Responses

I would like to make a Freedom of Information request regarding the provision of vestibular assessment and rehabilitation by your Trust’s Falls Prevention Service (or equivalent).
World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative published in September 2022 (see below link) recommend routinely asking about dizziness and undertaking follow up assessment to identify causes, including vestibular. They reference the high incidence of BPPV and vestibular dysfunction in those presenting with falls and suggest managing vestibular issues should be considered as part of a multifactorial approach.
World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative | British Geriatrics Society (bgs.org.uk)

The request therefore has 3 specific questions:
1. Does your falls prevention team (or equivalent) have staff trained to assess and treat vestibular dysfunction?
2. If so, from which profession(s)?
3. Do you have any plans to develop this part of your falls prevention service?

Permanent / international recruitment – questions
How many roles did you recruit via international recruitment during the period August 2024 to January 2025?
Please provide a further breakdown by:
• Number of Nurses including banding
• Number of Doctors including grades
• Number of AHP including banding

Of these hires made please confirm the number of hires made using a recruitment agency.
Please provide a further breakdown by:
• Number of Nurses including banding
• Number of Doctors including grades
• Number of AHP including banding

Of the agencies used, please confirm:
• Which agency was used for the hire
• Which framework was utilised for the hire
• Please include non-framework agencies also

FOI request: Mental health patient homicides at Gloucester Health and Care NHS Foundation Trust and independent investigations

1. Please disclose since 1994, how many homicides by trust patients have occurred within a year of contact with the trust (and its predecessor bodies).

Please give a breakdown by year.

2. How many of these patient homicides were reported to NHS England or its predecessor bodies?

Please give a breakdown by year.

3. How many of the patient homicides reported to NHS England were independently investigated under HSG 94-27?

If not all patient homicides were reported to NHS England and/or its predecessor bodies, can the trust explain why this was so?

Dear Gloucestershire Health and Care NHS Foundation Trust,

This is a request for information under the Freedom of Information Act 2000. I would like to request the following information:

1. The number of patients treated year-on-year by the Early Intervention in Psychosis team of Gloucestershire Health and Care NHS Foundation Trust in:
a. 2020/21
b. 2021/22
c. 2022/23
d. 2023/24
2. The number of staff that work in the Early Intervention in Psychosis team of Gloucestershire Health and Care NHS Foundation Trust in:
a. 2020/21
b. 2021/22
c. 2022/23
d. 2023/24
3. The percentage increase/decrease in the budget for the Early Intervention in Psychosis team of Gloucestershire Health and Care NHS Foundation Trust in:
a. 2020/21
b. 2021/22
c. 2022/23
d. 2023/24
4. What was the mean waiting time for EIP patients between first referral and starting treatment in:
a. 2020/21
b. 2021/22
c. 2022/23
d. 2023/24
5. What was the longest waiting time for an EIP patient on your caseload between first referral and starting treatment in:
a. 2020/21
b. 2021/22
c. 2022/23
d. 2023/24

Under the Freedom of Information Act please can you provide the following information:

1. Between January 2024 and December 2024 (inclusive) did the trust use any bed and breakfast accommodation for discharged mental health patients?
If so, how many beds?
2. What was the reason for using them?
3. During the same period how much was spent in total on B&B accommodation for mental health patients?

I am submitting a request under the Freedom of Information Act 2000. I would like to obtain data regarding the number of hospital admissions related to sunbed injuries. Specifically, I request the following information in whichever format is easiest to provide: SNOMED, ICD-11, or free text.

1. Sunbed Admissions (SNOMED)
The number of hospital admissions for patients presenting with sunbed-related injuries, classified under:
• 403588002 – Addiction to sunbed use (disorder)
• 242537009 – Exposure to man-made ultraviolet light (event)
• 466293001 – Ultraviolet tanning device (physical object)
If possible, please also include:
• Age group (e.g.: under 18, 18-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85-94, 95-100, over 100)
• Gender of the patient
• Brief description of the reason for admission
• Treatment received for the injury
2. Sunbed Admissions (ICD-11)
The number of hospital admissions for patients presenting with sunbed injuries, categorised under:
• EJ41 – Burn from exposure to artificial source of ultraviolet radiation
o EJ41.0 – Burn from exposure to therapeutic ultraviolet radiation
o EJ41.Y – Other specified burn from exposure to artificial source of ultraviolet radiation
o EJ41.Z – Burn from exposure to artificial source of ultraviolet radiation, unspecified
If possible, please also include:
• Age group (as above)
• Gender of the patient
• Brief description of the reason for admission
• Treatment received for the injury
3. Sunbed Admissions (Free Text)
The number of hospital admissions for patients presenting with sunbed injuries, provided in free text format.
If possible, please also include:
• Age group (as above)
• Gender of the patient
• Brief description of the reason for admission
• Treatment received for the injury
Timeframe
For each month over the past five years (2019–2024), please provide the total number of individuals recorded.

I am writing to formally request information under the Freedom of Information Act 2000
regarding the use of mechanical ventilation within your hospital trust, specifically for patients
undergoing an MRI scan and those requiring in-hospital transportation while intubated.
Please provide responses to the following questions:

1. What is the current policy for mechanical ventilation of patients undergoing an MRI scan
within your NHS trust?
2. Which department has the primary responsibility for overseeing the mechanical
ventilation of patients in the MRI suite? Is it the Intensive Care Unit (ICU) or the MRI
department?
3. Which mechanical ventilators are currently used when conducting MRI scans on patients
within your MRI department?
4. Please provide the make, model, and age of the current mechanical transport
ventilators used within your trust.
5. Could you list the specific MRI-compatible ventilators currently in use within your trust?
6. Please provide the contact details (name, job title, and email/telephone) of the lead
clinical person overseeing the use of mechanical transport ventilation within your trust.
7. Please provide the name and contact details of the technician responsible for
overseeing the usage and maintenance of these ventilators within your trust.

I am writing to request information under the freedom of information act on your organisations waiting list information.

1. Please can you fill in the table provided on waiting list figures for Adults and Children and Young People (CYP) split by Mental Health Condition

I write to make a formal request under the Freedom of Information Act 2000 for access to the following information held by Gloucestershire Health & Care NHS Foundation Trust:

I. Care of the Deteriorating Patient Policy
II. Digital Call Recording Policy
III. CLP247 Assessment and Care Management Policy
IV. CLP005 Health Records and Clinical Record Keeping Policy
V. Mental Health Intermediate Care Team (MHICT) Operational Policy v10
VI. Supporting Attendance Policy and Procedures
VII. Home Working Policy (Final)
VIII. Improving Performance Policy and Procedure v4
IX. Disciplinary Policy and Procedure v3
X. Core Assessment Form(s) within RiO
XI. Maxwell Centre/Suite Checklist Form
XII. Improving Access to Psychological Therapies (Let’s Talk) Operational Policy – including assessment and treatment guidance/policy for therapeutic approaches such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and Eye Movement Desensitisation and Reprocessing (EMDR).

Note: Please provide any policies, guidance, or procedures that were introduced, in use, or updated between April 2023 and September 2023. If specific documents from that period are unavailable, please provide the closest available version, and specify the time frame during which it was in use, as well as the date it was withdrawn, if known. Additionally if a policy has since been entirely replaced, updated, or changed, kindly provide the most recent version of that policy. And:
XIII. Multi-Agency Section 136 Policy, Procedure, and Guidance (only if it has been reviewed or updated as part of the Right Care, Right Person approach).

Please could you answer the following questions under the Freedom of Information Act.

1. Does your trust have a patient flow system?
2. If so, is it using the electronic patient record, Or the national offer built on Palantir/Foundry?
3. Or does the Trust have a specialist flow product? If so, what is the
• Supplier name
• System name
• Contract expiry date

I am writing under the Freedom of Information Act 2000 to request data on bed sore-related death reports and complaints made to this trust.

• Please provide any trust guidance on pressure care (for the care and prevention of pressure sores, pressure ulcers, or bed sores) issued to administrators and/or hospital staff in the past 24 months.
• For the following years, please provide the number of patients within the trust treated for bedsores (classified as ICD-10 code L-89), as filed in Datix, Ulysses or other relevant reporting systems:
o 2022
o 2023
o 2024

1. The names of any digital mental health technologies currently in use by the trust, including the start date for the contract and its duration. If the DMHT is being used as part of a pilot or research project please specify this.
2. The names of any service providers commissioned/sub-contracted by the trust to provide a healthcare service, which uses DMHT. I know that your ICB is responsible for commissioning services but I know that on occasion trusts will bring in third sector/independent sector providers on a sub-contract or other arrangement. Please only include those contracts arranged by the trust, not the ICB.

Please could you provide the following information:
General:

* Number of Sites
* Number of Employees
* Number of IT Staff
* Annual IT Budget

Web Security

1. Who is the provide of your current web security solution?
2. Does your current web security provide you visibility in to cloud and/or business application usage?
3. When is the contract up for renewal?
4. Typically, what is the chosen duration of these contracts 12, 24, or 36 Months?
5. Name and contact details of the person responsible?
6. Current annual spend for this contract?
7. Current number of licenses for this contract?
8. Did you purchase via a reseller, or partner (if yes, please specify who e.g. Phoenix, Softcat etc.)?
9. Are you planning on assigning specific budgets for securing web security in 2025?
10. Do you procure this technology through the G-Cloud framework (if not, how do you procure & plan to procure Web security in the future?)

Security Awareness Training

1. Do you current undertake cyber security awareness training with your staff?
2. Who is your current Security Awareness Training provider?
3. When is the contract up for renewal?
4. Typically, what is the chosen duration of these contracts 12, 24, or 36 Months?
5. Name and contact details of the person responsible?
6. Current annual spend for this contract?
7. Current number of licenses for this contract?
8. Did you purchase via a reseller, or partner (if yes, please specify who e.g. Phoenix, Softcat etc.)?
9. Are you planning on assigning specific budgets for Security Awareness Training in 2025?
10. Do you procure this technology through the G-Cloud framework (if not, how do you procure & plan to procure Security Awareness Training in the future?)

What is the total number of staff hired in a diversity, equality, equity or inclusion role?

What was the total spend on diversity, equality and equity or inclusion, including staff salaries and external training bodies and courses for the last financial year?

Pursuant to the Freedom of Information Act 2000, I am writing to request the following information regarding the datacentre(s) maintained by your NHS Trust:
1. Which technology vendors provide the trusts primary data storage arrays? E.g Dell/Netapp/Tintri/Pure/Storage/HPE//Nutanix etc.
2. What is the size in Terabytes of the primary storage environment?
3. When does the current support contract expire on the primary data storage arrays?
4. What data storage array technology does the trust use to house the PACS environment?
5. What is the size in Terabytes of the PACS storage environment?
6. When does the current support contract expires on the primary storage arrays?
7. Which PACS provider does the trust use?
8. What Electronic Patient Record technology does the trust use?
9. Which backup technology does the trust use? E.g Veeam, Commvault, Rubrik
10. When does the current support contract expire on the backup technology?
11. Does the trust use public cloud storage? – Azure/AWS/Google Cloud
12. Does the trust use Azure VmWare Solution?
13. Does the trust have any stateless applications?
14. Does the trust use containers?
15. Does the trust use kubernetes?
16. Which frameworks does the trust tend to use to purchase hardware for the datacentre?
17. Which partners does the trust tend to use to purchase hardware for the datacentre?

I am writing to request information under the freedom of information act on your organisations service provision cost.

1. Please can you provide the annual cost of providing the below services for the financial year 2023/2024?
• Learning Disability Services
o Adult Cost
o Children and Young People Cost
• Autism Services
o Adult Cost
o Children and Young People Cost
• Eating Disorder Services
o Adult Cost
o Children and Young People Cost
• Early Intervention in Psychosis Services
o Adult Cost
o Children and Young People Cost
• ADHD Services
o Adult Cost
o Children and Young People Cost
• Anxiety and Depression Services
o Adult Cost
o Children and Young People Cost

I am writing to submit a formal request for information under the Freedom of Information Act 2000. I kindly request the following details:

1. What are the biggest challenges your organisation currently faces in surveying and geospatial activity?

2. Are you confident in your full knowledge of the condition and knowledge of your impact on our local environment?

3. What are your organisation’s key strategic objectives for the next 12-24 months, and how does surveying and geospatial fit into these?

4. Please detail any planned development of sites or assets

5. Do you have a supplier for drainage mapping and surveying?

6. If so, please can you supply details of the contractual arrangements in place including date of award, details of any Framework used or link to the advertisement, contract value and duration

7. If not, please can you indicate what evaluation of the requirement for surveying and geospatial works have been undertaken?

8. Please share your planned procurement pipeline for surveying and geospatial works for the next 12 months

9. How do you engage with potential new suppliers—through open tenders, direct engagement, or supplier days?

10. Please can you confirm the individual responsible for managing your surveying and geospatial contracts or wider development contracts and provide their contact details and role title?

11. Please provide a list of frameworks that you procure related services through

12. Do you plan to repurpose any sites for renewable energy or solar farms?

13. Do you have any issues with subsidence in your properties? If so, where?

14. When developing/purchasing/selling a site, how do you verify that the boundaries are correct?

1. The total number of Health IT systems currently in use by the organisation.
2. The number of Health IT systems currently in use by the Trust that have BOTH DCB0129 (from the manufacturer) AND DCB0160 (from the deploying organisation) Clinical Safety Case Reports.
3. The number of Health IT systems currently in use by the Trust that have a valid DCB0129 Clinical Safety Case Report from the manufacturer ONLY (i.e. have a DCB0129 report but NOT a DCB0160 report).
4. The number of Health IT systems currently in use by the Trust that have a valid DCB0160 Clinical Safety Case Report from the deploying organisation ONLY (i.e. have a DCB0160 report but NOT a DCB0129 report from the manufacturer).
5. The total Whole Time Equivalent (WTE) of Clinical Safety Officers who are currently actively working on DCB0129/DCB0160 implementation within the Trust.

We would be most grateful if you could provide us, under the Freedom of Information Act, with some information regarding current Fire Alarms & Fire Suppression Systems in place.

The details we require are:

– Hardware Brand: The primary hardware brand of the organisation’s:
a. Fire Alarms
b. Sprinklers
c. Fire extinguishers
d. Fire Doors

– Existing Supplier: If there is more than one supplier, please split each contract up individually.

– Contract Type: What is included in the current contracts with these suppliers? Comprehensive, Semi Comprehensive including call outs, Basic Service Only.

– Contract duration, end date and review date of the current contracts with these suppliers.

– On average, what is the annual spend on each of these systems for the Trust?

– Contact Detail: Of the person from with the organisation responsible for each contract with details including full name, job title, direct contact number and direct email address.

– If the contract is a managed by an outside Facility Management Company, please can you provide all the relevant details with including the contact details of the responsible person from the FM (Facilities Management) Company.

I am writing to request information under the Freedom of Information Act 2000 regarding the Endoscopy Traceability software currently in use within the Trust.

Could you please provide the following details:

Software Name and Supplier
The name of the current Endoscopy Traceability software in use and the details of the supplier.

Duration of Use
How long has the Trust been using this Traceability software?

Contract Start Date
The start date of the current contract for the Endoscopy Traceability software.

Contract End Date
The end date of the current contract.

Current Annual Contract Value
The Annual value of the current contract.

Procurement Framework (if applicable)
If relevant, please provide details of the procurement framework used to award the contract.

Who is responsible for managing the Endoscopy Traceability software?
Which service does this software fall under.

What machines are currently being used by your Endoscopy department?

What EWD cabinets or sterilisers are being used in your Endoscopy service.

I am writing to request information under the freedom of information act on your organisation’s vacancy rates.
1. Please can you provide the current vacancy rates for the bellow staffing groups-
• Medical
• Nursing and Healthcare Assistants
• Scientific, Therapeutic and Technical (STT) and Allied Health Professionals (AHPs)
• Healthcare Scientists
• Administrative and Support Staff
2. Please can you provide the three job roles with the highest vacancy rates in your organisation? For example Psychiatry, Psychology, Mental Health Nursing etc

Please note while question one refers to staffing groups, question two is referring to specific job roles outlined by NHS England under the heading Mental Health Roles found here- https://www.england.nhs.uk/mental-health/working-in-mental-health/

1. What is the email retention policy at your trust for official NHS clinical staff emails related to patient care. Also, what is the retention policy for deleted clinical emails, deleted by staff from their mailbox?

1a) Does your trust require that clinical emails related to patient care be placed in the patient’s record?

2. What is the back-up policy at your trust for backing up clinical staff/doctor’s emails related to patient care? How often are the clinical emails backed-up and how long are the back-ups kept? Are the back-ups automated?

3. Are deleted clinical emails (deleted by staff) recoverable on the email system at your trust, either from onsite or offsite storage? How long after the emails are deleted by staff, can the emails be recovered from the different locations they are stored?

4. Your trust uses nhs.uk email so NHSMail helpdesk cannot assist with forensic discovery of emails. Hence, does your trust perform a forensic discovery equivalent to the forensic discovery provided by NHSmail help desk to retrieve deleted NHSmail (dot net) emails up to 2 years after they were created/sent even if deleted prior to 2 years by staff?

ie Can your trust retrieve deleted nhs.uk emails up to 2 years after they were created/received?

5. Do your doctor’s have the ability to permanently delete emails from all locations without IT system administrative privileges? Do the doctors at your trust have IT system administrative privileges?

6. When emails are deleted by clinical staff without significant knowledge and access rights, there are other possible places where the deleted emails can be recovered from: For example, local offline storage, where emails are cached on the local machine in an offline storage file (OST) which even when emails are deleted from the mailbox, can leave fully recoverable items, unless the OST file is forensically destroyed. Does your trust maintain an email OST for the staff NHS emails?

7. Are clinical staff emails archived off into different locations? If yes, what are these locations.

8. Can your trust IT team identify and create a log of emails deleted by a specified doctor working at your trust? How long after email deletion can the log still be created?

9. When emails are deleted on the local staff computer and need to be retrieved, administrators can perform a search across the entire MS 365 environment to establish the presence of any of these emails in other user mail-boxes and non-email storage locations – is this a process that your trust can perform via the IT team or other team?

10 If staff emails related to patient’s clinical care are requested under DPA 2018 SAR, what is the IT process undertaken at your trust to identify and retrieve the emails. Are offline storage searched and all locations as mentioned in this FOI or only the staff local computer/mailbox? Can you retrieve clinical emails requested under SAR DPA 2018 for up to 2 years after creation/send even if the staff have deleted them?

11) NHS’s data retention and information management policy states that “an email will be retained and available for forensic discovery in NHSMail for two years after it was sent/received or until it is deleted from the mailbox by staff, whichever is later.” Does your trust adhere to this policy with your nhs.uk email system? ie your trust must be able to retrieve a clinical email for 2 years after it was created or sent, even if it was deleted by staff prior to 2 years – NHSMail helpdesk cannot assist – so does your IT team have a process to ensure compliance with NHS’s policy highlighted above?

I am doing some research into hospital asset tracking management outside hospitals. Please could you advise re the following: · Do you have a formal digital system for tracking products sent to other hospitals? (E.g. loaning a hip to a private hospital then tracking its return/re order/billing and payment) · Which local hospitals private do you send products to? · How often do you send them? · Do you have a reliable mechanism for ensuring compliance, payment and expediting? · Do you have a formal returns process for items given to the public (e.g. crutches) I look forward to hearing from you. Florence

I am writing to you under the Freedom of Information Act 2000 to request the following information regarding your Trust’s processes to reduce medication waste. Please may you provide me with an answer to the following:

1. Does your Trust have a formal policy on medicines waste reduction?
i. Yes/No

2. Have any sustainability or environmental impact assessments been conducted regarding your Trust’s pharmaceutical waste
i. Yes/No
ii. If yes, please provide a brief summary of key findings.

3. Do you currently employ any staff specifically to support medicines waste?
i. Yes/No
ii. If yes, how many full time equivalents do you employ?

4. How often does your organisation report on the management of waste (including cost) at Board level?
i. Annually/Quarterly/Monthly/Never/Other (please state)

5. For each of the hospitals in your Trust, what is the value of medication you have had to waste in the last 2 financial years? This the value of medication that was the property of the hospital at the point it was wasted, i.e. the cost of medication that expired before int could be used.

6. For each hospital in your Trust, what has been your total drug spend over the past two financial years?

7. For the last two financial years combined what is the drug that you have wasted the most of, and what was the total cost?

8. Have any sustainability or environmental impact assessments been conducted regarding your Trust’s pharmaceutical waste
i. Yes/No
ii. If yes, please provide a brief summary of key findings.

1. Please answer yes or no. In January 2025 was your Trust conducting any… internal review / investigation / report being compiled… into a consultant that has had concerns raised about him or her (i.e.. a whistle-blower has come forward and named the person)?
2. Please answer yes or no. In January 2025 was your Trust conducting any… internal review / investigation / report being compiled… into a junior doctor that has had concerns raised about him or her (i.e.. a whistle-blower has come forward and named the person)?
3. Please answer yes or no. In January 2025 was your Trust conducting any… internal review / investigation / report being compiled… into a nurse that has had concerns raised about him or her (i.e.. a whistle-blower has come forward and named the person)?
4. Please answer yes or no. Has your Trust conducted / started or concluded an internal or external review / investigation of a medical member of staff since January 1st 2023 following a whistle-blowers or patient raising concerns?
5. Please answer yes or no. If you answered yes to question 4 – did the member of medical staff being investigated continue to have contact with patients whilst the… review/investigation/report being written… was ongoing?
6. If you answered yes to Question 4, is the member(s) of staff that was investigated / reviewed still working at your Trust following the review conclusions?
7. If you answered yes to Question 4, for those reports that have concluded, was the member of staff that was investigated / reviewed found to have fallen short of the standards your Trust would expect from their medical staff?
8. If you answered yes to Question 4, how many members of medical staff were reviewed/ investigated following an internal whistle-blower raising concerns?
9. If you answered yes to Question 4, was the whistle-blower also investigated?
10. Please answer yes or no. Do you have any experience of a malicious whistle-blower? If yes, please share further details if able.
11. Please share any review conclusions / reports / write ups where possible.
12. Please share any further details of your whistle-blower policy here. How do you manage whistle-blower when they raise concerns?

Freedom of Information Request – Ref: 263-2024 Thank you for your recent Freedom of Information...

As part of a MSc Midwifery dissertation, I am investigating the number of Consultant Midwives/Consultant Midwifery Posts in the UK (including the Channel Islands and Isle of Man). While Consultant Midwives (CMs) will primarily be employed within maternity services, an increasing number of Ambulance and Community/Mental Health organisations are utilising the specialist skills of senior Midwifery clinicians so I hope this data will help us to understand the distribution and impact of CMs in all our health services.

I would therefore be grateful if you would be able to provide the following information:

– Number of Consultant Midwives (headcount AND Whole Time Equivalent (WTE)) currently employed
– Number of vacant Consultant Midwifery posts (WTE), if applicable
– Salary band paid/offered to Consultant Midwives (e.g. Band 8b or Band 8c), if applicable
– Number of Trainee/Assistant Consultant Midwives (headcount AND WTE) currently employed
– Number of vacant Trainee/Assistant Consultant Midwife posts (WTE), if applicable
– Salary band paid/offered to Trainee/Assistant Consultant Midwives, if applicable

I would be most grateful if you would provide me, under the Freedom of Information Act, details in respect to the below.

A. Please confirm the number of operational Community Diagnostic Centre (CDC)’s under the ICB. And of this number how many are

Standard
Large
Hub and spoke

B. Please list the locations of the sites along with their designation (Standard, Large or Hub and Spoke)

C. Standard model –  which services are being provided and annual activity levels e.g. pathology – phlebotomy x amount of tests.

Imaging
Pathology
Physiological science

D. Large model – which services are being provided and annual activity levels e.g. pathology – phlebotomy x amount of tests.

Imaging
Pathology
Physiological science
Endoscopy

E. Hub and Spoke model – which services are being provided and annual activity levels e.g. pathology – phlebotomy x amount of tests.

F. Is audiology or hearing services including wax removal offered at any of the sites listed above? Please list the locations where it is being offered.

I would be most grateful if you would provide me, under the Freedom of Information Act, details in respect to the below.

1. Please list all providers that currently provide NHS audiology services in your region.

2. Please provide a copy of the current and most up to date service specification as contained in the relevant contract particulars for adult hearing care.

3. Please provide the date the adult hearing care service last was commissioned.

4. If adult hearing care is part of a wider service specification i.e. ENT, then please provide a copy of the current and most up to date service specification as contained in the relevant contract particulars.

5. If adult hearing care is part of a wider service specification i.e. ENT, then please provide the date this service was last commissioned.