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Corporate Administration NHS Greater Glasgow and Clyde Corporate HQ J B Russell House Gartnavel Royal Hospital Campus 1055 Great Western Road GLASGOW G12 0XH Corporate Administration NHS Greater Glasgow and Clyde Corporate HQ J B Russell House Gartnavel Royal Hospital Campus 1055 Great Western Road GLASGOW G12 0XH Telephone: 0141 201 4444 Ms Elizabeth Thomson Date 22 February 2019 Your Ref Our Ref BRD / AF / FOI /14296 SENT BY EMAIL TO: Direct Line 0141 201 4460 request-491181- Email [email protected] [email protected] Dear Ms Thomson REQUEST FOR INFORMATION FREEDOM OF INFORMATION (SCOTLAND) ACT 2002 ENVIRONMENTAL INFORMATION (SCOTLAND REGULATIONS 2004 Thank you for your request received on 8 October 2018 for the provision of the following information:- 1 How often have physical restraints used on mental health patients in mental health facilities been recorded as 'adverse events' in each of the past four years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18) 2. How many injuries (of mental health patients in mental health facilities) have been recorded as a result of restraint in each of the past 4 years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18) 3. How many deaths (of mental health patients in mental health facilities) have been recorded as a result of restraint in each of the past 4 years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18) We are treating your request under our procedures for responding to requests for information under the Freedom of Information (Scotland) Act 2002. I am now able to provide a response on behalf of NHS Greater Glasgow and Clyde (NHSGGC). I acknowledge that this request has been issued significantly outwith the statutory timescale set out in FOISA for such responses, and I offer my sincere apologies for the delay, and any inconvenience this has caused. The information that we are able to provide in response to your request is given below. NHS Greater Glasgow and Clyde (NHSGGC) is the largest NHS Board in Scotland and provides services to a core population of 1.2million, and specialist regional services to more than half the country's population. It also employs approximately 38,000 staff, which represents a quarter of the workforce in NHS Scotland. Within NHSGGC, clinical staff receive training in the use of safe and effective restraint techniques. The training programme includes de-escalation and safe handling methods. These interventions are always considered prior to the use of restraint. However there are some clinical situations where short term restraint may be necessary including rapid administration of medication and high risk to self and others. Staff are very aware of the distress that can be experienced by patients and others when restraint is required. The specialist Violence Reduction Team works closely with clinical staff to minimise the use of physical restraint and ensure that when this is necessary it is delivered safely and for short periods of time. To set the information below in context, I would ask you to note that NHSGGC deals with over 5,500 psychiatric in-patient episodes each year. 1. How often have physical restraints used on mental health patients in mental health facilities been recorded as 'adverse events' in each of the past four years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18) Please note that we are able to identify occasions when physical restraint has been used, and have identifed these by site. However ‘mental health facilities’ is not a specific term, as many sites within NHSGGC contain both acute services and mental health services. We are not able to identify whether the incidents relate specifically to ‘mental health patients’. Any incident is viewed as an ‘adverse event’ and recorded on the incident reporting system. The information that we are able to provide is shown in Attachment 1, however we are aware that this may have captured additional incidents that are outwith the parameters set by you. 2. How many injuries (of mental health patients in mental health facilities) have been recorded as a result of restraint in each of the past 4 years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18). We are able to provide information on the number of incidents which resulted in injury and which involved restraint. However please note that the injury in these incidents was not necessarily to the patient, and may have been the result of the initial incident rather than the restraint itself. We are not able to identify whether any injury where restraint was involved was as a result of the restraint, or was caused by the incident which gave rise to the need for restraint. 2014 2015 2016 2017 2018 16 27 25 28 8 Table 1: number of incidents which resulted in injury and involved restraint in mental health facilities – 01/04/2014-31/03/2018 – by year A full breakdown by site and year would potentially identify individuals, due to the small numbers involved. However an indication of total number of incidents by site is given below in Table 2. Unit Total Blythswood House <5 Dykebar Hospital 6 Gartnavel Royal Hospital 26 Langhill Clinic <5 Larkfield Unit <5 Leverndale Hospital 23 MacKinnon House 15 Parkhead Hospital <5 Rowanbank Clinic 8 Royal Alexandra Hospital <5 Royal Hospital for Children <5 Skye House Adolescent Unit 7 Stobhill Hospital <5 Waterloo Close <5 TOTALS 104 Table 2: number of incidents which resulted in injury and involved restraint in mental health facilities – 01/04/2014-31/03/2018 – by site Please note where there are small numbers these are presented as <5 to protect patient identification. This is due to the possibility that disclosure of actual figures would pose a risk that an individual or individuals could be identified from that information. This would be contrary to, and would put NHSGGC in breach of, Data Protection principles. In assessing this, we have followed guidelines issued by NHS NSS Information Services Division. A key principle of the guidelines discourages presenting numbers which are less than 5. We therefore decline to provide the actual figures on the basis that this is personal information. Section 38 of FOISA provides that information is exempt information if it constitutes personal information and that to disclose this information would contravene one or more of the data protection principles. The exemptions within FOISA that we have relied upon to withhold this information are section 38(1)(b) read in conjunction with section 38(2)(a)(i) of FOISA. This is an absolute exemption which means that if information is withheld under this exemption, we are not required to consider whether it is in the public interest to withhold it. 3. How many deaths (of mental health patients in mental health facilities) have been recorded as a result of restraint in each of the past 4 years? I would prefer this information broken down by facility and year. (2014/15, 2015/16, 2016/17, 2017/18) No deaths (of mental health patients in mental health facilities) have been recorded as a result of restraint in the past 4 years. I hope that this is helpful. If you are not satisfied with our response to your request, you have a right to request a review of this decision within 40 working days of receiving this response. The attached note describes our review procedure. Your request for review must be in permanent form and should state: That you are asking for a review of this decision and Why you are unhappy with the response you have received. If you wish us to carry out a review, please complete the form enclosed and return it to the Head of Corporate Governance and Administration, NHS Greater Glasgow & Clyde, Corporate HQ, JB Russell House, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH or by email to [email protected] If following a review you remain dissatisfied with the outcome, you have the right to ask for advice, assistance or to make a formal appeal in writing to the Scottish Information Commissioner, Kinburn Castle, Doubledykes Road, St Andrews, Fife, KY16 9DS or at www.itspublicknowledge.info/Appeal If following appeal to the Scottish Information Commissioner you still remain dissatisfied with the outcome, you have a right of appeal to the Court of Session on a point of law against the decision of the Scottish Information Commissioner. Should you require any clarification about this letter or the right to request a review please contact me at the details at the top of the first page of this letter. Yours sincerely Alison Flynn Alison Flynn Freedom of Information Manager Standard Enclosures: Request For Review Form Procedure for review of decision notified .
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