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Patient Notes — Paper and Electronic

I would like to request the following information under the Freedom of Information Act.

Question 1:
– Are PATIENT NOTES* in your trust: all paper, all electronic, or a mixture of both?
– If patient notes are primarily electronic:
– When did the trust transition from paper to electronic?
– What is the name of the electronic patient record platform used?
– If patient notes are primarily paper:
– Are there plans to transition from paper to electronic? If yes, when?
* ‘Patient notes’ here refers to written documentation of clinical encounters with patients, completed by a healthcare professional.

Question 2:
– Are DRUG CHARTS in your trust all paper, all electronic, or a mixture of both?
– If drug charts are primarily electronic:
– When did the trust transition from paper to electronic?
– What is the name of the electronic prescribing system used?
– If drug charts are primarily paper:
– Are there plans to transition from paper to electronic? If yes, when?

Question 3:
– Do the following departments in your trust use paper PATIENT NOTES (either partially or fully)? Please indicate Yes, No or Not sure / Not applicable.
– Inpatient wards
– Outpatients

Question 4:
– Do the following departments in your trust use paper DRUG CHARTS (either partially or fully)? Please indicate Yes, No or Not sure / Not applicable.
– Inpatient wards
– Outpatients

Question 5:
– Are fax machines still used in any part of your trust? (Yes / No)

If you have any queries, please don’t hesitate to contact me on ssantospaulo@bmj.com

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Wound Care

I have attached a word document which has been laid out for ease. It clearly identifies what information I would like to receive from this freedom of information request.
By saving the attached word document file, it will allow you to fill in the boxes directly, alternatively, it can be printed off and filled in manually if that is easier.

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Spiritual, religious and/or chaplaincy services

As part of a piece of work I am undertaking to review the spiritual, religious, and / or chaplaincy services offered by NHS England, I am contacting you to ask for the following information to please be provided.

1. How many whole-time equivalents are employed in the spiritual, religious, and / or chaplaincy service(s) and what are their bandings? Please differentiate between staff on substantive and temporary contracts, as well as staff working in the service on bank or agency contracts.

2. What are the typical core hours of the spiritual, religious, and / or chaplaincy service(s) on offer? How are these service(s) provided over the week (i.e. weekdays only, seven days a week, etc)?

3. What type of support (such as regular activities, events, or gatherings) is offered by the spiritual, religious, and / or chaplaincy service(s)? Please differentiate this between support offered to patients, support offered to family / friends, and support offered to staff members.

4. What on-call or out-of-hours provisions are made by the spiritual, religious, and / or chaplaincy service(s) at your Trust? Please differentiate between provisions offered by staff members employed by the Trust, and provisions offered by external contractors / arrangements.

5. What support is offered to the spiritual, religious, and / or chaplaincy services(s) by external organisations? For instance, what contracts are held by the Trust for this / these service(s) and who are these contracts with?

6. On average, how many service users are supported by the spiritual, religious, and / or chaplaincy service(s) in a week? Please take an average of service users supported between January and December 2024.

7. What is the overall satisfaction for the spiritual, religious, and / or chaplaincy service(s) offered by your Trust? Please provide the overall satisfaction for the period January 2024 to December 2024.

8. What supervision, if any, is provided to staff working in the spiritual, religious, and / or chaplaincy service(s)? Please identify whether this is provided by your Trust or by an external provider, and the average annual cost for this provision.

9. Please provide a contact name and contact email address if there should be any additional queries relating to this Freedom of Information request.

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Insourcing for Pathology Services

Under the Freedom of Information Act 2000, I request the following information regarding your use of insourcing for haematology, histopathology, and/or microbiology services between 1 April 2024 and the date of this request (i.e., the last 12 months):

Service Usage:

Does your trust currently use (or has it used in the last 12 months) insourcing providers for any of the following services?

a) Haematology
b) Histopathology
c) Microbiology
d) Oncology
(If yes, please specify which specialties)

Provider Details:

For each insourced specialty above, provide:
a) The name(s) of the external provider(s).
b) The start and end date(s) of the contract(s).

Scope & Volume:

A brief description of the services covered (e.g., “blood film reporting,” “biopsy analysis,” “infection screening”).

Estimated annual spend (or total spend) on these insourcing arrangements for 2023/24.

Procurement Method:
Was the contract awarded via a framework (e.g., NHS SBS DPS, Crown Commercial Service)? If yes, state which one.

If no insourcing is used for these specialties, please state “None.”

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Exceptions for Routine Treatment Implants

I understand that whilst the Sexual Health team do not provide routine treatment regarding certain implants, exceptions may be made for certain groups. Please could you share a copy of the exceptions list / exceptions policy?

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Wheelchair Services: Open Caseloads and Waiting Times

As you will be aware, the recently released Wheelchair Alliance report has highlighted the postcode lottery experienced by wheelchair users, and the many long waits. I am interested in the underlying data.

Please provide the following information separately for each of the wheelchair services in your area. This data is ‘essential’ or ‘basic’ information relating to each referral and should be easily extracted from the relevant Case Management System, Electronic Patient Record, or similar. Please feel free to provide the data in alternative formats, e.g. an Excel spreadsheet, if appropriate.

1a) How many open referrals does the service have for ADULTS?
1b) Of those open referrals, how many have been open for LESS than 18 weeks?
1c) Of those open referrals, how many have open for MORE than 18 weeks?
1d) Of those open referrals, how many have been open for MORE than 52 weeks?
1e) Of those open referrals, how many are ‘low need’ (per NHS Wheelchair Data Collection definition)?
1f) Of those open referrals, how many are ‘medium need’?
1g) Of those open referrals, how many are ‘high need’?
1h) Of those open referrals, how many are ‘specialist need’?
1i) Of those open referrals, how many are for powered wheelchairs?

2a) How many open referrals does the service have for CHILDREN/YOUNG PEOPLE?
2b) Of those open referrals, how many have been open for LESS than 18 weeks?
2c) Of those open referrals, how many have open for MORE than 18 weeks?
2d) Of those open referrals, how many have been open for MORE than 52 weeks?
2e) Of those open referrals, how many are ‘low need’ (per NHS Wheelchair Data Collection definition)?
2f) Of those open referrals, how many are ‘medium need’?
2g) Of those open referrals, how many are ‘high need’?
2h) Of those open referrals, how many are ‘specialist need’?
2i) Of those open referrals, how many are for powered wheelchairs?

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Administering of Injections

I am writing to request information under the Freedom of Information Act 2000 regarding the administration of injections to patients without their consent within the Trust.

Specifically, I request the following information for the period 1 January 2020 – 15 March 2025:
1. The total number of times patients were administered injections without their consent and the date of any such cases.
2. A breakdown of the medications administered (e.g., antipsychotics, sedatives) in these cases.
3. The legal authority under which these injections were administered.
4. The number of incidents where rapid tranquilization was used and the date of any such cases.
5. Any policy documents or guidelines used by the Trust regarding the administration of injections without consent.

If any part of this request exceeds the cost limit under the FOI Act, I would appreciate advice on how I may refine my request to stay within the limit.

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Use of Processed Meats Containing Nitrates or Nitrites in Meals

I am writing to make a request for information under the Freedom of Information Act 2000.

I would like to request the following information regarding the use of processed meats containing nitrates or nitrites in meals provided by your authority.

1. Does your organisation procure or serve processed meat (such as bacon, ham, sausages, or other cured meats) that contain nitrates or nitrites as preservatives?

2. If so, please provide details of the types of processed meat served and any guidance or policies in place regarding their procurement.

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NHS Treatment of Botched Overseas Surgeries

I am submitting this request under the Freedom of Information Act 2000 to obtain data on NHS treatment of complications arising from surgical procedures performed overseas.

Request Details

1. NHS Admissions for Complications Following Overseas Surgeries
• The total number of hospital admissions where the NHS has treated patients for complications resulting from surgeries conducted abroad.
• A yearly breakdown from January 2020 to January 2025 (or the most recent available period).

2. Breakdown of Patients Treated
For each year, please provide where available:
• Age group of patients (e.g.: under 18, 18-24, 25-34, 35-44, 45-54, 55-64, 65+).
• Gender of patients.

3. Data Classified Under Relevant ICD-10 Codes (or their NHS equivalents):
Please provide a breakdown of cases recorded under the following ICD-10 codes related to complications of surgical procedures:
• T81 – Complications of procedures (e.g., infections, wound disruption, foreign bodies left in the body).
• T82-T85 – Complications of prosthetic devices, implants, and grafts.
• T86 – Failure and rejection of transplanted organs and tissues.
• T87 – Complications of amputations and reattachments.
• T88 – Other complications of surgical and medical care (including anaesthesia-related complications).
• Y60-Y69 – Surgical errors and misadventures (e.g., accidental punctures, foreign objects left inside patients, failure of sterile precautions, inappropriate procedures).
• Y70-Y79 – Medical devices associated with adverse incidents.
• Y83-Y84 – Abnormal patient reactions or complications following surgery or other medical procedures.

4. Specific Details on Procedures Leading to NHS Admissions
Where available, please provide:
• The type of surgery the patient originally underwent abroad (e.g., cosmetic surgery, weight loss surgery, orthopaedic surgery, dental work, etc.).
• The intended purpose of the surgery (e.g., aesthetic enhancement, weight loss, joint replacement, reconstructive surgery, etc.).
• The type of complication requiring NHS intervention (e.g., infection, implant failure, excessive bleeding, wound breakdown, nerve damage, sepsis).

5. NHS Cost of Treating Complications from Overseas Surgeries
• The total annual cost incurred by the NHS in treating complications from overseas surgeries.
• If available, an estimated breakdown of costs by procedure type.

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High Acuity Monitoring

We would like to place a Freedom of Information request, wishing to obtain an Install Base report for Monitoring systems within high acuity areas at your NHS hospitals.

Additional Questions

• How many anaesthetic rooms do you have in Theatres?
• How many theatre rooms do you have?
• Do you have a telemetry system for coronary care?
• How many telemetry systems do you have?

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Analysis on the Uptake of Biosimilar Use for Ustekinumab

I am conducting an analysis on the uptake of biosimilar use for Ustekinumab.

I would be grateful if you could please tell me how many patients were treated with Ustekinumab (for any disease) for the three-month period specified within the questions.

Q1 – How many patients were treated with Ustekinumab and its biosimilars (for any disease) from the start of October 2024 to the end of December 2024?
Please use the latest available 3 months if October to December is not available and specify which 3 months have been used.

Q2 – How many patients were treated with Stelara and its biosimilars (for any disease) in the months October 2024, November 2024, and December 2024?
Please use the latest available 3 months if October to December is not available and specify which 3 months have been used.

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Ophthalmology IT Systems and Imaging Capabilities

Under the Freedom of Information Act 2000, I would like to request the following information regarding the ophthalmology services and IT systems used within your Trust:

Ophthalmology Department & IT Record System
1. Does your Trust have an ophthalmology department and/or provide ophthalmology clinics?
2. If so, what is the name of the principal IT record system used to document results from patient consultations within ophthalmology?

Imaging Capabilities & System Integration
3. Does the principal IT system allow clinicians to view images from scans conducted during a clinic visit?
4. Are there any types of medical images that cannot be imported into this principal IT system? If so:
• What is the name of the IT programme used by clinicians to view these images?
• What is the name of the scan/modality that generates these images?

Data Integration with National Systems
5. Does the principal IT system integrate with the NHS Spine or other national patient record systems (e.g., OpenEyes, Medisoft, Epic)?
6. Does the system support the exchange of structured data with other NHS Trusts or external healthcare providers?

Patient Access & Communication
7. Does the system allow patients to access their ophthalmology records, including images, via the NHS App or another patient portal?
8. Are there any restrictions on how imaging data can be shared with patients and external providers?

Image Storage & Viewing Capabilities
9. What is the storage capacity and retention policy for ophthalmology-related imaging within the IT system?
10. If images are not viewable within the principal IT system, does the Trust use a separate PACS (Picture Archiving and Communication System) for ophthalmology imaging?

Future IT Developments & Interoperability
11. Is the Trust planning any upgrades or changes to its ophthalmology IT infrastructure in the next five years?
12. Are there known interoperability challenges that affect the transfer of ophthalmology data within the Trust or between NHS organizations?

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The Primary Care-Associated Helicobacter Pylori testing

This FOI request seeks to establish the types, numbers, costs and timings of Helicobacter pylori tests performed by your Trust (or on its behalf) for primary care providers.

Question 1: Your Trust
In your response to this FOI request, could you please specify the identity of the parts of your Trust for which this FOI is relevant, and for which you are responding.

Question 2: Types of Tests and Providers Which types of tests relevant for the primary care diagnosis of Helicobacter pylori (e.g., stool antigen test, urea breath test, serology) do you perform within your Trust, or have performed on your behalf by a Third party? If outsourced, could you please specify the Third party used.

Question 3: Test Types and Volumes
How many Helicobacter pylori tests of each of these types were performed by your Trust or on its behalf in the most recent 12-month period, or other defined accounting period for which data is available?

Question 4: Requirements for in-Person Testing Which types of tests required the in-person attendance of the patient at your Trust or its Third-party provider for testing, how many such in-person attendances were required, and what was the average time taken between patient arrival and departure?

Question 5: Turnaround Time for Test Results Specifying each type of Helicobacter pylori test performed by your Trust, or on its behalf, could you please provide the average time (in hours) between receipt of sample to transmission of test result to the GP practice?

Question 6: Test costs and Tariffs
For each type of Helicobacter pylori test performed by your Trust or on its behalf, what is the total cost of performing the test to your Trust or the Third party provider (i.e., personnel, infrastructure, reagents and consumables, etc)? What does your Trust charge for performing each of these tests? Do these tests correspond to standard NHS tariffs or HRG codes? If so, could you please specify the tariff code and amount charged for each test type.

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