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Responses > 261-2024

Freedom of Information request 261-2024

Response published: 13 January 2025
Clinical Activity Data | Misc | Student University

FOI Request

Q1 Trust Name:
Q2 Type of Healthcare Facilities
o District General Hospital (DGH) (1)
o Specialty Hospital (2)
o Private Hospital (3)
o Community Hospital (4)
o Other (Please Specify) (5)
Q3 Demographic of Hospital Care
o Adult Hospital (1)
o Paediatric Hospital (2)
o General Hospital (Both paediatric and adult) (3)
o GP surgery (4)
o Other (Please Specify) (5)
Q4 Respondent’s Role in the Trust:
o Medical Records Manager (1)
o IT Specialist (2)
o Clinician (3)
o Administrator (4)
o Other (Please Specify) (5)
Q5 Does your Trust use electronic patient records (EPR)?
o Yes (1)
o No (2)
Q6 Which EPR system does your Trust use?
▢ Cerner (1)
▢ Epic (2)
▢ System C (3)
▢ Dedalus (4)
▢ Altera (5)
▢ Other (Please Specify (6)
Q7 Does the EPR system used by your Trust include a specific section for recording food, drug, latex, and other allergies?
o Yes (1)
o No (2)
Q8 If yes to question 7, how is the initial allergy information typically entered into the system? (Select all that relevant)
▢ Manually by Doctor (1)
▢ Manually by Pharmacist (5)
▢ Manually by Nurse (6)
▢ Manually by Dietitian (7)
▢ Automatically from Previous Records (2)
▢ Manually by Administrative Staff (3)
▢ Other (Please Specify) (4)
Q9 If yes to question 7, who is responsible for updating and/or checking allergy information in the patient's electronic record? (Select all that apply)
▢ Clinicians (e.g., doctors, nurses) (1)
▢ Administrative Staff (2)
▢ Pharmacists (3)
▢ IT/Technical Support Staff (4)
▢ Don’t Know (5)
▢ Other (Please Specify) (6)
Q10 How is the allergy information flagged or highlighted in the patient’s records to alert healthcare providers?
o Red Flag (1)
o Pop-up Alert (2)
o Highlighted Text (3)
o Other (Please Specify) (4)
o Not highlighted/ alerted on the system (5)
Q11 What training, if any, is provided to staff on the correct recording of allergies in patient records?
o Mandatory Training Sessions (1)
o Optional Training (2)
o No Training Provided (3)
o Other (Please Specify) (4)
Q12 If training is provided on allergy documentation, does it specifically cover different types of allergies in the training materials?
o Only drug allergy recording (1)
o Both drug and non-drug allergy recording (2)
o Drug, food, and other non-drug allergy recording (e.g., latex) (3)
o Don't know/ Unsure (4)
Q13 Does your Trust have a Local Guideline or Standard Operating Procedure (SOP) in place covering allergy documentation on the EPR?
o Yes (3)
o No (5)
o Don't know/ Unsure (4)
Q14 If yes to Question 13, does this guideline/SOP include documentation for allergens below? (Select all that relevant)
▢ Drugs (1)
▢ Food (2)
▢ Other non-drug substances (e.g. latex) (3)
▢ Don't know/ Unsure (5)
Q15 Does your hospital have access to specialist allergy advice for paediatric patients?
o Yes, please specify if this service available is available through In-House, Local Centre or Regional Centre. (1)
o No (2)
Q16 Does your hospital have access to specialist allergy advice for adult patients?
o Yes, please specify if this service available is available through In-House, Local Centre or Regional Centre. (1)
o No (2)
Q17 Does the incident reporting platform have a specific category for recording food or other non-drug allergy incidents?
o Yes (1)
o No (2)
Q18 In the last 10 years, has your Trust recorded any incidents where a patient was administered a food, drug, or other substance (e.g., latex) they were known to be allergic to?
o Yes (1)
o No (2)
Q19 If yes to question 18, how many such incidents have been reported in the last 10 years? [Numerical Response]
o <5, please specify (1)
o 5 - 9, please specify (2)
o 10 - 19, please specify (3)
o ≥ 20, please specify (4)
o Don't know (5)
Q20 If yes to question 18, please indicate the number of incidents for each category: [Numerical Response]
▢ Drug allergy incidents (1)
▢ Food allergy incidents (2)
▢ Incidents to other allergic substances (3)
▢ Don't know/ unaware (4)
Q21 Considering the start date of your EPR system, how many years' worth of incident data have you been able to search for this survey? Ideally, up to 10 years. (e.g. 2014 - 2024)
Q22 For reported DRUG ALLERGY incidents, what are the drugs involved, age group (≤17 or >17 years), and level of harm (no harm, low harm, moderate harm, severe harm or death), listing up to 10 cases prioritized by severity of harm, followed by the most recent incidents?
Please indicate the total cases below if more than 10 cases were reported.
Example: Case 1 (Amoxicillin, >17yo, low harm).
▢ Case 1 (allergen, age, level of harm) (1)
▢ Case 2 (allergen, age, level of harm) (2)
▢ Case 3 (allergen, age, level of harm) (3)
▢ Case 4 (allergen, age, level of harm) (4)
▢ Case 5 (allergen, age, level of harm) (5)
▢ Case 6 (allergen, age, level of harm) (7)
▢ Case 7 (allergen, age, level of harm) (8)
▢ Case 8 (allergen, age, level of harm) (9)
▢ Case 9 (allergen, age, level of harm) (10)
▢ Case 10 (allergen, age, level of harm) (11)
▢ If more than 10 cases are reported, please indicate the total number of cases below. (13)
▢ No drug allergy incidents reported (14)
Q23 For reported FOOD and OTHER NON-DRUG ALLERGY incidents, what are the allergens involved, age (confirm age via clinical record if required), reactions, if serious incident reported and level of harm (no harm, low harm, moderate harm, severe harm or death), listing up to 10 cases prioritized by severity of harm, followed by the most recent incidents?
Please indicate the total cases below if more than 10 cases were reported.
Example: Case 1 (Peanut, 3yo, anaphylaxis, serious incident reported, moderate harm).
▢ Case 1 (allergen, age, reaction, serious incident reported, level of harm) (1)
▢ Case 2 (allergen, age, reaction, serious incident reported, level of harm) (2)
▢ Case 3 (allergen, age, reaction, serious incident reported, level of harm) (3)
▢ Case 4 (allergen, age, reaction, serious incident reported, level of harm) (4)
▢ Case 5 (allergen, age, reaction, serious incident reported, level of harm) (5)
▢ Case 6 (allergen, age, reaction, serious incident reported, level of harm) (7)
▢ Case 7 (allergen, age, reaction, serious incident reported, level of harm) (8)
▢ Case 8 (allergen, age, reaction, serious incident reported, level of harm) (9)
▢ Case 9 (allergen, age, reaction, serious incident reported, level of harm) (10)
▢ Case 10 (allergen, age, reaction, serious incident reported, level of harm) (11)
▢ If more than 10 cases report, please indicate the total number of cases below. (13)
▢ No food allergy OR other non-drug allergy incidents reported (14)
Q24 For FOOD AND OTHER NON-DRUG ALLERGY incidents, how many of the incidents was the allergen clearly documented in patients notes/correspondence prior to the incident? Please insert the number of cases involved in each category. (e.g. 0 - 100)
▢ Food allergies documented correctly, please specify: (1)
▢ Food allergies not documented, please specify: (2)
▢ Non-drug allergies documented correctly, please specify: (3)
▢ Non-drug allergies not documented, please specify: (4)
▢ The food/ non-drug allergens were not previously known (7)
Q25 For FOOD AND OTHER NON-DRUG ALLERGY incidents, how many of the incidents was the allergen correctly documented on the relevant field in EPR prior to incident (Cerner / Epic / Other)? Please insert the number of cases involved in each category. (e.g. 0 - 100)
▢ Food allergies documented correctly, please specify: (1)
▢ Food allergies not documented, please specify: (2)
▢ Non-drug allergies documented correctly, please specify: (3)
▢ Non-drug allergies not documented, please specify: (4)
▢ The food/ non-drug allergens were not previously known (5)
Q26 What were the causes identified in the food or other non-drug incidents? (Multiple answers allowed)
▢ Allergy not recorded in EPR (1)
▢ Allergy recorded but not flagged/alerted (2)
▢ Staff did not check EPR (3)
▢ Incorrect substance administered due to similar names/packaging (4)
▢ System error or failure (5)
▢ Other (Please Specify) (6)
▢ Unsure/ Don't know (7)
Q27 What challenges, if any, does your Trust face in accurately recording and managing allergy information in EPR systems?
Q28 What improvements do you suggest could be made at a national level to better manage allergy information in patient records?

FOI Response

Freedom of Information Request – Ref: 261-2024

Thank you for your recent Freedom of Information request. Please find our response below.

You asked:

1. Trust name

Our response:

Gloucestershire Health and Care NHS Foundation Trust

You asked:

2. Type of Healthcare Facilities

Our response:

Community Hospital

You asked:

3. Demographic of Hospital Care

Our response:

Adult Hospital

You asked:

4. Respondent’s Role in the Trust:

Our response:

IT Specialist

Other: Chief Pharmacist

You asked:

5. Does your Trust use electronic patient records (EPR)?

Our response:

Yes

You asked:

6. Which EPR system does your Trust use?

Our response:

Other: SystmOne, RiO, IAPTus, Lilie, SOELhealth

You asked:

7. Does the EPR system used by your Trust include a specific section for recording food, drug, latex, and other allergies?

Our response:

Yes

You asked:

8. If yes to question 7, how is the initial allergy information typically entered into the system?

Our response:

Other: By the registered clinician clerking patient in

You asked:

9. If yes to question 7, who is responsible for updating and/or checking allergy information in the patient’s electronic record? 

Our response:

Clinicians (eg. doctors, nurses)

You asked:

10. How is the allergy information flagged or highlighted in the patient’s records to alert healthcare providers?

Our response:

Pop-up alert

You asked:

11. What training, if any, is provided to staff on the correct recording of allergies in patient records?

Our response:

Mandatory Training Sessions 

You asked:

12. If training is provided on allergy documentation, does it specifically cover different types of allergies in the training materials?

Our response:

Drug, food, and other non-drug allergy recording (e.g., latex) 

You asked:

13. Does your Trust have a Local Guideline or Standard Operating Procedure (SOP) in place covering allergy documentation on the EPR?

Our response:

No

You asked:

14. If yes to Question 13, does this guideline/SOP include documentation for allergens below? 

Our response:

N/A

You asked:

15. Does your hospital have access to specialist allergy advice for paediatric patients?

Our response:

No

You asked:

16. Does your hospital have access to specialist allergy advice for adult patients?

Our response:

Yes: Local Acute organisation

You asked:

17. Does the incident reporting platform have a specific category for recording food or other non-drug allergy incidents?

Our response:

No

You asked:

18. In the last 10 years, has your Trust recorded any incidents where a patient was administered a food, drug, or other substance (e.g., latex) they were known to be allergic to?

Our response:

Yes

You asked:

19. If yes to question 18, how many such incidents have been reported in the last 10 years? 

Our response:

Gloucestershire Health and Care NHS Foundation Trust formed in October 2019, therefore we are only able to provide information since this time. There have been 68 incidents since 01/04/2020.

You asked:

20. If yes to question 18, please indicate the number of incidents for each category:

Our response:

Drug allergy incidents 41
Food allergy incidents 7
Incidents to other allergic substances 17
Don’t know/ unaware 3

 

You asked:

21. Considering the start date of your EPR system, how many years’ worth of incident data have you been able to search for this survey? Ideally, up to 10 years. (e.g. 2014 – 2024)

Our response:

01/04/2020 – 13/12/2024. Prior to 01/04/2020 different local risk management systems were used to record incidents in the predecessor organisations to Gloucestershire Health and Care NHS Foundation Trust. Data is not directly comparable.

You asked:

22. For reported DRUG ALLERGY incidents, what are the drugs involved, age group (≤17 or >17 years), and level of harm (no harm, low harm, moderate harm, severe harm or death), listing up to 10 cases prioritized by severity of harm, followed by the most recent incidents? Please indicate the total cases below if more than 10 cases were reported.

Our response:

Drugs involved Adrenaline, Amoxicillin, Aspirin, Chlorphenamine, Ciprofloxacin, Co-amoxiclav, Codeine, Dihydrocodeine, Flucloxacillin, Furosemide, Haloperidol, HPV vaccine, Influenza vaccine, Insulin, Morphine, Nepafenac, Paracetamol, Penicillin, Piperacillin + Tazobactam, Trimethoprim, WellKid Multi-Vitamin, Zolendronic Acid
No Harm 34
Low Harm 7
Moderate Harm 0
Severe Harm 0
Death 0
Age group ≤17 years 5
Age group >17 years 29
Age group unknown 7
Our Ref Allergen Age group Level of harm
Case 1 GHC27258 Morphine >17 years Low
Case 2 GHC35011 HPV vaccination ≤17 years Low
Case 3 GHC39069 Morphine >17 years Low
Case 4 GHC43738 Insulin >17 years Low
Case 5 GHC46795 Adrenaline >17 years Low
Case 6 GHC68529 Trimethoprim >17 years Low
Case 7 GHC79394 Chlorphenamine ≤17 years Low
Case 8 GHC72059 Co-amoxiclav >17 years None
Case 9 GHC72568 WellKid Multi-Vitamin ≤17 years None
Case 10 GHC77341 Co-amoxiclav >17 years None
41 drug allergy incidents reported

 

You asked:

23. For reported FOOD and OTHER NON-DRUG ALLERGY incidents, what are the allergens involved, age (confirm age via clinical record if required), reactions, if serious incident reported and level of harm (no harm, low harm, moderate harm, severe harm or death), listing up to 10 cases prioritized by severity of harm, followed by the most recent incidents? Please indicate the total cases below if more than 10 cases were reported.

Our response:

Allergens involved Blue contrast dye (injectable), Cigarette smoke, Food (Fish), Food (Mushrooms), Food (type not specified), Inadine dressing, Incontinence pad, Latex catheter, Latex containing compression garment, Latex gloves, Latex tubigrip, Medihoney, Nuts (type not specified), Nuts (Walnuts), Plasters, Silicone dressing, Surgical face mask
No Harm 15
Low Harm 8
Moderate Harm 1
Severe Harm 0
Death 0
Age group ≤17 years 2
Age group >17 years 17
Age group unknown 5
Our Ref Allergen Age group Level of harm
Case 1 GHC80966 Medihoney >17 years Moderate
Case 2 GHC10994 Food (type not specified) Unknown Low
Case 3 GHC24052 Plasters >17 years Low
Case 4 GHC24076 Latex catheter >17 years Low
Case 5 GHC28754 Latex catheter >17 years Low
Case 6 GHC34627 Latex tubigrip ≤17 years Low
Case 7 GHC38780 Latex catheter >17 years Low
Case 8 GHC70934 Incontinence pad >17 years Low
Case 9 GHC72832 Cigarette smoke Unknown Low
Case 10 GHC77600 Nuts (Walnuts) ≤17 years None
24 food and other non-drug allergy incidents reported

 

You asked:

24. For FOOD AND OTHER NON-DRUG ALLERGY incidents, how many of the incidents was the allergen clearly documented in patients notes/correspondence prior to the incident? Please insert the number of cases involved in each category. (e.g. 0 – 100)

Our response:

This information is not recorded within our incident system, therefore we are unable to provide a response to this question

You asked:

25. For FOOD AND OTHER NON-DRUG ALLERGY incidents, how many of the incidents was the allergen correctly documented on the relevant field in EPR prior to incident (Cerner / Epic / Other)? Please insert the number of cases involved in each category. (e.g. 0 – 100)

Our response:

This information is not recorded within our incident system, therefore we are unable to provide a response to this question

You asked:

26. What were the causes identified in the food or other non-drug incidents? 

Our response:

Allergy not recorded in EPR 2
Allergy recorded but not flagged/alerted 3
Staff did not check EPR 0
Incorrect substance administered due to similar names/packaging 1
System error or failure 1
Other (Please Specify) 2 Unexpected reaction to blue contrast dye during procedure (1), Food given to wrong patient (1), Incorrect advice from manufacturer that garment latex free (1)
Unsure/ Don’t know 15

 

You asked:

27. What challenges, if any, does your Trust face in accurately recording and managing allergy information in EPR systems?

Our response:

N/A

You asked:

28. What improvements do you suggest could be made at a national level to better manage allergy information in patient records?

Our response:

N/A

Next steps:

Should you have any queries in relation to our response, please do not hesitate to contact us. If you are unhappy with the response you have received in relation to your request and wish to ask us to review our response, you should write to:

Louise Moss
Head of Legal Services / Associate Director of Corporate Governance
c/o Gloucestershire Health and Care NHS Foundation Trust
Edward Jenner Court
1010 Pioneer Avenue
Gloucester Business Park
Brockworth, GL3 4AW
E-mail: louise.moss@ghc.nhs.uk

If you are not content with the outcome of any review, you may apply directly to the Information Commissioner’s Office (ICO) for further advice/guidance. Generally, the ICO will not consider your case unless you have exhausted your enquiries with the Trust which should include considering the use of the Trust’s formal complaints procedure. The ICO can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.