‘Unaware’ guidance received

An internal audit document obtained by the Londonderry Sentinel under the Freedom of Information Act said the Chief Executive’s office had not received the information, but a check also showed the office was on the list of email recipients.

The document entitled: “Western Health and Social Care Trust-Dissemination of Information 2009/2010,” was carried out by the WHSCT Internal Audit Unit based at Gransha Park.

The audit about the passing on of information within the WHSCT covered the period from April-December 2009, but was carried out between January and March 2010.

One of the pieces of information that the audit examined was a letter from Northern Ireland’s Chief Nursing Officer (CNO), dated May 6, 2009. The letter was called ‘CNO: 1/2009 Swine Flu Influenza-Urgent Communication: Transport of antiviral medication. Diagnostic swabbing in-hours period 8am-6pm.’

The content of this document CNO from Professor Martin Bradley advised that community nurses be provided with virology swab testing kits and personal protective equipment in order to support their medical colleagues.

The letter states: “In order to facilitate the timely swabbing of events it would be very helpful if your trust were to assign a small number of named individuals to carry out this task and inform the Emergency Operations Centre (EOC).

Highlighted

“One other issue has been highlighted by the EOC and Primary Care leads, namely, that when the community nurse is collecting swabs from either the GP out of hours centre (or other Trust designated collection point) that they would collect, from the hospital pharmacy, antiviral medication (Tamiflu or Relenza) required by the same patient. This avoids unnecessary journeys for family members and ensures that the patient receives their medication in a timely manner. The intention is to ensure that antiviral medication and swabs are co-located.”

The CNO letter is addressed to ‘Chief Executives, HSC Trusts, Directors of Nursing, HSC Trusts, Chief Pharmacists HSC Trusts,’ and was carbon copied to ‘Medical Directors HSC Trusts.’

However, the internal audit on the dissemination of this vital piece of information notes that the information was not received in the Chief Executive’s office.

Findings

On Page 5 of the audit report the findings noted: “The guidance was circulated within pharmacy, however there is no evidence of further distribution to other relevant staff such as community nurses. It was also noted that this CNO letter was not received in the Chief Executive’s Office, although the review of recipients as detailed on the e-mail issued by the DHSS&PS highlighted that it was sent to the Chief Executive. It should also be noted that the e-mail was also issued to those officers within the Trust to whom the Chief Executive was required to cascade the circular.”

The audit states: “The issuing of the circular to all relevant officers within the Trust negates the potential that a circular is overlooked. However there is a risk that action at the highest level of management will not take place if the Chief Executive is unaware of the guidance. There is no evidence that all necessary action was taken to fully implement this guidance.”

In addition, the Sentinel asked the Department of Health and Social Services if any further urgent circulars concerning information on dealing with swine flu were sent from the Chief Nursing Officer within a six month period after the original communication was circulated on May 6, 2009.

A spokesman for the Department of Health replied: “I can confirm that there were no further letters in the 6 month period after 6 May, 2009 from the Chief Nursing Officer to the Chief Executive at the Western Trust.”

The internal audit document concludes with a recommendation that states: “The Chief Executive’s Office should ensure that all guidance is appropriately recorded as received and action taken where necessary.”

The response contained in a ‘Management Comment’ accepts the recommendation stating: “The Trust supports the recommendation and will endeavour to ensure it is fully implemented.”

The implementation date is listed as 7 May 2010.