SUSSEX 2020

Sussex Partnership NHS Foundation Trust

Our Reference: SPFT FOI 21/22-041

Date: 18 May 2021     
                                                                                      Swandean
Arundel Road
Worthing
West Sussex
BN13 3EP
Tel 0300 304 0100
Email: FOI@sussexpartnership.nhs.uk
 
Our publication scheme [link]  

REQUEST UNDER THE FREEDOM OF INFORMATION ACT 2000

 
I refer to your original request for information under the Freedom of Information Act 2000 (the Act), received by us on 25 April 2021 which reads as follows:
 
Please provide ECT information under the FOI act to the following questions:
 
1. Please supply patient’s information ECT leaflet.
2. Please supply patient ECT consent form.
3. Please supply any ECT reports/investigations
4. How many ECT in 2020?
5. What proportion of patients were men/women?
6. How old were they?
7. What proportion of patients were classified BAME?
8. How many were receiving ECT for the first time?
9. How many patients consented to ECT?
10. How many ECT complaints were investigated outside the NHS and CCG?
11. How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
12. How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
13. How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
14. How many patients have suffered complications during and after ECT and what were those complications?
15. Have there been any formal complaints from patients/relatives about ECT?
16. If so, what was their concerns?
17. How many patients report memory loss/loss of cognitive function?
18. What tests are used to assess memory loss/loss of cognitive function?
19. Have MRI or CT scans been used before and after ECT?
20. If so what was the conclusion?
21. How does the Trust plan to prevent ECT in the future?
 
Please provide SERIOUS INCIDENT information under the FOI act to the following questions:
  1. Please supply any serious incident reports/investigations
  2. How many SERIOUS INCIDENT REPORTS in 2020?
  3. What proportion of patients were men/women?
  4. How old were they?
  5. What proportion of patients were classified BAME?
  6. How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?
  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)?
  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)?
  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?
  11. Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
  12. If so, what was their concerns?
  13. How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
Please provide restraints information under the FOI act to the following questions: 
  1. Please supply any Restraints/investigations
  2. How many RESTRAINTS in 2020?
  3. What proportion of patients were men/women?
  4. How old were they?
  5. What proportion of patients were classified BAME?
  6. How many RESTRAINTS were investigated outside the NHS and CCG?
  7. How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
  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?
  11. Have there been any formal complaints from patients/relatives about RESTRAINTS?
  12. If so, what was their concerns?
  13. Are counts of forced injections available?
  14. How does the Trust plan to reduce restraints in the future?
Please provide SECLUSION information under the FOI act to the following questions:
 
  1. Please supply any SECLUSION reports/investigations
  2. How many SECLUSIONS in 2020?
  3. What proportion of patients were men/women?
  4. How old were they?
  5. What proportion of patients were classified BAME?
  6. How many SECLUSIONS were investigated outside the NHS and CCG?
  7. How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
  8. How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
  9. How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
  10. How many patients have suffered complications during and after SECLUSION and what were those complications?
  11. Have there been any formal complaints from patients/relatives about SECLUSION? l) If so, what was their concerns?
  12. How does the Trust plan to prevent SECLUSION in the future?
Please provide MEDICATION ERRORS information under the FOI act to the following questions:
  1. Please supply any MEDICATION ERRORS reports/investigations
  2. How many MEDICATION ERRORS in 2020?
  3. What proportion of patients were men/women?
  4. How old were they?
  5. What proportion of patients were classified BAME?
  6. How many MEDICATION ERRORS were investigated outside the NHS and CCG?
  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)?
  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)?
  9. How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
  10. How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
  11. Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
  12. If so, what was their concerns?
  13. How does the Trust plan to prevent MEDICATION ERRORS in the future?
THE TRUST’S RESPONSE
 
Under the Act, the Trust has two duties to individuals requesting information: firstly, to confirm whether or not it holds the information requested and secondly to provide a copy of that information.

The Trust must comply with both of these duties, unless one of the exemptions contained within the Act applies. 
 
Under Section 1(1)(a) of the Act, the Trust can confirm that it holds part of the information relevant to your request and this has been provided where possible below.

ECT
  1. Please see attached.
  2. Please see attached.
  3. None.
  4. West Sussex – 1,055 (54 patients)             East Sussex – 580 (65 patients)
  5. West Sussex – 67% female / 33% male     East Sussex – 54% female / 46% male
  6. West Sussex - ages ranged from 23 to 92   East Sussex - ages ranged from 35 to 86
  7. 2%
  8. 65%
  9. West Sussex – 48%                                 East Sussex – 59%
  10. This information is not known.
  11. This information is not known.
  12. This information is not known.
  13. This information is not known.
  14. Some patients can encounter transient bradycardia or tachycardia during treatment, this is easily resolved with essential medications administered by the anaesthetists.If further investigations are necessary we would request these before the next prescribed treatment.
  15. None.
  16. Not applicable - see above.
  17. Short term memory loss is common during a course of ECT. This tends to resolve once the treatment has stopped. We monitor patients’ memory very closely by using the Montreal Cognitive Assessment (MOCA) and Mini-Mental State Examination (MMSE) scales. Various mental health conditions can contribute to loss of memory and cognitive functioning.
  18. MOCA, MMSE, Comprehensive Psychopathological Rating Scale (CPRS) and talking to patients.
  19. Only if clinically indicated.
  20. Either indicates if it is safe to proceed with treatment or not.
  21. ECT is a vital and lifesaving treatment for patients who have severe depression.Patients have usually tried several psychotropic medications and this has failed to alleviate their symptoms, therefore ECT is prescribed. Nearly half of our patients make their own decision to have ECT and some feel this is the only treatment which keeps them well and out of hospital.

Serious Incidents

1. We are unable to share any Serious Incident (SI) Reports as these contain personal information regarding patients *

2. 101
 
3. Of the 101 SIs from 01/01/2020 - 31/12/2020 the following table shows the data by gender:
 
Gender Total
Female 45
Male 56
Total 101
 
4. Of the 101 SIs from 01/01/2020 - 31/12/2020 the following table shows the data by age range:
 
Age Range Total
16 and under 2
17-20 4
21-30 17
31-40 19
41-50 12
51-60 17
61-70 12
71 and over 18
Total 101
 
5. Of the 101 SIs from 01/01/2020 - 31/12/2020 the following table shows those classified as BAME:
 
Ethnic Group          Number  
Any Other Asian Background 2
Any Other White Background 1
Arab 1
Asian or Asian British - Indian 1
Black or Black British - African 1
 
6. 3 (Three)

7. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

8. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

9. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

10. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

11. No

12. Not applicable

13. Sharing of learning from incidents, towards zero suicide strategy.
 

Restraints

 
1. We are unable to share any Incident Reports as these contain personal information regarding patients *

2. 1,384

3. Please see below:
 
Gender Total
Female 824
Male 560
 
4. Please see below:
 
Age Range Total
<18 132
18-29 639
30-39 218
40-49 134
50-59 77
60-69 85
70-79 60
>80 44
 
5. Please see below:
 
Ethnic Group Total
Asian or Asian British - Bangladeshi 25
Mixed - White and Black African 21
Black or Black British - African 18
Black or Black British - Caribbean 12
Asian or Asian British - Any other Asian background 10
Other Ethnic Groups - Any other ethnic group 7
Asian or Asian British - Pakistani 6
Mixed - Any other mixed background 6
Black or Black British - Any other Black background 5
White - Irish 4
Mixed - White and Black Caribbean 4
Other Ethnic Groups - Arab 2
Asian or Asian British - Indian 1
Mixed - White and Asian 1
 
6. None.

7. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

8. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

9. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

10. Please see below:
 
Injury No.
Bruise 10
Bleeding 5
Abrasion 5
Pain 3
Ache 2
Scratch 2
Swelling/bump 2
Laceration/cut 2
Redness 1
Discomfort 1
Grand Total 33
 
11.There was one complaint across the organisation which related to the use of restraint in 2020. We are unable to share the details as may contain patient identifiable information *

12. Yes

13. Reduction of restriction strategy (6 key areas: Leadership and governance • Workforce development • Personalised support • Involving people • Restrictive practice reduction tools • Performance measurement) and involvement in the national QI programme to reduce restrictive interventions.
 
Seclusion
 
1. We are unable to share any Incident Reports as these contain personal information regarding patients *

2. 327

3. Please see below:
 
Gender Total
Female 231
Male 87
 
4. Please see below:
 
Age Range Total
<18 11
18-29 137
30-39 78
40-49 28
50-59 13
60-69 13
70-79 0
>80 2
 
5. Please see below:
 
Ethnic Group Total
Mixed - White and Black African 17
Black or Black British - African 15
Black or Black British - Caribbean 9
Asian or Asian British - Any other Asian background 7
Asian or Asian British - Bangladeshi 6
Other Ethnic Groups - Any other ethnic group 4
White - Irish 4
Mixed - Any other mixed background 3
Black or Black British - Any other Black background 1
Mixed - White and Black Caribbean 1
 
6. None.

7. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

8. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

9. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

10. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

11. Please restraint section above.

12. Please restraint section above.

13. Reduction of restriction strategy (6 key areas: Leadership and governance • Workforce development • Personalised support • Involving people • Restrictive practice reduction tools • Performance measurement) and involvement in the national QI programme to reduce restrictive interventions.

Medication Errors
 
1. We are unable to share any Incident Reports as these contain personal information regarding patients *

2. 807

3. Please see below:
 
Gender Total
Female 284
Male 343
 
4. Please see below:
 
Age Range Total
<18 10
18-29 125
30-39 106
40-49 71
50-59 70
60-69 68
70-79 59
>80 55
 
 5. Please see below:
 
Ethnic Group Total
Mixed - White and Black African 3
Black or Black British - African 6
Black or Black British - Caribbean 3
Asian or Asian British - Any other Asian background 6
Asian or Asian British - Bangladeshi 2
Other Ethnic Groups - Any other ethnic group 1
White - Irish 3
Mixed - Any other mixed background 7
Black or Black British - Any other Black background 2
Mixed - White and Black Caribbean 5
Mixed – White and Asian 3
 
6. None.

7. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

8. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

9. This information is not held on the incident reporting system so would require a manual trawl through electronic medical records **

10. Please see below:
 
Injury Type No.
Irritation - Skin / Eyes 1
Needlestick/sharps Injury 1
Bruise 1
 
11. 40.
 
12. Please see below:
 
Category of complaints No.
Prescribing 14
Adverse Drug Reactions 10
Failure to Prescribe 8
Prescribing Error 4
Refusal to Prescribe 2
Dispensing Error 2
Grand Total 40
 
13. The Trust is in the process of piloting and implementing an electronic prescribing and administration system (ePMA), which will assist with improving prescribing and administration errors.
 
Under the Act the Trust does not have to provide you with a copy of this information if one of the exemptions in the Act applies. In this case, the Trust considers that section 12 and section 40 applies as marked in the information above [*section 40 / **section 12], so will not be providing you with a copy of this information. Please see consideration of exemptions below.

CONSIDERATION OF EXEMPTIONS

Under the Act the Trust does not have to provide you with a copy of this information if one of the exemptions in the Act applies. 
 
We are unable to provide information to answers marked *, which we consider to be personal information protected by the Data Protection Act 2018, and therefore exempt from disclosure under Section 40 of the Freedom of Information Act 2000.
 
The Trust considers that section 12 applies to answers marked **, so will not be providing you with a copy of this information. This is because to complete a response to this question will require a significant investment in time to review. It would involve a manual audit, reviewing individual cases to collate the required information and would exceed the appropriate cost limit.
 
 As such, we assess this to cost more than the appropriate limit.  As you may know,  section 12(1) of the Freedom of Information Act makes provision for public  authorities to refuse requests for information where the cost of dealing with them  would exceed the appropriate limit, which for public bodies is set at £450. This  represents the estimated cost of locating, retrieving and extracting the information.
 
 In order for us to respond to your request, we would need to charge a fee, which we  can assess later in accordance with section 13 of the Freedom of Information Act  2000 and the Freedom of Information Fees Regulations. However, if you are able to  narrow the scope of your request, we may be able to provide the information free of  charge, as it would cost less than the appropriate limit to do so. For instance, you  may wish to refine your request by being more specific about the information that  you particularly wish to obtain. Any reformulated request the Trust receives from  you will be treated as a fresh Freedom of Information request.
 

RE-USE OF INFORMATION

 
To comply with the Re-use of Public Sector Information Regulations (2005), this information is provided to you under the Open Government Licence (OGL). This licence does not grant you any right to use the Information in a way that suggests any official status or that Sussex Partnership NHS Foundation Trust endorses you or your use of the Information.  The re-use of this information indicates your acceptance of the terms and conditions as set out in the Open Government Licence [link]
When you use our information under the OGL, you should include the following attribution: 
Sussex Partnership NHS Foundation Trust 2021, licensed under the Open Government License.
If you wish to re-use information outside of the licence terms then please inform the Trust, as unauthorised re-use may be in breach of copyright law. For information where the copyright is owned by another person or organisation, you must apply to the copyright owner to obtain their permission to re-use. 

FURTHER QUERIES
 
I hope that this explanation to you of why the Trust has not disclosed the information you have sought is clear.
 
Should you have any general questions, please don’t hesitate to contact me directly by email at FOI@sussexpartnership.nhs.uk 
 
If you are unhappy with the way in which your request has been handled, the Trust has an internal review procedure through which you can raise any concerns you might have. A request for an internal review should be submitted in writing to Ian Genner, FOI Officer at the above address or by email to FOI@sussexpartnership.nhs.uk
 
If you are dissatisfied with the outcome of the internal review procedure, you can appeal to the Information Commissioner, who will consider whether the Trust has complied with its obligations under the Act, and can require the Trust to remedy any problems.
 
You can find out more about how to do this, and about the Act in general, on the Information Commissioner’s website at: www.ico.org.uk. 
 
Complaints to the Information Commissioner should be sent to:
 
First Contact Team
Information Commissioner’s Office
Wycliffe House, Water Lane
Wilmslow, Cheshire
SK9 5AF 
 
Please remember to quote our FOI reference number which can be found at the top of this letter in any future correspondence.
 
I do hope you find the information provided helpful.
 
Yours sincerely

Ian Genner Freedom of Information Officer

On behalf of the Corporate Governance Team