Friendship group affiliated to HVN

  

You requested the following information:  

 

See attached patient ECT information leaflet “patient information leaflet.pdf”

 

See the attached patient ECT consent form “Patient agreement to ECT – consent form 1.pdf”

 

Please note, ECT reports, and investigations are exempt under section 40(2) (personal  information) of the Freedom of Information Act (2000) as these contain documents contain  confidential information regarding patients and staff. revealing this personal information  contravenes the principles of confidentiality within the Data Protection Act (2018).

 

69 patients had ECT in 2023

 

Males were 36% of patients and were Females 64% of patients

 

The average age was 54.79 years [between 23 – 82]. 

 

 

BAME made up 31 [44.9%] of ECT patients

 

 

This information is exempt under section 12 of the Freedom of Information Act 2000 (cost  limit) as the Trust estimates that the cost of complying with your request would exceed the  appropriate limit. The reason for this exemption is because an audit would be required to extract this information which falls outside the scope of the FOIA.

 

This information is note held. The Trust has only started collecting this data in the last year so this data will be available next year. It is now a question on our ECT treatment pack in line with ECTAS standards 2023.

 

 Please refer to the answer for question eight

 35% of patients were Informal and consenting and 65% were Detained.

 

None

 

 None 

 

We have not had any mortality review of a death where ECT was mentioned or linked to.

 

Please refer to question fourteen

 

Please refer to the answer to question four

 

None

N/A

 

19.How many patients report memory loss/loss of cognitive function? Please refer to the answer to question four

 

20.What tests are used to assess memory loss/loss of cognitive function?  Please refer to the answer to question four

 

In patients with no cognitive impairment prior to ECT there was no change in MMSE.

In those with pre-existing cognitive impairment there was a decline in MMSE.

For subjective memory complaint 10% felt their memory had worsened 70% remained the same 14% improved.

 

Subjective memory loss CPRS

Objective memory loss MMSE

 

Electroconvulsive therapy (ECT) is the most efficacious treatment available for individuals with severe affective disorders.

Although electroconvulsive therapy (ECT) is considered the most efficacious treatment available for individuals with severe affective disorders, ECT’s availability is limited and declining, suggesting that information about the population-level effects of ECT is needed. Question 21 confirmed that even in the trust we need to improve information about efficacy, safety and not prevent but increase the offer to this treatment to the Treatment Resistant Depressive and Bipolar patients.

 In the short-term treatment of the major depressive episode, the combination of ECT and pharmacotherapy as continuation treatment is more potent than either intervention alone. Unfortunately, ECT has been used in the UK mainly when antidepressants haven’t worked, and the depression is severe. 

 The rate of use in the UK is a sixth that in the US. Many people who haven’t responded to antidepressants or psychotherapy could benefit from ECT, but do not get it. 

Electroconvulsive therapy may be associated with reduced short-term psychiatric inpatient readmissions among psychiatric with severe affective disorders. This potential population health effect may be overlooked regarding the availability of ECT, meaning electroconvulsive therapy may be an effective and cost-effective treatment for treatment-resistant depression and should be considered after failure of 2 or more lines of pharmacotherapy and/or psychotherapy. Offering ECT after 2 failed lines of pharmacotherapy/psychotherapy is most likely to maximise its health-economic value and is concordant with recommendations from some national guidelines and ECT specialists. The increasing use of ECT by offering it earlier in the course of treatment-resistant depression could significantly improve outcomes for this difficult-to-treat patient population.

 

Please note, restraint reports, and investigations are exempt under section 40(2) (personal information) of the Freedom of Information Act (2000) as these contain documents contain confidential information regarding patients and staff. revealing this personal information contravenes the principles of confidentiality within the Data Protection Act (2018).

 

A total of 2634 restraint incidents were reported in 2023.

 

The provision of the requested information would exceed the appropriate cost limit under Section 12, which is currently £450. This equates to 18 hours of staff time at £25 an hour. This is because the information requested is not easily retrievable as we do not hold this information in a readily accessible format. To locate and retrieve this information would require a manual search of all individual records. Under the FOIA, an authority is allowed to refuse a request where to comply with the request would exceed the appropriate cost limit.

Please refer to the answer for question three

Please refer to the answer for question three

 

This information is exempt under section 12 of the Freedom of Information Act 2000 (cost  limit) as the Trust estimates that the cost of complying with your request would exceed the  appropriate limit. The reason for this exemption is because an audit would be required to extract this information which falls outside the scope of the FOIA.

 

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

Please refer to the answer for question one

 

 

Please refer to the answer for question one

 

Please refer to the answer for question one

 

Please refer to the answer for question one

 

 

6

Please see the below table showing the top categories of concerns.

Please refer to the answer for question one

 

The Trust has a multidisciplinary working group, including lived experience representatives, which focuses on safety, including use of restraint and seclusion, in the Trust. The group employs a quality improvement methodology and other change methodologies to test, evaluate and then scale and spread improvement initiatives.

 

 

Please note, seclusion reports and investigations are exempt under section 40(2) (personal information) of the Freedom of Information Act (2000) as these contain documents contain confidential information regarding patients and staff. revealing this personal information contravenes the principles of confidentiality within the Data Protection Act (2018).

 

A total of 281 seclusions were reported in 2023.

 

The provision of the requested information would exceed the appropriate cost limit under Section 12, which is currently £450. This equates to 18 hours of staff time at £25 an hour. 

This is because the information requested is not easily retrievable as we do not hold this information in a readily accessible format. To locate and retrieve this information would require a manual search of all individual records. Under the FOIA, an authority is allowed to refuse a request where to comply with the request would exceed the appropriate cost limit

 

 

Please see the answer to question three.

 

Please see the answer to question three.

 

This information is exempt under section 12 of the Freedom of Information Act 2000 (cost  limit) as the Trust estimates that the cost of complying with your request would exceed the  appropriate limit. The reason for this exemption is because an audit would be required to extract this information which falls outside the scope of the FOIA.

  

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

 

Please refer to the answer for question one.

 

Please refer to the answer for question one.

 

Please refer to the answer for question one.

 

Please refer to the answer for question one.

 

<5

Please note where there are low numbers in answer to the request, this is indicated as  <5 (less than five). This information is exempted for disclosure under Section 40 (2) of  the FOIA as disclosure of the information may increase the likelihood of identifying an  individual which would contravene the principles of confidentiality within the Data  Protection Act (2018).

 

 The top concern in this category was issues with medication

 

 

The Trust has established a patient safety improvement programme which has in its first 1218 months focused on reducing violence and restrictive practice in patient services. The programme provides an organisational structure and support and expertise. Directorate safety leads are responsible for developing improvement plans and testing change ideas in 3 monthly cycles before learning is shared across the Trust at a shared learning collaborative event. 

The Trust seclusion policy is also focused on prevention of seclusion. There is a separate work stream looking at implementation of the policy. This is in the diagnostic phases and requires data work before it can progress.

 

 

Please note, medication error reports and investigations are exempt under section 40(2) (personal information) of the Freedom of Information Act (2000) as these contain documents contain confidential information regarding patients and staff. Revealing this personal information contravenes the principles of confidentiality within the Data Protection Act (2018).

 

There were 1648 medication errors reported in 2023.

 

The provision of the requested information would exceed the appropriate cost limit under Section 12, which is currently £450. This equates to 18 hours of staff time at £25 an hour. This is because the information requested is not easily retrievable as we do not hold this information in a readily accessible format. To locate and retrieve this information would require a manual search of all individual records. Under the FOIA, an authority is allowed to refuse a request where to comply with the request would exceed the appropriate cost limit.

 

Please refer to question three

 

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

Please refer to question three

 

This information is exempt under section 12 of the Freedom of Information Act 2000 (cost  limit) as the Trust estimates that the cost of complying with your request would exceed the  appropriate limit. The reason for this exemption is because an audit would be required to extract this information which falls outside the scope of the FOIA

 

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)?  Please refer to question three

 

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)? Please refer to question three

 

Please refer to question three

Please refer to question three

 

39 complaints were received

 

The top issues in this category were prescribing errors and Problems with medication 

 

 

 

The Trust encourages reporting. We examine themes of errors and devise Quality

Improvement Projects (QIPs) where necessary. In addition, the overall aim or purpose of the Medicines Safety Committee is to ensure the safe use of medicines in the Trust  Key objectives: 

▪ To review the medication section of the trust incident reporting policy 

▪ To agree a process for improving the rate and quality of medication incident reporting in the  trust 

▪ To agree a system for follow-up of medication incidents 

▪ To agree a system for disseminating learning points from commonly reported and serious medication incidents

▪ To recommend changes to medicines procedures where necessary 

▪ To develop medicines procedures where necessary 

▪ To inform the trust and other relevant stakeholders of risks identified from medication  errors. 

▪ To recommend ways of reducing the likelihood of serious errors recurring and developing  ways of minimising risk from medication errors. 

▪ To provide a summary of incidents in the annual medicines report to the trust board. This  will include assurance to the trust board that medicines incidents are appropriately reported and that follow-up includes learning and a change in practice where necessary. 

▪ To review the medication risks on the trust assurance log (risk register). 

▪To liaise with KHP partners when necessary in order to standardise practice and share learning across the trusts and CCGs. 

▪ To advise on any changes in the medicines policy following complaints about medicines from patients and carers. The committee meets four times a year