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MH Services

Specialist Treatment and Recovery (STAR) Team

The Specialist Treatment and Recovery (STAR) team is a team commissioned by GICB to provide assistance with complex mental health needs that cannot be met by existing commissioned services.

Firstly can you provide all information you have regarding the responsibility, duties and aims of the STAR team? Are they a subsection of the recovery team? What facilities, treatments and resources do they have access to? Are they supposed to interact with patients directly or do they possess a more bureaucratic role or do the members provide treatment themselves?

Secondly can you provide a contact email address for the STAR team.

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Memory Assessments

I am writing to you on behalf of Alzheimer’s Research UK (Registered charity number 1077089) under the Freedom of Information Act 2000 to request the following information from Gloucestershire Health & Care NHS Foundation Trust.

Please can you provide us with the following:

A. The number of memory assessment services that you operate.

B. The area covered by each of these memory assessment services.

For each individual memory assessment service you operate:

1. The service’s annual funding for each of the years 2018-2024 inclusive.

2. The source/s of funding for the service for each of the years 2018-2024 inclusive.

3. The total annual number of patients seen by the service for each of the years 2018-2024 inclusive.

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Animal Assisted Therapy

I would like to determine the number of NHS Mental Health Trusts that offer Animal Assisted Therapy to their patients.

I would also like to know how much is spent by the Mental Health Trusts on Animal Assisted Therapies each year.

Finally I would like to know who conducts the animal assisted interventions, is it NHS clinicians or teams brought in specifically to conduct the intervention.

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299-2024

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1. Any records regarding the recreational use of Ketamine in Gloucestershire, including the prevalence of Ketamine use and any services commissioned to address the problem
2. The total number of referrals made to the drug and alcohol services related to, in whole or in part, the consumption of Ketamine, for each calendar year

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300-2024

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1. Clozapine Titration Protocol:
Please provide a copy of or details about the current Clozapine titration protocol used by the Trust. This includes the procedures, guidelines, and any specific criteria followed for titrating Clozapine doses.
2. Outpatient and/or Community Titration:
Does Gloucestershire Health and Care NHS Trust offer Clozapine titration in outpatient and/or community settings? If so, when was this service first introduced?
3. Specialised Teams vs. CMHT Responsibilities:
Is Clozapine titration conducted by a specialised team within Gloucestershire Health and Care NHS Trust, or are Community Mental Health Teams (CMHTs) expected to carry out the titration as part of their general duties?
If it is done by a specialised team, please provide further details regarding the structure of the team.
4. Clozapine Titration for Under-18s:
Does Gloucestershire Health and Care NHS Trust offer Clozapine titration for patients under the age of 18? If so, when was this practice introduced and are there any specific guidelines for titrating Clozapine in this age group?

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268-2024

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Do you have a section 117 register that is kept up to date – i.e. new patients added when they have section 117 eligibility and patients removed when eligibility ends?
Is the register accessible to staff within your Trust via the intranet?
Do you have a timescale set for section 117 reviews? – i.e. 3 months, 6 months, annual review etc
Does the register include information about the people on your register that require a section 117 reviews and whether these are in date or overdue?
Does your Trust have processes in place to monitor overdue reviews and the number of people on the register who are eligible for section 117 aftercare? If so can you provide details of monitoring arrangements i.e. MHA Operations Committee, reports to teams etc and the frequency of these
Who is responsible for updating the section 117 register within your Trust – i.e. IT department, Performance team, MHA team
Do you have a single point of access for funding queries i.e. which ICB, which Local Authority is responsible for section 117 funding? If so is this via a legal team, social care team, MHA office?
How many patients do you have on your section 117 register?
What proportion of patients have reviews in date?
What proportion have out of date reviews?
Do you have a system in place i.e. a specific team that will undertake section 117 reviews for patients who have entitlement but are not currently open to services

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221-2024(2)

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1. Can you confirm if Gloucestershire Health and Care NHS Foundation Trust have any Eating Disorder Inpatient Services?
2. Please provide the number of patients in total with an eating disorder that have died of any cause so far this year and in each of the past 5 years, providing figures as <5 for any years that include deaths less than 5. 

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256-2024

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1. Please state any digital technologies, e-therapies, internet-delivered therapies, online or digital therapies, digitally enabled therapies or digital therapeutics for adult mental health problems that your Trust has procured, contracted or are paid for by the service for use by service users.
2. Additionally, please state any digital technologies, e-therapies, internet-delivered therapies, online or digital therapies, digitally enabled therapies or digital therapeutics for adult mental health problems that your Trust uses or recommends to service users.
3. For the period of 2023/24, please provide any data monitoring information you collect on the technologies listed above.
4. Please list any Talking Therapies (formerly known as IAPT) providers that run services on your behalf or in connection with your Trust.
5. If these services are not run directly by the NHS please state who runs them and what they are (e.g. Social Enterprise, Limited Company, third sector group).
6. Please state any organisations or third parties (e.g. ORCHA) you have partnered with or commissioned to create or provide an app library.
7. For the period 2023/24 please state the total number of people your Trust treated for common mental health problems

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252-2024

1. Please identify the Talking Therapies service that you are answering on behalf of.
2. Please may you inform us whether Body Dysmorphic Disorder (BDD) appears on your drop-down menu as a diagnosis/ problem descriptor on for example
IAPTus or PC-MIS software for measuring outcomes? (If not, what descriptor, do you use?)
3. If it is not on the drop-down menu, can you identify people with BDD in a different way (for example, the number who have completed the Body Image Questionnaire for BDD)?  
4. Do you use a digital front door like Limbic to screen clients? If yes, which one do you use, and does it directly screen for BDD?
5. Please inform us whether your staff ask the recommended screening question to help identify people with BDD? (The “Talking Therapies manual for anxiety and depression” recommends a question “Have you worried a lot about your appearance or the way a bodily feature looked and wish you could think about it less?”. ) If you do not use the recommended question, do you routinely screen for BDD with a different question or leave it up to therapists to identify if it appears clinically relevant? (if yes, what is the question)?
6. If you use a screening question to try to identify people with BDD, at what stage do you ask the question. e.g., (a) first contact/triage, (b) at assessment at step 2 guided self-help (c) at assessment for step 3 (high intensity)?
7. Please inform us if you use the recommended Anxiety Disorder Specific Measure (ADSM) “The Body Image Questionnaire” (BIQ) in people with BDD to determine outcomes during therapy?  If not, do you use the PHQ9 and GAD7 for BDD or something else?
8. For people discharged in the year 1st April 2023 – 31st March 2024, please inform us of the total number of people you discharged (all diagnoses, at least one contact) and the total number of people discharged for BDD as the main problem.
9. For people discharged in the year 1st April 2023 – 31st March 2024, please inform us of the total number of people you took on for therapy (all diagnoses, at least 2 contacts) and the total number of people with BDD that you took on for therapy (at least 2 contacts) that were discharged.
10. Of those that you took on for therapy, what proportion / numbers of people with BDD received treatment at Step 2 with a PWP? If treatment is with a PWP, what proportion and number is a generic CBT for anxiety/ depression or other approach, and what proportion and number received a specific computer program or workbook for BDD?  Please specify which one you use.
11. Of those with BDD who received treatment at Step 2 with a PWP, what was the average number of sessions for generic CBT for anxiety/ depression and for a specific computer program or workbook for BDD?
12. For people discharged from the 1st April 2023 to 31st March 2024 with the last treatment type being step 3, what was the average number of sessions in the episode for those treated with BDD and the average for all other diagnoses in the service?
13. For people discharged in the year 1st April 2023 – 31st March 2024, please inform us of the number of people with BDD who had 2 Body Image Questionnaires completed prior to discharge (and the number who had the GAD7 instead of the BIQ) at Step 2 and at Step 3 (high intensity)?
14. For people discharged in the year 1st April 2023 – 31st March 2024, what percentage and number of people with BDD in the treated sample achieve reliable improvement at Step 2 and Step 3? (Note the reliable change on the BIQ is ≥10 – please state if you are using the GAD7 for reliable improvement). How does that compare to the percentage and number who achieve reliable improvement on all the other diagnoses in the service?
15. For people discharged in the year 1st April 2023 – 31st March 2024, what was the mean and standard deviation and number of clients of the Body Image Questionnaire in those taken on for treatment at Step 2 and at Step 3?
16. For people discharged in the year 1st April 2023 – 31st March 2024, what was the mean and standard deviation and number of clients with BDD on the Body Image Questionnaire after treatment at Step 2 and at Step 3?
17. For people discharged in the year 1st April 2023 – 31st March 2024, what proportion and number achieve reliable improvement and recovery after treatment (≤ 40 is no longer a case) with BDD on the Body Image Questionnaire at Step 2 and Step 3?
18. How many of your CBT therapists have attended a top up workshop or any other training in treating BDD?
19. Please can you do a survey of your CBT therapists in your service and ask them.  
“How much of a priority do you think is training in BDD compared to other problems in your service?”
1. – Not a priority 
2. – Low priority 
3. – Medium priority
4. – High priority
5. – Essential 

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251-2024

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Q 1 Please provide for the five individual years 2019-24 the total number of patient safety reviews in inpatient mental health carried out by the trust.

Q 2 Out of those PSR’s how many examined a patient death?
Q 3 Out of those fatal PSR’s please let me know how many deaths in the report were linked to staffing levels. ( a straightforward wordsearch in the conclusions would suffice).

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064-2024

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Please provide Electro Convulsive Treatment (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 2023?
5.What proportion of patients were men/women?
6.How old were they?
7.What proportion of patients were classified people of the global majority or racialised communities (“POC / BAME”)?
8.How many people covered by the equality act received ECT ?
9.How many people were offered talking therapy prior to ECT ?
10.How many were receiving ECT for the first time?
11.How many patients consented to ECT?
12.How many ECT complaints were investigated outside the NHS and CCG?
13.How many patients died during or 1 month after ECT and what was the cause (whether or not ECT was considered the cause)?
14.How many patients died within 6 months after ECT and what was the cause (whether or not ECT was considered the cause)?
15.How many patients died by suicide within 6 months of receiving ECT (whether or not ECT was considered the cause)?
16.How many patients have suffered complications during and after ECT and what were those complications?
17.Have there been any formal complaints from patients/relatives about ECT?
18.If so, what was their concerns?
19.How many patients report memory loss/loss of cognitive function?
20.What tests are used to assess memory loss/loss of cognitive function?
21.Have MRI or CT scans been used before and after ECT?
22.If so, what was the conclusion?
23.How does the Trust plan to prevent ECT 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 2023?
3.What proportion of patients were men/women?
4.How old were they?
5.What proportion of patients were classified people of the global majority or racialised communities (“POC / BAME”)?
6.How many people covered by the equality act were restrained?
7.How many RESTRAINTS were investigated outside the NHS and CCG?
8.How many patients died during or 1 month after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
9.How many patients died within 6 months after RESTRAINTS and what was the cause (whether or not RESTRAINTS was considered the cause)?
10.How many patients died by suicide within 6 months of receiving RESTRAINTS (whether or not RESTRAINTS was considered the cause)?
11.How many patients have suffered complications during and after RESTRAINTS and what were those complications?
12.Have there been any formal complaints from patients/relatives about RESTRAINTS?
13.If so, what was their concerns?
14.Are counts of forced injections available?
15.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 2023?
3.What proportion of patients were men/women?
4.How old were they?
5.What proportion of patients were classified people of the global majority or racialised communities (“POC / BAME”)?
6.How many people covered by the Equality Act were secluded ?
7.How many SECLUSIONS were investigated outside the NHS and CCG?
8.How many patients died during or 1 month after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
9.How many patients died within 6 months after SECLUSION and what was the cause (whether or not SECLUSION was considered the cause)?
10.How many patients died by suicide within 6 months of receiving SECLUSION (whether or not SECLUSION was considered the cause)?
11.How many patients have suffered complications during and after SECLUSION and what were those complications?
12.Have there been any formal complaints from patients/relatives about SECLUSION?
13.If so, what was their concerns?
14.How does the Trust plan to reduce SECLUSIONS 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 2023?
3.What proportion of patients were men/women?
4.How old were they?
5.What proportion of patients were classified people of the global majority or racialised communities (“POC / BAME”)?
6.How many people covered by the equality act endured medication errors ?
7.How many MEDICATION ERRORS were investigated outside the NHS and CCG?
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)?
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)?
10.How many patients died by suicide within 6 months of receiving MEDICATION ERRORS (whether or not MEDICATION ERRORS was considered the cause)?
11.How many patients have suffered complications during and after MEDICATION ERRORS and what were those complications?
12.Have there been any formal complaints from patients/relatives about MEDICATION ERRORS?
13.If so, what was their concerns?
14.How does the Trust plan to prevent MEDICATION ERRORS in the future?

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212-2024

1 (a) In the last 12 months (of data), in total how many patients with Schizophrenia and other non-mood disorders (F20-F29 inclusive) were managed by your Trust.
1 (b) In the last 12 months (of data), in total how many patients diagnosed Schizophrenia (F20 only) were managed by your Trust.

2 (a) In the last 12 months (of data), how many patients with Schizophrenia and other non-mood disorders have been treated within each of the following services:
• Early Intervention Psychosis service team
• Community Mental Health Team

2 (b) In the last 3 months (of data), how many patients with Schizophrenia had no change to the antipsychotic medication within each of the following services. This includes patients with no change in dose.
• Early Intervention Psychosis service team
• Community Mental Health Team

3 (a) In the last 12 months (of data), how many patients with Schizophrenia and other non-mood disorders were discharged to primary care from each of the following services?
• Early Intervention Psychosis service team
• Community Mental Health Team

3 (b) In the last 12 months (of data), how many patients with Schizophrenia and other non-mood disorders were discharged from the Early Intervention Psychosis service team to the Community Mental Health Team

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233-2024

1. The number of individuals who have received support or counselling related to fireworks (e.g., anxiety, trauma, or phobias triggered by fireworks).

2. The data categorised by:
1. Age
2. Gender
3. Year (2021, 2022, 2023, and 2024).
4. Month
5. If possible, broken down by condition:
i. Anxiety, Trauma, Depression, PTSD, Phobia, Ligyrophobia (also spelled Ligurophobia or Phonophobia).

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179-2024

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For each of the last three calendar years (2022, 2023, and 2024) could you please provide me with:
1. the number of mental health patients who have been physically restrained;
2. the individual number of restraint incidents per patient on average;
3. the number that involved face-down restraint;
4. the number of patient injuries as a result of any physical restraint; and
5. the number of staff injuries as a result of any physical restraint.

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193-2024

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Overview of Services:
A comprehensive list of all services and programmes currently offered specifically for people with co-existing mental health and substance use needs.
Details on whether these services are integrated (addressing both issues simultaneously) or if they operate separately.
Access and Eligibility:
The eligibility criteria for accessing these services.
Information on referral processes, including whether self-referrals are accepted.
Performance and Outcomes:
Copies of any evaluations, audits, or performance reports related to these services from the past three years.
Key performance indicators used to measure the effectiveness of the services.
Partnerships and Collaborations:
Information on any partnerships with other organisations (e.g., NHS trusts, charities, community groups) in delivering these services.
Details of joint initiatives or programmes aimed at supporting this client group.
Future Developments:
Any planned changes, expansions, or reductions to these services in the next 12 months.
Strategies in place to improve service delivery for individuals with co-existing mental health and substance use needs.
Access and Eligibility:
Average waiting times from referral to initial assessment and from assessment to commencement of treatment.
Service Capacity and Utilisation:
The total number of individuals who have accessed these services in the past three years, broken down by year.
The maximum capacity of each service or programme.
The number of staff dedicated to these services, including their professional qualifications.
Staffing and Expertise:
Details of any specialised training provided to staff for working with co-existing conditions.
Funding and Resources:
The annual budget allocated to these services for the past three financial years.
Information on any funding changes during this period and the reasons for such changes.

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178-2024

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I am making a Freedom of Information Request for both ICD10 first diagnosis discharge codes and cases (and the same for OPCS codes and cases if you have any), recorded per individual facility in your health authority.
Any information must be totally anonymised.
I am requesting the data for the last five calendar years, i.e. 2018, 2019, 2020, 2021, 2022, 2023.
The suggested data format is in columns:
1. Facility name
2. Primary diagnosis ICD-10 4 or 5 digits (The ICD 10 data set I am asking for comprises the range A000 to Q999)
3. (all OPCS codes)
4. Number of cases
5. Years

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