Request
Under the terms of the Freedom of Information Act, I'd like to request all serious untoward Incident reports for the last financial year.
Our Response
I refer to your email requesting SUI reports for the last financial year.
I can confirm in accordance with S.1 (1) of the Freedom of Information Act 2000 (FOIA) that we do hold some of the information that you have requested. The following link to the disclosure log section of our website should provide you with the information that you require which was released in response to an earlier information request:
http://www.eastmidlands.nhs.uk/about-us/access-to-information/freedom-of-information/foi-disclosure-log/2010-disclosure-log/april-2010/serious-untoward-incidents/
The information that I am referring you to details data from the SUIs reported to NHS East Midlands from the start of 2008 to date. For expediency, this data has been electronically produced by NHS East Midlands and you might therefore want to contact constituent organisations to verify these figures before further reporting. This is particularly necessary where there may be instances where the incidents have coded incorrectly by the Trust. The following link to our website will enable you to do this:-
http://www.eastmidlands.nhs.uk/the-local-nhs/nhs-organisations/
Supporting Information and Guidance on Information Provided
The information supplied needs to be seen in a wider context. Clinicians and managers of NHS care want to ensure that when a serious event or incident occurs there are systemic measures in place for safeguarding people, property, NHS resources and reputation. The purpose of the reporting system is to enable the NHS to actively learn from incidents and to ensure that where required changes are identified they become embedded in practice.
High reporting does not necessarily mean an unsafe hospital or unsafe care. Indeed, reporting is encouraged to facilitate an open culture of learning.
You should also be aware that some of these incidents will be de-escalated as SUIs once the investigation begins as it is sometimes found that the incident is not as serious as first thought, or was not actually preventable. Foundation Trusts (FTs) are not necessarily required to report SUIs to NHS East Midlands (although some choose to do so), it depends on the terms of their contract with the Primary Care Trust and the conditions of authorisation from Monitor.
The relative size of Trusts and the range of services they provide obviously has a bearing on the number and type of SUIs that have been reported. National reporting criteria require Trusts to report certain infections.
Exempted Information and Small Numbers Data
While we have provided the majority of information requested we have withheld the actual dates of the incidents under section 40(2) of the Freedom of Information Act. This is because we feel that disclosure of this information, if taken in conjunction with other information such as the name of the Trust and type of incident, carries with it a real threat that the individuals involved in the incidents could be identified. This is especially relevant in cases where only one occurrence of a particular incident has happened at an individual Trust.
Similarly, I have also disguised some of the figures around child abuse and suicide cases under section 40 of the FOIA, which as you might be aware, is an absolute exemption relating to Personal Information, as these lines relate to less than 5 individuals in line with the current guidance available to us on the use of small number data. The purpose of section 40 of the Act is to protect personally identifiable information and the privacy of living persons.
In coming to this decision, we have recognised that we are not the data controllers in this instance, we simply hold summary details of incidents which are recorded in greater detail at our constituent organisations and we could not guarantee that this information would not be used in conjunction with other information to piece together details of the incident.
Investigation Reports
You asked for a copy of the SUI reports relating to each incident. Although I can confirm that the SHA holds some investigation reports, we estimate that the time taken to locate the documents and retrieve them would take us well over the 18-hour FOIA fee compliance limit We therefore consider that the exemption under Section 12 of the FOIA may be engaged. This is not a qualified exemption and we therefore do not have to consider the application of the public interest test. It might, of course, be the case that you are able to refine your request in terms of the fees limit in which case please let me have details of your refined request as soon as possible. Please note though, that we would be unable to provide you with any information which directly or indirectly might identify any individuals concerned.
We also consider that the exemption in Section 31 of the FOIA also applies in this case. The exemption set out in section 31 reads as follows:
"Information … is exempt information if its disclosure under this Act would, or would be likely to, prejudice … the exercise by any public authority of its functions for … (j) the purpose of protecting persons other than persons at work against risk to health … arising out of or in connection with the actions of persons at work."
This is a qualified exemption so we have applied the public interest test. Our reasons for concluding that the exemption applies are that we believe that disclosure of information of the kind contained in these reports would be likely to prejudice the process of such investigations as they would discourage cooperation and openness and thus diminish a significant means of safeguarding the health and welfare of patients cared for in NHS facilities.
We have taken into account the public interest in openness and transparency, accountability in the administration of public services and ensuring appropriate standards of clinical practice.
We have weighed these factors against the following which tend towards withholding the information:
- the existence of other avenues for independent investigation, which providing the opportunity for patients to query and staff to answer concerns
In all the circumstances of the case, we have determined that the public interest in maintaining the exemption outweighs the public interest in disclosing the information.
I hope that this information is of use. If you are dissatisfied with the way in which we have dealt with your request you can ask us to review our decision by writing to:-
Mr Moosa Patel
Director of Corporate Affairs
NHS East Midlands
Octavia House
Interchange Business Park
Bostock's Lane
Sandiacre
Nottingham
NG10 5QG
If at the conclusion of any review you remain dissatisfied you may complain to the Information Commissioner who can be contacted at:-
The Office of the Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
