FOI 5689 Operations and Intensive Care

Published: February 28, 2018

1) The total number of operations you performed in your operating theatres between 1/4/2017 and 30/9/2017 inclusive

17,437

2) The total number of high dependency / intensive care beds (level 2 or level 3) you had available to you on 30/9/2017

No beds were free, the units were at full capacity

3) The total number of cases that went to a level 2 or level 3 post-operatively, either planned or unplanned

Total 92 between 01/04/2017 and 30/09/2017

4) The total number of operations in any speciality where you cancelled the procedure on the day of surgery because of lack of availability of a level 2 or level 3 bed between 1/4/2017 and 30/9/2017

There were 14 operations cancelled which cited ‘No critical care bed’ between 01/04/2017 and 30/09/2017

FOI 5774 Cyber Security

Published: February 28, 2018

1. Does your organisation adhere to the Network Security guidance outlined by the National Cyber Security Centre, within its ’10 Steps to Cyber Security’?

The Trust does hold this information; however we are withholding it under Section 31 (3) of The Freedom of Information Act as the disclosure could prejudice the prevention or detection of (cyber) crime. There is therefore significant public interest in not providing this information.

2. Do you ensure that security patches for critical vulnerabilities are routinely patched within 14 days, as recommended by the National Cyber Security Centre?

o Yes

3. Have you suffered from any service outages on your network in the last two years, however small?

o Yes

4. Did any of these outages cause a loss, reduction or impairment to your organisation’s delivery of essential services?

o Yes

5. Was the root cause of the service outage identified and confirmed – at the time or afterwards?

o Yes

6. Is it possible that any service outages you have suffered in the last two years was caused by a cyber attack – such as ransomware, DDoS attack, or malware?

o Yes

7. Are you aware that Distributed Denial of Service (DDoS) attacks are a significant contribution to service interruptions, outages and downtime?

o Yes

FOI 5757 Transplant Guidelines and Tacrolimus

Published: February 28, 2018

1. Please can you send me a link to your transplant guidelines? I would like to know what tacrolimus is used and why?

Please see attached. SOP 008 V9 I1 Management of GvHD in allo recipients AK

This document is intended to develop a standard operating procedure for the management of graft versus host disease occurring in recipients of allogeneic blood progenitor cell transplants at Birmingham Heartlands Hospital.

We use tacrolimus as second line immunosuppression if the patient experiences significant side effects with ciclosporin (severe allergic reactions, hypertension, renal or hepatic impairment, fluid retention, evidence of ciclosporin related TTP).

2. Also could you tell me who is on the Drugs and therapeutics committee please?

 Tania Carruthers – Clinical Director of Pharmacy
 Carol Evans – Interfacing Prescribing Manager
 Yogita Chikermane – Consultant Anaesthetics
 Gurdeep Chopra – Principal Pharmacist – Clinical Effectiveness & Medication Safety
 Katy Davies – Pharmacist – Medicines Information
 Siljia Eveson – Midwife
 Kavita Gopee – Nurse
 Scott Hackett – Consultant Paediatrics/Neonates
 Natasha Jacques – Principal Pharmacist – Specialised Medicine & Community Services
 Karen Ennis – Assistant Head of Medicines Management CCG
 Nilima Rahman-Lais – Deputy Head of Medicines Management CCG
 Charalampos Kartsios – Consultant Haematology
 Caroline Maynard – Faculty Nurse Educator
 Shahzad Razaq – Principal Pharmacist – Medicine and Anti-Infectives
 Ellen Shirley – Principal Pharmacist – Cancer Services
 Vijayan Suresh – Consultant Renal
 Su Dorrian – Consultant Emergency Department
 Rachel Ferreday – General Manager Division 1
 Tim Priest – Consultant Anaesthetist

FOI 5736 Complaints and Technology

Published: February 26, 2018

  1. Any complaints or escalations from each trust across the UK relating to technology. Including new technology being introduced (iPads etc.) as well as complaints about the internal computer systems. I would like this information broken down by hospital or other location (e.g. ambulance dispatch centre or community area), and would like the details of each the complaint.

The Trust does hold the information you have requested, however we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450. The appropriate limit would be exceeded if it would require more than 18 hours work.

  1. If the above has an impact on the A&E department, I would like that detailed separately. 

 

Not Applicable

 

  1. Any information that is submitted internally relating to complaints about technology

 

The Trust does hold the information you have requested, however we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450. The appropriate limit would be exceeded if it would require more than 18 hours work.

 

In order to provide this information the ICT Department would need to scrutinise  over 900 priority calls held on their database system. It is estimated that this would take longer than 18 hours.    To scrutinise 900 P1s and decide what would affect ‘normal running’ would take a couple of managers around 70 hours (based on reading through each call and coming to a decision as to whether it affected normal running)

 

  1. Information about any tech trials your trust has been a part of, including smart watches, iPads etc. and any feedback you have had on these.

 

The Trust does hold the information you have requested, however we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450. The appropriate limit would be exceeded if it would require more than 18 hours work. However, we can tell you that all key, critical Department/services refer to their Business Continuity Plans and Disaster Recovery Plans, in the event of a disruption.

 

The ICT department do not fund tech trials. Clinical areas may have trailed tech devices. In order to provide this information we would have to review all projects and supporting documentation for the last five year time period, across the whole of the Trust. This piece of work would take a significant amount of time due to the amount of projects submitted over this period, and that projects are managed by a number of staff over a number of department and services.

 

  1. Any instances of periods of time where hospitals are unable to function normally because of issues with the IT systems. Including details of the trust and time it took to fix the issue

 

During the WannaCRY incident email’s with attachments were blocked for the afternoon, and reinstated on the evening of the 12th May. The link between HEFT and the Community sites were disconnected, so no infected PC‘s from the Community could connect to the site, for this reason, some GP surgeries could not access clinical letters through Electronic Document Transfer (Docman).

 

In 2017 an unauthorised device was plugged into a network point and disrupted two wards. The wards were up and running within two hours.

 

  1. Results of the employee survey for the past 2 years, including any mentions of frustrations around technology. 

 

The results of the annual staff survey are published on the NHS survey website, and we have enclosed the reports for 2012 to 2016.  The 2017 results will be published on the 6th March 2018.

We have reviewed the staff comments in relation to frustrations around technology from the previous 5 years, which are summarised below:

Year Survey Staff comments – frustration around technology
2012 National Staff Survey No comments
2013 National Staff Survey No comments
2014 National Staff Survey 9 comments relating to: IT slow / printer issues (x2), Poor systems & infrastructure (x7).
2015 National Staff Survey 11 comments relating to: IT slow, duplicate systems paper and electronic (x6), ineffective / inadequate IT systems (x2), not enough computers (x1).
2016 National Staff Survey 5 comments relating to: IT systems ineffective and not fit for purpose (x2), old IT systems (x1), poor IT systems (x1), more capacity needed (x1).

 

In addition, we introduced a quarterly staff survey in 2014, which we run 3 times a year.  We have reviewed the staff comments in relation to frustrations around technology from the data we have, which is summarised below:

Year Survey Staff comments – frustration around technology
2014/15 Quarterly staff surveys No comments
2015/16 Quarterly staff surveys 10 comments relating to: Computer systems slow, poor & counter-productive (x7), computers not working and poor wifi (x1), duplicate systems (x1), more laptops/ipads (x1),
2016/17 Quarterly staff surveys 6 comments relating to: IT systems are slow(x1), poor IT systems (x3), IT systems inadequate (x2)
2017/18 Quarterly staff surveys 4 comments relating to: Poor IT systems (x3), inadequate/old (x1),

NHS_staff_survey_2012_RR1_full

NHS_staff_survey_2013_RR1_full

NHS_staff_survey_2014_RR1_full

NHS_staff_survey_2015_RR1_full

1. NHS_staff_survey_2016_RR1_full

I would also like information on:

  1. Information on the computer systems and operating systems that are currently being used in each trust

 

The Trust does hold this information; however we are withholding it under Section 31 (3) of The Freedom of Information Act as the disclosure could prejudice the prevention or detection of (cyber) crime. There is therefore significant public interest in not providing this information.

 

 

 

FOI 5792 Telephone Contracts

Published: February 26, 2018

Please can you send me the following contract information with regards to the organisation’s telephone system maintenance contract (VOIP or PBX, other) for hardware and Software maintenance and support:

  1. Contract Type: Maintenance, Managed, Shared (If so please state orgs)

Maintenance – Unify

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

Not Applicable

  1. Annual Average Spend: The annual average spend for this contract and please provide the average spend over the past 3 years for each provider                 

£89,500

  1. Number of Users:

Over 500

  1. Hardware Brand: The primary hardware brand of the organisation’s telephone system

Realtis DX

  1. Application(s) running on PBX/VOIP systems: Applications that run on the actual PBX or VOIP system. E.g. Contact Centre, Communication Manager.

Voip – Data Track – Netcall

  1. Telephone System Type: PBX, VOIP, Lync etc

PABX – VOIP

  1. Contract Duration: please include any extension periods.

12 months

  1. Contract Expiry Date: Please provide me with the day/month/year.

31/12/2018

  1. Contract Review Date: Please provide me with the day/month/year.

July 2018

  1. Contract Description: Please provide me with a brief description of the overall service provided under this contract.

24 hour, 7 days a week maintenance

  1. Go to Market: How where these services procured, please provide me with either the tender notice or the framework reference number. Please specify if procured through other routes.

In compliance with Trust Standard Financial instructions – Below EU Threshold

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

David Buxton – Head of Procurement – 01214241624, David.Buxton@heartofengland.nhs.uk

If the service support area has more than one provider for telephone maintenance then can you please split each contract up individually for each provider.  

If the contract is a managed service or is a contract that provides more than just telephone maintenance please can you send me all of the information specified above including the person from with the organisation responsible for that particular contract.

If the maintenance for telephone systems is maintained in-house please can you provide me with:

  1. Number of Users:

Not Applicable

  1. Hardware Brand: The primary hardware brand of the organisation’s telephone system.

Not Applicable

  1. Application(s) running on PBX/VOIP systems: Applications that run on the actual PBX or VOIP system. E.g. Contact Centre, Communication Manager.

Not Applicable

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

Not Applicable

 Also if the contract is due to expire please provide me with the likely outcome of the expiring contract.

If this is a new contract or a new supplier please can you provide me with a short list of suppliers that bid on this service/support contract?

Not Applicable

FOI 5780 Television

Published: February 26, 2018

  1. I wondered which company provides the service?

Hospedia

2. I wanted a list of each tv package offered, including what is included, the full costs, the duration, and the list of channels this provides access to?

  12 hrs

£

2 days

£

3 days

£

5 days

£

7 days

£

14 days

£

30 days

£

5 TV channels 5 12.5 15 20 25 35 40
29 TV channels 7.50 15 20 30 35 45 50
Big Bundle – tv, movies, audio books and tv box sets 10 17.50 25 35 40 50 70
In addition to the above, Sky Sports packages are also available:
1 Sky Sports Channel £5 per day
5 Sky Sports Channels 10 15 20 30      

3. I wondered if there are any ways a patient can watch the tv for free and if so what are these periods and how are they accessed?

Free services include

  • Free TV between 8am and 12 noon (7am to 7pm in children’s wards) in most hospitals
  • Free unlimited outbound phone calls to 01, 02, and 03 landline numbers
  • Free radio all day every day                                                                                                                                                                                                            4. I wondered which payment methods are available to pay for the tv service and if there are any additional costs such as admin fees etc?

Patients can call the Hospedia’s Customer Care Team anytime using the telephone on the bedside system and pay by credit or debit card. Alternatively, most hospitals will have vending machines that take cash and will issue you with a paycard to upload credit to your account.

Alternatively, once registered, you can you use the Hospedia Mobile App available to download free from itunes or Google Play                                                                                                                                                                        5.I wondered if refunds are available for the service and if so in what circumstances?

Refunds can only be given for purchases made by credit or debit card, and can only be returned to the same card.                                                                                                                                                                                 6.Does the trust profit from this scheme and if so how many in the last financial year?

The Trust does not profit from this scheme

 

 

FOI 5768 Maternity and Bereavement

Published: February 26, 2018

1)      Do you operate a maternity unit?

 

Yes

 

2)      How many specialist bereavement midwives do you employ?

 

2 x full time bereavement midwives and a team of midwife bereavement key workers who cover a 24 hour bereavement unit.

 

3)      How many of your specialist bereavement midwives work full-time?

 

1 x full time and the other full time post is a job share.

 

4)      Does the bereavement midwife keep in contact with patients when they have left hospital? By ‘contact’ we mean face-to-face appointments or phone conversations.

 

Yes – we have an open door policy for all of our families. We contact them after discharge by phone, we will do home visits where required and families know they can come and see us on the bereavement unit whenever they wish.

 

5)      Is there a ‘maximum’ time period that the bereavement midwife will keep contact with patients after they have left hospital?

 

No we have an open door policy for support and offer it in subsequent pregnancy.

 

6)      How many children died while being cared for at your maternity unit – between January 1st 2017 and December 31st 2017?.

Stillbirths 44
Neonatal Deaths 47

FOI 5767 Eating Disorders

Published: February 26, 2018

I am writing to request information under the Freedom of Information Act 2000. My request is regarding the prevalence of Eating Disorders within your Trust.  To outline my query as clearly as possible, I am requesting the following information:

1. Within your Trust how many patients have you treated with any variant of Eating Disorder in the year 2016/17?

(Please state whether patients were treated as an inpatient, outpatient or non-elective).

 178
2.

 

In the year 2016/17 how many patients did you treat with the following conditions:  
a)    Anorexia Nervosa?  60
b)   Bulimia Nervosa?  48
c)    Binge Eating Disorder?  4
d)   Eating Disorder Not Otherwise Specified (EDNOS)/Other Specified Feeding or Eating Disorder (OSFED)?  69

FOI 5761 Winter Pressure Cancellations

Published: February 26, 2018

Could the trust please provide the following details about cancellations for non-clinical reasons, and last minute (on the scheduled day of arrival at hospital or later) non-clinical cancellations

  December 2016/17 January 2016/17 December 2017/18 January 2017/18
Operations cancelled by the trust The Trust does hold this information. However, we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450 as we would need to review individual patient records.

 

Operations cancelled by the trust at the last minute  97  148  139  80
Day  cases (excluding operations) cancelled by the trust The Trust does hold this information. However, we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450.

 

We currently do not monitor cancellations where a patient was not intending to have an operation.

To verify data for these cancellations, we would need to examine each recorded cancellation to establish if they were day cases and if the patient intended to have an operation.

Day cases (excluding operations) cancelled by the trust at the last minute
Outpatient / clinic appointments cancelled by the trust  

We do not hold this information. In most cases an outpatient appointment will be rebooked rather that cancelled i.e. no cancellation will be recorded. This means that there is no method to obtain this information accurately.

 

Outpatient / clinic appointments cancelled at the last minute
Total cancellations As above, we do not hold all of this information, and for some other information the Trust does hold this information. However, we estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000.
How many of the total cancellations were given a new date within 28 days?  We estimate that compliance with your request would exceed the appropriate costs limit under section 12 of the Freedom of information Act 2000. This is currently £450.

 

However, we can verify that all the Operations cancelled by the trust at the last minute for non-clinical reasons were given a date within the 28 days.

 

Cancellation codes used

The following cancellation codes have been used and are categorised as Cancellations on the Day for non-clinical reasons.

NA Admin error – wrong letter issued
NC Emergency took priority
ND Equipment failure
NE Equipment unavailable
NF Hospital failed to starve
NG Investigations not completed
NH No bed
NI No critical care bed
NJ Notes not available
NK Ran out of time – started late
NL Ran out of time – previous case overran
NM Ran out of time – list overbooked
NN Ran out of time – due to bed delays
NO Staff unavailable – anaesthetist
NP Staff unavailable – surgeon
NQ Staff unavailable – theatre team
NS Admin error – added to wrong list
NT Hospital Transport Failed
NU No Interpreter booked

FOI 5753 GDPR compliance

Published: February 26, 2018

  1. How would you describe your GDPR preparedness?
  1. Already compliant
  2. On target to be compliant by May 25th 2018
  3. Project underway but suffering difficulties
  4. Barely started
  5. Haven’t started

The Trust does not meet any of these descriptions in relation to GDPR preparedness.  I can confirm that work to prepare us is on-going and will continue.

 

  1. Have you identified all your data processing partners?
  1. Yes
  2. No
  3. Unsure

c) Unsure- It is not possible for us to confirm or deny whether all processing partners have been identified as if there are ones we are unaware of we wouldn’t know.

  1. Do you have contracts in place with all your data processing partners?
  1. Yes
  2. No
  3. Unsure                                                                                                                    c) Unsure- As above it is not possible for us to confirm or deny this. Part of the work the Trust is undertaking for GDPR is looking to update agreements where needed, but this is on-going.

 

 

  1. Do you use a third party to provide data erasure or destruction services on your end of life IT infrastructure?
  1. Yes
  2. No (ICT have advised that they do not use any such third parties)
  3. Unsure
  1. If you use a third party, do you have a contract in place with them?
  1. Yes
  2. No
  3. Unsure
  4. Not Applicable

 

  1. How have you assessed ‘sufficient guarantees’ from this company? (Please tick all that apply)
  • In writing from them
  • Via Contract Terms
  • Relevant accreditation
  • Independent Assessment/Audit
  • Not Applicable

 

  1. Does this contract include clarification on process for dealing with: (Please tick all that apply)
  • Breach Notification?
  • Subject Access Requests
  • Changes in processing activities which require a DPIA
  • Not Applicable

 

  1. If you use a third party what is their name?

Not Applicable

 

  1. How regularly do you or an independent third party, audit this company?
  1. Never
  2. Every 6 months
  3. Every 12 months
  4. Irregularly but over 12 months
  5. Unsure
  6. Not Applicable

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