Good Morning Wendy, please see below response copied into email text
Trust response:
1.Please supply patient’s information ECT leaflet – please find attached to email
∙ Royal College of Psychiatrists ECT leaflet
∙ CQC 'Your rights about consent to treatment'
∙ Grafton Worcester - ECT: Making your decision
∙ Grafton Worcester - ECT: Your guide to treatment
∙ Grafton Worcester - ECT: Information for relatives & Carers
∙ Grafton Worcester - ECT Suite: A visual guide (pictural)
∙ Grafton Worcester - ECT: A guide for outpatients
∙ Onside Advocacy services - external leaflet provided to patients and carers (not attached)
∙ Information is also available in audio format / British sign language / other languages on request (not attached)
2.Please supply patient ECT consent form
Please see attached ECT consent forms 1 and 4, used by both ECT services
3.Please supply any ECT reports/investigations
None
4.How many ECT in 2024?
193 ECT treatments were delivered in Worcester in 2024
5.What proportion of patients were men/women?
16 patients received ECT in Worcester in 2024. Male = ≤5 patients
6.How old were they?
Ranging from 26 to 82 years of age
7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
≤5 patients
8.How many people covered by the equality act - specific protected characteristics - excluding age + gender - received ECT ?
All patients were covered by the equality act
9.How many people were offered talking therapy prior to ECT ?
15 were offered talking therapy.
10.How many were receiving ECT for the first time?
9 patients
11.How many patients consented to ECT?
∙ All patients had valid consent forms 1 or 4 for ECT, depending on their capacity to consent to this treatment.
∙ 9 patients had capacity to consent to ECT.
∙ 7 patients did not have capacity to consent to ECT.
12.How many ECT complaints were investigated outside the NHS ?
None
13.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
None
14.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
None
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?
None
17.Have there been any formal complaints from patients/relatives about ECT?
No formal complaints but we have received compliments from our patients and carers about ECT
18.If so, what was their concerns?
N/A
19.How many patients report memory loss/loss of cognitive function?
None
20.What tests are used to assess memory loss/loss of cognitive function?
∙ Montreal Cognitive Assessment (MoCA) - at baseline, then every 4 treatments and at end of course
∙ Comprehensive Psychopathological Rating Scale (CPRS) - before every single ECT treatment
∙ Autobiographical Questions - at baseline, then every 4 treatments and at end of course
∙ Mental Capacity Assessments (MCA) before each ECT treatment
∙ Mental state examinations during weekly ward reviews including cognition / memory
∙ Consultation with family members to assess changes in functioning / cognition
∙ Occupational therapy assessments to assess cognition
∙ Direct patient questioning about their memory and any changes they may perceive (ward teams, community teams and ECT treating team)
∙ Post ECT follow up for 3 months after ECT which includes further MoCA testing at 2 months
21.Have MRI or CT scans been used before and after ECT?
Yes, where clinically indicated
22.If so, what was the conclusion?
Ruling out organic causes to presentation
23.How does the Trust plan to prevent ECT in the future?
No document exists
ECT Herefordshire
3.Please supply any ECT reports/investigations
There have been no Reports or investigations within the Hereford ECT service.
4.How many ECT in 2023?
13 patients received ECT in 2024 in Hereford. This totalled 135 ECT treatments.
5.What proportion of patients were men/women?
In Hereford there were ≤5 male patients & <10 female patients.
6.How old were they?
20-30, ≤5 patients, 31-40, ≤5 patients, 41-50, ≤5 patients, 51-60, 0 patients, 61-70, ≤5 patients, 71-80, 7 patients, 81-90, ≤5 patients.
7.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")?
None.
8.How many people covered by the equality act received ECT ?
All patients were covered by the equality act.
9.How many people were offered talking therapy prior to ECT ?
7 patients were too unwell for talking therapy.
6 patients were offered.
10.How many were receiving ECT for the first time?
≤5 patients received ECT for the first time in the Hereford service.
11.How many patients consented to ECT?
≤5 patients consented to ECT in the Hereford service.
12.How many ECT complaints were investigated outside the NHS and CCG?
None.
13.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
≤5 ECT was not deemed as cause
14.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
None.
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?
None.
17.Have there been any formal complaints from patients/relatives about ECT?
No.
18.If so, what was their concerns?
N/A.
19.How many patients report memory loss/loss of cognitive function?
None.
20.What tests are used to assess memory loss/loss of cognitive function?
ABMQ’s/MOCA- pre, post and after every 4th treatment.
Comprehensive rating scale (CPRS) before every treatment.
21.Have MRI or CT scans been used before and after ECT?
Yes, if clinically indicated.
22.If so, what was the conclusion?
CT/MRI scans have been used to rule out any organic causes for mental health issues/injuries of the brain.
23.How does the Trust plan to prevent ECT in the future?
No Document exists
1.Please supply any Restraints/investigations nil
|
2.How many RESTRAINTS in 2024/205 – During this period there were 1052 cases of restraints reported. Types of Restraint Interventions |
Total |
|
De-Escalation & Rapid Tranquilisation |
43 |
|
Disengagement Skill |
14 |
|
Mechanical Restraint |
≤5 |
|
Physical Intervention (Planned) |
235 |
|
Physical Intervention (Planned) & Rapid Tranq |
104 |
|
Physical Intervention (Unplanned) |
561 |
|
Physical Intervention (Unplanned) & Rapid Tranq. |
91 |
|
Not recorded |
≤5 |
3.What proportion of patients were men/women? – Male = 359 and Female = 687
|
4.How old were they? Row Labels |
Total |
|
17-36 |
608 |
|
37-56 |
215 |
|
57-76 |
140 |
|
77-96 |
89 |
|
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")? Row Labels |
Total |
|
British - White |
896 |
|
White & Black Caribbean - Mixed |
56 |
|
Chinese - Other Ethnic |
21 |
|
Not Stated |
21 |
|
Other White - White |
20 |
|
Pakistani - Asian Or Asian British |
13 |
|
Black African - Black Or Black British |
10 |
|
Other Asian - Asian Or Asian British |
7 |
|
Other Mixed - Mixed |
≤5 |
|
Other Black - Black Or Black British |
≤5 |
|
Black Caribbean - Black Or Black British |
≤5 |
6.How many people covered by the equality act - specific protected characteristics - excluding age + gender - were restrained? See question 5.
7.How many RESTRAINTS were investigated outside the NHS? None
8.How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)? ≤5 deaths reported. Restraints were not considered a contributing factor.
9.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)? ≤5 deaths reported. Restraints were not considered a contributing factor.
10.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)? none
11.How many patients have suffered complications during and after RESTRAINTS and what were those complications? 0 complications reported.
12.Have there been any formal complaints from patients/relatives about RESTRAINTS? 0 complaints received.
13.If so, what was their concerns? Not applicable.
|
14.Are counts of forced injections available? if so how many people were forcible injected ? Rapid Tranquilisation |
Total |
|
De-Escalation & Rapid Tranquilisation |
43 |
|
Physical Intervention (Unplanned) & Rapid Tranq. |
91 |
|
Total |
134 |
15.How does the Trust plan to reduce restraints in the future? No document exists
16.How many of these restraints were face down restraints? 0 reported.
Please provide SECLUSION information under the FOI act to the following questions: -
1.Please supply any SECLUSION reports/investigations Nil
2.How many SECLUSIONS in 2024? There were 11 incidents of seclusion in 2024 with 7 different patients.
3.What proportion of patients were men/women? All male
4.How old were they? 17-36 = ≤5, 37-56 = ≤5, 70+ = ≤5
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")? ≤5
6.How many people covered by the equality act - specific protected characteristics - excluding age + gender - were secluded ? All patients were covered by the equality act
7.How many SECLUSIONS were investigated outside the NHS? Nil
8.How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? None
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)? None
10.How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)? None known
11.How many patients have suffered complications during and after SECLUSION and what were those complications? None
12.Have there been any formal complaints from patients/relatives about SECLUSION? No
13.If so, what was their concerns?
14.How does the Trust plan to reduce SECLUSIONS in the future? No document exists
Medication Errors
1.Please supply any MEDICATION ERRORS reports/investigations nil
|
2.How many MEDICATION ERRORS in 2024/2025 = There were 1184 medication errors reported, below is the table outlining the medication incident types reported. Medication Incident Types |
Total |
|
Delay/Failure To Monitor Medication |
12 |
|
Med Error - Wrong Time |
35 |
|
Medication - Delay/Failure To Order |
32 |
|
Medication - Documentation |
94 |
|
Medication - Patient Concordance |
84 |
|
Medication - Pharmacy Supply Issue |
42 |
|
Medication - Policy Not Followed |
114 |
|
Medication - Prescribing |
106 |
|
Medication - Product Problem |
14 |
|
Medication - Stock Discrepancy |
80 |
|
Medication - Temperature Monitoring |
25 |
|
Medication - Visit Allocation |
16 |
|
Medication - Wrong Drug |
57 |
|
Medication - Wrong Frequency |
42 |
|
Medication - Wrong Or Omitted Dose |
273 |
|
Medication - Wrong Patient |
41 |
|
Medication - Wrong Route |
≤5 |
|
Medication Error Outside Of Our Care (Non-LFPSE) |
82 |
|
Medication Supply - Community Issue |
11 |
|
Medication Supply - Trust Issue |
20 |
3.What proportion of patients were men/women? – Male = 349 and Female = 386
|
4.How old were they? Age at the time incident |
Total |
|
0-19 |
501 |
|
20-39 |
101 |
|
40-59 |
124 |
|
60-79 |
248 |
|
80-100 |
210 |
|
5.What proportion of patients were classified people of the global majority or racialised communities ("POC / BAME")? 30 Patient Ethnicity |
Total |
|
British - White |
615 |
|
Not Recorded |
512 |
|
Other White - White |
27 |
|
Pakistani - Asian Or Asian British |
9 |
|
White & Asian - Mixed |
≤5 |
|
Black African - Black Or Black British |
≤5 |
|
White & Black Caribbean - Mixed |
≤5 |
|
Other Ethnic Category - Other Ethnic |
≤5 |
|
Black Caribbean - Black Or Black British |
≤5 |
|
Irish - White |
≤5 |
|
Other Asian - Asian Or Asian British |
≤5 |
|
Indian - Asian Or Asian British |
≤5 |
6. Number of patients covered under the Equality Act (excluding age and gender) who experienced medication errors: All patients were covered by the equality act
7. How many MEDICATION ERRORS were investigated outside the NHS ? None
8. Number of patient deaths during or within 1 month of a medication error, and the cause of death: 5 deaths reported. Of these, ≤5 were attributed to natural causes and ≤5 causes were unknown.
9. Number of patient deaths within 6 months of a medication error, and the cause of death: ≤5 deaths reported. Causes of deaths were natural.
10. Number of patient suicides within 6 months of a medication error: 0 suicides reported.
11. Number of patients who experienced complications during or after a medication error, and the nature of those complications: 0 complications reported.
12. Number of formal complaints received from patients or relatives regarding medication errors: 7 complaints were received, all related to prescribing errors.
13. Nature of concerns raised in complaints: Concerns centered around prescribing errors and adverse drug effects.
14. Future plans to prevent medication errors: No document exists
Please note: In accordance with the Data Protection Act 1998 we are unable to provide figures where the number of patients is less than or equal to five and could risk the identification of those patients. In these cases ≤5 is used to indicate that a figure between 1 and 5 is being suppressed.
Kind Regards
FOI Officer
WHCNHS.FOIrequest@nhs.net
2 Kings Court | Charles Hastings Way | Worcester | WR5 1JR