Freedom of Information
Springfield University Hospital
Trust Headquarters, Building 15
61 Glenburnie Road
London SW17 7DJ
Direct line: 0203 513 6110
Email: FOI-requests@swlstg.nhs.uk
Website: www.swlstg.nhs.uk
Date: 16 February 2023
Ref:1456-FOI
Dear Mrs Micklewright
Freedom Of Information Request- Human Rights Abuse - 2021 Data - BLACK LIVES MATTER - Women's Rights Matter - Community Power Matters
Thank you for your enquiry
I am writing in response to your freedom of information request
Please accept my apologise for the delay in response and the inconvenience and distress this has caused
This letter is in response to 1456-FOI and serves as the response for both 1456-FOI and 1544-FOI - 1544-FOI has been closed as a duplicate
The response to the 2021 request highlighted in the recent ICB meeting as not having been responded to has also been attached for your attention
This response was originally sent out on the 5th May 2021(Ref 1110-FOI); please accept my apologies if it was not received
For ease of reference, your request is set out below in bold and our response is in italics
Please provide ECT information under the FOI act to the following questions: -
Please supply patient’s information ECT leaflet.
Please see attached PDF
Please supply patient ECT consent form
Please see attached PDF
Please supply any ECT reports/investigations
0
How many ECT in 2021?
29 patients had ECT in 2021
What proportion of patients were men/women?
12 males; 17 Females
How old were they?
|
Age in Years |
|
|
|
68 |
44 |
26 |
|
74 |
59 |
76 |
|
67 |
27 |
66 |
|
66 |
27 |
76 |
|
64 |
29 |
82 |
|
51 |
78 |
68 |
|
52 |
61 |
79 |
|
60 |
60 |
79 |
|
60 |
66 |
51 |
|
74 |
54 |
|
What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
3 patients
How many were receiving ECT for the first time?
The ECT Clinic does not collate this data. Obtaining this data would require perusal of the entire health record for all 29 patients who had ECT
How many patients consented to ECT?
Out of the 29 patients 13 consented
The remainder lacked capacity to consent and were lawfully treated under the provisions of section 58A of the Mental Health Act
How many ECT complaints were investigated outside the NHS and CCG?
None , we had no complaints
How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
The ECT Clinic does not collate mortality data on patients who have left the service
How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
The ECT Clinic does not collate mortality data on patients who have left the service
How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
The ECT Clinic does not collate mortality data on patients who have left the service
How many patients have suffered complications during and after ECT and what were those complications?
The term complications is to be understood as something over and above expected side effects.
By analogy, pain Is an expected side effect of abdominal surgery, but a perforated bowel would be a complication.
No patients have suffered complications during or after ECT.
Have there been any formal complaints from patients/relatives about ECT?
None , We had no complaints
If so, what was their concerns?
Not Applicable
How many patients report memory loss/loss of cognitive function?
The ECT Clinic does not collate this data
What tests are used to assess memory loss/loss of cognitive function?
Clinical evaluation
patient self-evaluation of memory using the Comprehensive Psychopathological Rating Scale (CPRS)
Montreal Cognitive Assessment
Mini Mental State Examination (MMSE).
Have MRI or CT scans been used before and after ECT?
No. There would be no clinical indication to perform CT or MRI scans before and after ECT.
If so, what was the conclusion?
Not applicable
How does the Trust plan to prevent ECT in the future?
The Trust has no plans to “prevent” ECT, which is a treatment approved by NICE for use under specific circumstances that include as a lifesaving intervention.
Please provide SERIOUS INCIDENT information under the FOI act to the following questions:
Please supply any serious incident reports/investigations?
The cost of complying with this component of your request would exceed the limit set by section 12(1) of the Freedom of Information Act.
So, on this occasion we will not be taking this component of your request further.
The law allows us to decline to answer FOI requests when we estimate it would cost us more than £450 (18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.
This would entail reviewing details of 2094 incidents (see the response below). T
o complete this work in under 18 hours would require over 116 incidents an hour to be processed to be below the maximum, and that would exclude the time taken to respond to the other components of your request.
I do not believe that this is possible and have therefore concluded that the position is more than the limit prescribed in the act.
Although the Trust cannot answer this component of your request now, we might be able to answer a refined request within the cost limit.
Please be aware that we cannot guarantee at this stage that a refined request will fall within the FOIA cost limit.
You can find out more about Section 12(1) by reading the full text of the Act, available at http://www.legislation.gov.uk/ukpga/2000/36/section/12.
I am sorry that on this occasion I have not been able to answer this aspect your request. You have the right to appeal our decision if you think it is incorrect.
Details can be found at the end of this letter Due to the volume of work to print and copy this information to send this number of incident forms this would fall outside of the time allowed within section 12 of the Freedom of Information Act
How many SERIOUS INCIDENT REPORTS in 2021?
|
Year |
2021 |
|
SI’s (reported to NHS England) |
116 |
What proportion of patients were men/women
|
Gender |
2021 |
|
Male |
69 |
|
Female |
47 |
|
Grand Total |
116 |
How old were they?
|
Age |
Number |
Age |
Number |
|
|
13 |
1 |
45 |
2 |
|
|
14 |
1 |
48 |
2 |
|
|
15 |
2 |
49 |
2 |
|
|
16 |
3 |
50 |
2 |
|
|
17 |
1 |
51 |
2 |
|
|
18 |
1 |
52 |
3 |
|
|
19 |
3 |
53 |
3 |
|
|
20 |
6 |
54 |
1 |
|
|
21 |
1 |
55 |
1 |
|
|
23 |
1 |
56 |
2 |
|
|
24 |
1 |
57 |
3 |
|
|
26 |
1 |
58 |
3 |
|
|
27 |
3 |
59 |
1 |
|
|
28 |
3 |
61 |
1 |
|
|
29 |
5 |
62 |
1 |
|
|
30 |
2 |
63 |
2 |
|
|
31 |
0 |
64 |
1 |
|
|
32 |
1 |
65 |
1 |
|
|
33 |
4 |
67 |
2 |
|
|
34 |
2 |
68 |
2 |
|
|
35 |
3 |
69 |
1 |
|
|
36 |
2 |
71 |
1 |
|
|
37 |
3 |
72 |
1 |
|
|
38 |
1 |
73 |
1 |
|
|
39 |
1 |
76 |
1 |
|
|
40 |
2 |
77 |
1 |
|
|
41 |
5 |
79 |
1 |
|
|
42 |
3 |
81 |
2 |
|
|
43 |
2 |
|
|
|
|
44 |
6 |
|
|
|
|
Grand Total |
116 |
|||
|
|
|
|
|
|
What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
Ethnicity |
2021 |
|
White British |
57 |
|
Unknown/Not stated |
16 |
|
Black African |
10 |
|
Other White |
8 |
|
Other Asian |
6 |
|
White & Black African |
4 |
|
Indian-Asian Or Asian British |
3 |
|
Black Caribbean |
3 |
|
Irish-White |
3 |
|
Other White - White |
2 |
|
Other Black |
1 |
|
White & Black Caribbean |
1 |
|
Other Mixed |
1 |
|
Other Ethnic |
1 |
|
Grand Total |
116 |
How many SERIOUS INCIDENT REPORTS were investigated outside the NHS and CCG?
None
How many patients died during or 1 month after SERIOUS INCIDENT REPORTS and what was the cause (whether SERIOUS INCIDENT REPORTS was considered the cause)
None
How many patients died within 6 months after SERIOUS INCIDENT REPORTS and what was the cause (whether SERIOUS INCIDENT REPORTS was considered the cause)?
None
How many patients died by suicide within 6 months of receiving SERIOUS INCIDENT REPORTS (whether SERIOUS INCIDENT REPORTS was considered the cause)?
None
How many patients have suffered complications during and after SERIOUS INCIDENT REPORTS and what were those complications?
None
Have there been any formal complaints from patients/relatives about SERIOUS INCIDENT REPORTS?
None
If so, what was their concerns?
Not applicable
How does the Trust plan to prevent SERIOUS INCIDENTS in the future?
Patient safety is about maximising the things that go right and minimising the things that go wrong for people receiving healthcare.
We aim for continuous improvement of patient safety, alongside wider quality improvement.
Following the publication of the Patient Safety Incident Response Framework (PSIRF) the Trust is working to implement this within the 12 months, this brings about a new approach on responding to patient safety incidents for the purpose of learning and improvement and preventing these incidents from happening.
The Trust has an identified two Patient Safety Specialists who are overseeing and supporting patient safety activities across the organisation.
In the meantime the Trust continues to carry out Root Cause Analysis Investigation s(RCA) to identify learning and make improvements based on the learning and recommendations.
Please provide restraints information under the FOI act to the following questions: -
Please supply any Restraints/investigations?
There were none
How many RESTRAINTS in 2021?
1755
What proportion of patients were men/women?
174 Female, 199 Male
How old were they?
|
Age |
Patients Restrained |
Age |
Patients Restrained |
|
13 |
1 |
47 |
8 |
|
14 |
2 |
48 |
10 |
|
15 |
6 |
49 |
4 |
|
16 |
7 |
50 |
5 |
|
17 |
7 |
51 |
8 |
|
18 |
15 |
52 |
4 |
|
19 |
9 |
53 |
8 |
|
20 |
12 |
54 |
2 |
|
21 |
14 |
55 |
1 |
|
22 |
7 |
56 |
4 |
|
23 |
8 |
57 |
4 |
|
24 |
7 |
58 |
8 |
|
25 |
10 |
59 |
5 |
|
26 |
7 |
60 |
5 |
|
27 |
6 |
61 |
7 |
|
28 |
9 |
62 |
3 |
|
29 |
12 |
63 |
4 |
|
30 |
6 |
64 |
1 |
|
31 |
9 |
65 |
2 |
|
32 |
3 |
66 |
3 |
|
33 |
5 |
67 |
2 |
|
34 |
9 |
68 |
3 |
|
35 |
8 |
69 |
1 |
|
36 |
9 |
71 |
2 |
|
37 |
10 |
72 |
2 |
|
38 |
4 |
73 |
2 |
|
39 |
9 |
75 |
3 |
|
40 |
4 |
76 |
3 |
|
41 |
9 |
78 |
3 |
|
42 |
7 |
81 |
1 |
|
43 |
7 |
83 |
1 |
|
44 |
2 |
88 |
1 |
|
45 |
4 |
90 |
1 |
|
46 |
7 |
93 |
1 |
What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
BME Category |
Patients Restrained |
|
BME |
167 |
|
Non-BME |
201 |
|
Not Known |
5 |
How many RESTRAINTS were investigated outside the NHS and CCG?
None
How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
2 (Unexpected Death and Death Reported On NHS SPINE – NFA)
How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
6 (2 x Unexpected Death, 1 x Suspected Suicide (Actual) Undetermined, 2 x Death Due To Natural Causes, 1 x Death Reported On NHS SPINE – NFA
How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
1 (Suspected Suicide (Actual) Undetermined)
How many patients have suffered complications during and after RESTRAINTS and what were those complications?
This data is held however could only be obtained through manual review of each of the 1755 restraint incidents;
the cost of complying with this component of your request together with the others as noted in this response would exceed the limit set by section 12(1) of the Freedom of Information Act.
So, on this occasion we will not be taking this component of your request further.
The law allows us to decline to answer FOI requests when we estimate it would cost us more than £450 (18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.
Although the Trust cannot answer this component of your request now, we might be able to answer a refined request within the cost limit.
Please be aware that we cannot guarantee at this stage that a refined request will fall within the FOIA cost limit.
You can find out more about Section 12(1) by reading the full text of the Act, available at http://www.legislation.gov.uk/ukpga/2000/36/section/12.
I am sorry that on this occasion I have not been able to answer this aspect your request
Have there been any formal complaints from patients/relatives about RESTRAINTS?
Not known
If so, what was their concerns?
Not applicable
Are counts of forced injections available?
340
How does the Trust plan to reduce restraints in the future?
The trust training is accredited with the Restraint Reduction Network and British Institute of Learning Disabilities (RR/BILD).
The aim of the accredited programme is to protect people’s fundamental human rights and promote person centred, best interest and therapeutic approaches to supporting people when they are distressed Improve the quality of life of those being restrained and those supporting them
Please provide SECLUSION information under the FOI act to the following questions: -
Please supply any SECLUSION reports/investigations
There were none
How many SECLUSIONS in 2021?
400
During the pandemic where patients where covid positive and unable to self-isolate due to their underlying illness they were nursed in seclusion – these instances are included within our seclusion instances during 2020 and 2021.
What proportion of patients were men/women?
|
Gender |
Patients Secluded |
|
Female |
40 |
|
Male |
118 |
How old were they?
|
Age |
Patients Secluded |
Age |
Patients Secluded |
|
|
14 |
1 |
38 |
4 |
|
|
15 |
1 |
40 |
1 |
|
|
16 |
3 |
41 |
2 |
|
|
17 |
4 |
42 |
6 |
|
|
18 |
8 |
43 |
4 |
|
|
19 |
6 |
44 |
2 |
|
|
20 |
5 |
45 |
3 |
|
|
21 |
6 |
46 |
3 |
|
|
22 |
3 |
47 |
2 |
|
|
23 |
4 |
48 |
3 |
|
|
24 |
4 |
49 |
2 |
|
|
25 |
4 |
50 |
3 |
|
|
26 |
1 |
51 |
4 |
|
|
27 |
3 |
52 |
5 |
|
|
28 |
4 |
53 |
3 |
|
|
29 |
7 |
54 |
1 |
|
|
30 |
4 |
55 |
1 |
|
|
31 |
4 |
56 |
2 |
|
|
32 |
2 |
58 |
1 |
|
|
33 |
4 |
59 |
2 |
|
|
34 |
8 |
60 |
1 |
|
|
35 |
2 |
61 |
1 |
|
|
36 |
4 |
63 |
1 |
|
|
37 |
7 |
68 |
1 |
|
|
|
|
69 |
1 |
|
|
|
|
|
|
|
What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
BME Category |
Patients Secluded |
|
BME |
84 |
|
Non-BME |
71 |
|
Not Known |
3 |
How many SECLUSIONS were investigated outside the NHS and CCG?
0
How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
0
How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
2
How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
1
How many patients have suffered complications during and after SECLUSION and what were those complications?
This data is held however it forms a part of individual patient records and is not disclosable.
Have there been any formal complaints from patients/relatives about SECLUSION?
None
If so, what was their concerns?
N/A
How does the Trust plan to reduce SECLUSIONS in the future?
The Trust has a Safety in Motion programme that outlines a strategy for reducing all forms of restrictive practices and particularly to prevent situations where seclusion may need to be used.
There is a comprehensive training programme associated with this and the process starts with agreeing Mutual Expectations as to how the service user can expect to be treated during their admission and the behaviours that are acceptable and those that are unacceptable.
All episodes of seclusion are extensively reviewed by both medical and nursing staff and debriefs are held to evaluate if lessons can be learned or if other strategies could be used instead on seclusion as this intervention is always use as a last resort
Please provide MEDICATION ERRORS information under the FOI act to the following questions: -
Please supply any MEDICATION ERRORS reports/investigations
Please see attached
How many MEDICATION ERRORS in 2021?
45
What proportion of patients were men/women?
|
Gender |
Patients with Medication Errors reported |
|
Female |
25 |
|
Male |
15 |
|
Not Known |
4 |
How old were they?
|
Age at Incident |
Patients with Medication Errors reported |
Age at Incident |
Patients with Medication Errors reported |
|
Not known |
4 |
40 |
1 |
|
7 |
1 |
43 |
2 |
|
12 |
1 |
44 |
2 |
|
13 |
1 |
45 |
1 |
|
16 |
1 |
46 |
1 |
|
17 |
1 |
47 |
2 |
|
18 |
1 |
51 |
1 |
|
23 |
1 |
53 |
1 |
|
24 |
1 |
58 |
2 |
|
25 |
1 |
59 |
1 |
|
26 |
1 |
62 |
1 |
|
27 |
1 |
63 |
1 |
|
28 |
1 |
65 |
1 |
|
29 |
1 |
66 |
1 |
|
30 |
1 |
68 |
1 |
|
31 |
1 |
73 |
1 |
|
32 |
2 |
95 |
1 |
|
35 |
1 |
|
|
|
37 |
1 |
|
|
What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
|
Is BME |
Patients with Medication Errors reported |
|
BME |
16 |
|
Non-BME |
24 |
|
Not Known |
4 |
How many MEDICATION ERRORS were investigated outside the NHS and CCG?
None
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 do not hold information in this way
How many patients died within 6 months after MEDICATION ERRORS and what was the cause (whether or not MEDICATION ERRORS was considered the cause)?
We do not hold information in this way
How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
We do not hold information in this way
How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
(interpreted as Moderate Harm and Above)
Patient with a nut allergy experienced anaphylactic reactions after Naseptin nasal cream was prescribed to help with the nosebleeds.
Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
Yes, there were 4 complaints received in 2021
If so, what was their concerns?
The mother of a patient on an acute was complained that when the patient was discharged, they were not given oral medication as was prescribed which led to a deterioration in the patient’s mental state
A patient complained that a staff member from the HTT left her with x28 tablets of medication when she was only meant to be left with a short term supply (due to risk issues)
A relative complained that there were several occasions where the patient was given their depot injection late
A relative complained that a patient’s Olanzapine reduction was not tapered within recommended guidelines. This complaint was later withdrawn
How does the Trust plan to prevent MEDICATION ERRORS in the future?
By embedding Just Culture across the Trust
To learn from the incidents report and identify any systemic errors to minimise such errors from happening
Utilising Trust monthly learning bulletin as a tool to spread learning and share incidents
Updating policies and procedures to reflect learning from incidents
I trust that this response satisfies your request.
However if you are not satisfied and need to correspond further regarding this request, you may appeal by setting out your concerns in writing for the attention of myself and the Information Governance Manager.
Please ensure that the reference number that appears in the subject line above is quoted to make it easier for the team to deal with further correspondence.
In the event that you remain dissatisfied with the outcome of any appeal, you have the right to appeal to the Information Commissioner’s Office (ICO), although they will expect you to exhaust the Trust internal complaints policy before they will consider a case. For further details see www.ico.gov.uk
Yours sincerely
Philip Murray
Director of Finance and Performance