Dear Wendy,
Thank you for your email.
As requested, please find our response to your FOI request questions below - please note that we were not able to copy the contents of policy documents into the body of the email (copies attached).
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 2024?
27
*Data range – Jan 24 to Dec 24
5.What proportion of patients were men/women?
Men – 19%
Women – 81%
*Data range – Jan 24 to Dec 24
6.How old were they?
|
Age Group |
# Patients |
|
30-44 |
2 |
|
45-59 |
5 |
|
60-74 |
13 |
|
75+ |
7 |
*Data range – Jan 24 to Dec 24
7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
POC/BAME = 29.6%
*Data range – Jan 24 to Dec 24
8.How many people covered by the equality act - specific protected characteristics - excluding age + gender - 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?
12
*Data range – Jan 24 to Dec 24
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 ?
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: There were no reported deaths during ECT treatment
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)?
As above
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?
No
*Data range – Jan 24 to Dec 24
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/investigations
We do not write reports for individual restraints.
2.How many RESTRAINTS in 2024?
Note – restraints include physical, seclusion and chemical restraint (which in turn includes oral medication, rapid tranquilisation and PRN). Additionally, there is often a combination of restraint. Prisons are not included in this.
All restraints – 470
Physical restraints (in combination with another type of restraint) – 320
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 - specific protected characteristics - excluding age + gender - were restrained?
Section 12 Exemption – As above.
7.How many RESTRAINTS were investigated outside the NHS?
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: There were no reported deaths during restraint
1 month after restraint:
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 inpatient services.
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?
There were 5 complaints related to restraint
13.If so, what was their concerns?
That the patient felt restraint was not necessary x1
The patient felt they were handled roughly during restraint x1
The patient sustained injury during restraint x 1
No support was offered to deescalate the situation x1
Property was removed from the patient during restraint and not returned x1
14.Are counts of forced injections available? if so how many people were forcible injected ?
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.
16.How many of these restraints were face down restraints?
6
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 2024?
13 (includes a combination of other type)
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 - specific protected characteristics - excluding age + gender - were secluded ?
Section 12 Exemption – As above.
7.How many SECLUSIONS were investigated outside the NHS?
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: There were no reported incidents of death during seclusion
1 month after seclusion:
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 inpatient services.
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION 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 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?
There was 1 complaint related to seclusion
13.If so, what was their concerns?
The patient asserted that they were too unwell to have been removed from seclusion in a private hospital and sent to a PICU.
14.How does the Trust plan to reduce SECLUSIONS 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 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 2024?
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 2024 without manually reviewing approximately 1792 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?
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 - specific protected characteristics - excluding age + gender - endured medication errors ?
Section 12 Exemption – As above.
7.How many MEDICATION ERRORS were investigated outside the NHS ?
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/at time of medication error: There were no reported deaths during a medication error
1 month after medication error:
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 inpatient services.
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)?
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 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?
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 MEDICATION ERRORS?
There were 5 complaints related to Medication errors.
13.If so, what was their concerns?
Wrong drug/quantity x 2
Prescribing error x 2
Medication changed without informing patient x 1
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