Friday 03 May 2024
Internal Reference Number: FOI_7641
Date Request Received: 02/01/2024 00:00:00
Date Request Replied To: 17/01/2024 00:00:00
This response was sent via: By Email
Request Summary: Policy for managing people with intrathecal drug delivery pumps at Salisbury District Hospital
Request Category: Health
| Question Number 1: I am writing as a hospital who provide intrathecal therapy services to enquire about your practice or policy for managing patients with pumps, when they cannot attend the clinic for a refill. This situation usually occurs because of intercurrent acute illness or pressure sores, but sometimes because of inadequate hospital transport services. To help you identify the appropriate people to answer these questions, intrathecal pumps are usually managed by the neurorehabilitation clinic / spinal injuries service/ pain management service/ neurosurgery or neurology. Alternatively you could ask your procurement team who has ordered Medtronic Synchromed intrathecal pumps or Medtronic 8551 refill kits. In Salisbury it is probably the spinal injuries rehab service What is the address of your base refill clinic, with postcode? | |
| Answer To Question 1: This is not a service our Spinal Services provide, this service was transferred to Solent Healthcare. This is not a service that our Pain Management Service provide. | |
| Question Number 2: How many adults with pumps for spasticity/dystonia do you manage with intrathecal baclofen? | |
| Answer To Question 2: Please see answer to question 1. | |
| Question Number 3: How many adults with pumps for pain do you manage with intrathecal opioids? | |
| Answer To Question 3: Please see answer to question 1. | |
| Question Number 4: How many children under the age of 18 with pumps for spasticity/dystonia do you manage with intrathecal baclofen? | |
| Answer To Question 4: Please see answer to question 1. | |
| Question Number 5: How many children under the age of 18 with pumps for pain do you manage with intrathecal opioids? | |
| Answer To Question 5: Please see answer to question 1. | |
| Question Number 6: Approximately how many pump refills does your service do each month at your usual locations ? | |
| Answer To Question 6: Please see answer to question 1. | |
| Question Number 7: Do you accept people attending on a stretcher for refills? | |
| Answer To Question 7: Please see answer to question 1. | |
| Question Number 8: How often do you refill pumps away from your base hospital clinic? Eg Once/month, once/year, once in 5 years | |
| Answer To Question 8: Please see answer to question 1. | |
| Question Number 9: What is the furthest you have travelled from your clinics to refill a pump, in miles or time, in the past 3 years ? | |
| Answer To Question 9: Please see answer to question 1. | |
| Question Number 10: For the first time, a patient is unable to attend the clinic by wheelchair or stretcher for a planned refill, because of acute illness or transport failure. They are expected to recover and be fit to attend refill clinics in the future. They are 90 minutes drive from your usual refill service base and there is no more local service which could refill the pump before it runs out. Would you plan: a) no refill and when pump runs dry advise local doctors to manage withdrawal symptoms with medication by another route. b) staff from base clinic travels to refill pump at patient’s home or local hospital, before it runs dry. Who would travel? Doctor who runs the service? doctor in training who is rotating through the service? Nurse who refills pumps in clinic? Do you arrange second person to travel to chaperone, check procedure or open vials to maintain sterility? No. /Yes, then who? Or a video call to check procedure/programming? When refilling away from usual clinic, would you ask pharmacy to prepare a sterile syringe with the total drug to be injected into the pump, or would you aspirate from separate vials at their home, as is usually done in clinics? c) patient transferred to your hospital for in-patient management and refill d) Other, please explain | |
| Answer To Question 10: Please see answer to question 1. | |
| Question Number 11: If you have refilled it once while they are acutely unwell, but subsequently the patient is unable to attend the out-patient clinic by wheelchair or stretcher for any future refills, and resides 90 minutes drive from your usual refill service base, and there is no more local service which does home refills to take over long term management, would you plan: a) no visits for further refills or dose reduction b) no further refills but home visits to reduce ITB dose in stages before pump runs dry. b) regular home visits to refill pump until end of battery life, but pump not replaced. c) regular home visits to refill pump indefinitely and pump replacement at end of battery life. e) patient travels by stretcher ambulance, admitted overnight for regular refills f ) Other, please explain | |
| Answer To Question 11: Please see answer to question 1. | |
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Our staff at Salisbury District Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of NHS Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
