black British - African	3	9.38%
Black or Black British - Caribbean	2	6.25%
Other Ethnic Groups - Any Other Group	3	9.38%

Grand Total	32	100.00%

8.How many people covered by the equality act received ECT?

All patients are covered by the Equality Act

9.How many people were offered talking therapy prior to ECT?

Section 12 Exemption – To collate this information would require collecting data from several mental health services and manually accessing/reviewing and mapping the data. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

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.

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

11.How many patients consented to ECT?

All informal patients who have capacity are asked to give consent to treatment.

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

We would not hold this information.

13.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: None

1 month after ECT:

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 and breach the fair processing principles of the UK GDPR (Section 40 Exemption). We would not necessarily hold information for any patients that died outside of the Trust’s services.

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

As above.

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

None.

16.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 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

17.Have there been any formal complaints from patients/relatives about ECT?

18.If so, what was their concerns?

N/A

19.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 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

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

See attached “ECT policy and pack”

21.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 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

22.If so, what was the conclusion?

See above.

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

See attached “ECT policy and pack”

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

1.Please supply any Restraints reports/investigations

We do not write reports for individual restraints.

2.How many RESTRAINTS in 2023?

667 incident reports where the patient was restrained in Acute and Crisis, Forensic inpatient and ALD services. Please note, ‘restraint’ is used to define chemical restraint (PRN, oral or rapid tranquilisation), mechanical restraint (safety pod) or physical restraint (kneeling, side, standing, seated, prone or supine).

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 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

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 people covered by the equality act were restrained?

Section 12 Exemption – As above.

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

We would not hold this information.

8.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: None

1 month after restraint:

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

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 (Section 12 Exemption) and breach the fair processing principles of the UK GDPR (Section 40 Exemption). Please note that we would not necessarily hold this information for any patients that died outside of the Trust’s inpatient services.

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

As above

11.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.

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

The Trust received 2 complaints regarding restraint.

13.If so, what was their concerns?

1x allegation of excessive force

1x complaint regarding privacy & dignity during restraint

14.Are counts of forced injections available?

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

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

Reducing restrictive practice is a key patient safety priority for the trust. Various work is being carried out with our staff and service users to do this. Please see the attached reducing restrictive practice policy.

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 2023?

16 incidents of seclusion reported in Forensic inpatients.

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 people covered by the Equality Act were secluded?

Section 12 Exemption – As above.

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

We would not hold this information.

8.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: None

1 month after seclusion:

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)?

As above.

11.How many patients have suffered complications during and after SECLUSION 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 medical records and would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000 and breach the fair processing principles of the UK GDPR (Section 40 Exemption).

12.Have there been any formal complaints from patients/relatives about SECLUSION?

13.If so, what was their concerns?

N/A

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

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 2023?

Section 12 Exemption – Due to the way in which medication errors are categorised within our incident reporting system (Datix), we are unable to confirm the number of medication errors in 2023 without manually reviewing approximately 572 incident reports to identify exactly which incidents are medication errors. This would exceed the appropriate cost/time limit under Section 12 of the Freedom of Information Act 2000.

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 people covered by the equality act endured medication errors?

Section 12 Exemption – As above.

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

We would not hold this information.

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)?

During medication error: We can confirm that no patients died at the time of a medication error.

1 month after medication error:

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)?

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

As above.

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

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

Yes (see below)

13.If so, what was their concerns?

Wrong drug/quantity – 8

Delay to Medication – 17

Failure to monitor – 13

14.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,

Information Governance Office

E: oxl-tr.FOI@nhs.net