Services for Foetal Alcohol Spectrum Disorders

Sandra Butcher made this Freedom of Information request to NHS Haringey Clinical Commissioning Group as part of a batch sent to 25 authorities

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear NHS Haringey Clinical Commissioning Group,

I am writing as a volunteer researcher for the National Organisation for Foetal Alcohol Syndrome-UK (www.nofas-uk.org) to make a request for information under the Freedom of Information Act. I am working in cooperation with an ad hoc group of leaders from the organisation and other experts to frame and shape this research project and to analyse the information we receive.
Background

In February 2017, Lord Boateng asked the government “what assessment they have made of the measures adopted in Scotland which provide guidance and support for children and young adults affected by foetal alcohol spectrum disorders.” Lord O’Shaughnessy replied that “Early intervention services can help reduce some of the effects of Foetal Alcohol Spectrum Disorders (FASD) and prevent some of the secondary disabilities that result. Responsibility for commissioning these services lies with clinical commissioning groups. [Hansard, Written Question HL5052, 10 February 2017. https://www.parliament.uk/business/publi...

This government policy was reiterated in July 2017 when Lord Campbell-Savours asked the government “what support they are providing for persons whose condition has been described as foetal alcohol spectrum disorder.” [Hansard, Written Question HL500 and Written Answer, 18 July 2017, https://www.parliament.uk/business/publi... In response, Lord O’Shaughnessy for the government wrote that “It is recognised that Foetal Alcohol Spectrum Disorders (FASD) can have a significant impact on the early development of children, their behaviours and their life chances. Early intervention services can help reduce some of the effects of FASD and prevent some of the secondary disabilities that result. Responsibility for commissioning these services lies with clinical commissioning groups.” This was again repeated on 8 May 2018 by Steve Brine, Parliamentary Under-secretary at the Department of Health and Social Care. [Hansard, Written Question 139045, 8 May 2018. https://www.parliament.uk/business/publi...

The following conditions fall under the Foetal Alcohol Spectrum Disorder (FASD) umbrella: Foetal Alcohol Syndrome (FAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD), Foetal Alcohol Effects (FAE) and partial Foetal Alcohol Syndrome (pFAS)) or neurodevelopmental disorders linked to prenatal alcohol exposure (NDPAE)

Request for Information

In the light of these government statements that CCGs are responsible for commissioning services I would like to ask:

1) Please provide copies of any policies your CGG has on the commissioning of services for those with an FASD.
2) What services has your CCG commissioned to meet the ‘reasonable requirements’, as is your duty under Section 3 NHS Act 2006, of those in your area who have or may have Foetal Alcohol Spectrum Disorders as a result of antenatal exposure to alcohol, and what is your CCG doing to secure improvement in the physical and mental health of persons with Foetal Alcohol Spectrum Disorders and for the prevention, diagnosis and treatment of FASD (as is in your power under Section 3A NHS Act 2006)? Please release any information you hold concerning provision for:
a. prevention education following the Chief Medical Officers’ guidelines that the safest course is not to drink while pregnant or attempting to become pregnant;
b. diagnosis for both children and adults;
c. post-diagnostic care in the years 2013- 2018 from professionals including, but not limited to, paediatricians, GPs, nurses, psychologists, occupational therapists, speech and language therapists, mental health services and other disability support services to provide specialised intervention services for patients on the FASD spectrum across their lifespan?

3) Please release any information concerning how is your CCG exercising its duty (as specified under Section 14R NHS Act 2006) to securing “continuous improvement in the quality of services provided” to individuals with Foetal Alcohol Spectrum Disorders “for or in connection with the prevention, diagnosis or treatment” of FASD?
4) What is the budget for commissioned services for FASD in the current financial year? What was the budget in financial years beginning in 2013, 2014, 2015, 2016 and 2017?
5) Please release any agreed plans for service expansion for future years.
6) Has your CCG conducted, commissioned or assisted the conduct of research into any matters relating to the causation, prevention, diagnosis or treatment of Foetal Alcohol Spectrum Disorders, as is in your powers according to Section 5 NHS Act 2006 Schedule 1 (paragraph 13).
7) Does your CCG commission services from the National FASD Clinic? If so, what is the budget for this in the current financial year?
8) Please release any information concerning ways in which your CCG is fulfilling its duty (specified under Section 14Z, NHS Act 2006) to promote education and training related to FASD?
9) Do you have a lead person in your CCG on FASD? Please provide the name and role of the person responsible.
10) Please release any information concerning the steps are you taking or have you taken (according to your duty under section 14Z2 of the NHS Act, 2006), to involve individuals with FASD or their caregivers in “planning commissioning arrangements; in the development and consideration of proposals for change; in decisions affecting the operation of commissioning arrangements where implementation would have an impact on the manner in which services are delivered or the range of services available.”?
11) How many inquiries/requests/letters have you received from medical practitioners or patients/families in your area related to FASD in the years 2013-2018?

if you are considering rejecting this request on the grounds of the costs of responding exceeding the statutory limits then please respond to as many of the numbered items as possible within the limit, in the
order they have been presented.

Thank you in advance for your answers.

Yours faithfully,

Martin Butcher

Foi (NHS HARINGEY CCG), NHS Haringey Clinical Commissioning Group

Thank you for your request for information. This email is to acknowledge
that your request is being handled under the Freedom of Information Act
2000.

Haringey CCG will reply as soon as possible  and in any event within 20
working days following the date we received your request.

If you have any queries about this request, please do not hesitate to
contact  us at [Haringey CCG request email]

Best wishes
Brett
Brett Vallance
PALS, Complaints & FOI Manager
Haringey Clinical Commissioning Group (CCG)
4th Floor River Park House
225 High Road
Wood Green
N22 8HQ

show quoted sections

Foi (NHS HARINGEY CCG), NHS Haringey Clinical Commissioning Group

Your Freedom of Information Act request: FOI_ [4229] –RESPONSE

 

Dear Mr Butcher

 

Thank you for your enquiry requesting information under the Freedom of
Information Act 2000.

 

Please find below our response to your request:

1)      Please provide copies of any policies your CGG has on the
commissioning of services for those with an FASD. 

NHS Haringey CCG doesnot have any specific policies on the commissioning
of services for those with FASD.

2)      What services has your CCG commissioned to meet the 'reasonable
requirements', as is your duty under Section 3 NHS Act 2006, of those in
your area who have or may have Foetal Alcohol Spectrum Disorders as a
result of antenatal exposure to alcohol, and what is your CCG doing to
secure improvement in the physical and mental health of persons with
Foetal Alcohol Spectrum Disorders and for the prevention, diagnosis and
treatment of FASD (as is in your power under Section

 

3A NHS Act 2006)? Please release any information you hold concerning
provision for:
a.      prevention education following the Chief Medical Officers'
guidelines that the safest course is not to drink while pregnant or
attempting to become pregnant; Information about the risks and
consequences for those trying to conceive or pregnant is provided by
Haringey GPs, midwives and support workers through our primary care teams,
commissioned maternity services and our health visiting service. 

b.      diagnosis for both children and adults; Parents who are concerned
about their child would discuss this with the GP or health visitor in the
first instance. If there is a risk of FASD, then onward referral would be
made to our local children’s services- community paediatrics and the child
development team. Depending on the age of the child, CAMHS would also be
involved. In an adult, it would be through a GP who would make appropriate
onward referral to adult services. Tertiary referral to specialist
services would be made by secondary care providers (our local hospitals)
once initial diagnostic work and treatment had been undertaken. 

c.      post-diagnostic care in the years 2013- 2018 from professionals
including, but not limited to, paediatricians, GPs, nurses, psychologists,
occupational therapists, speech and language therapists, mental health
services and other disability support services to provide specialised
intervention services for patients on the FASD spectrum across their
lifespan? We  have commissioned services under block contracts for mental
health, CAMHS, child development, community paediatrics and therapies.
 These services would be available to those with FASD. It is likely that
social care services within the council may be involved with those who
have learning disabilities as a result of FASD. For children and young
people in need of more specialist services and support, they would be
discussed at our complex care panel to determine how we will support and
child or young person with this diagnosis and tri-partite funding may be
agreed across education, health and social care.  Children and young
people with FASD may also have an education, health and care plan (EHCP)
through the council.  Specialist services at tertiary centres would be
available on a case by case basis and would be referred to the
commissioner for consideration by a secondary care clinician after being
seen locally. 

3)      Please release any information concerning how is your CCG
exercising its duty (as specified under Section 14R NHS Act 2006) to
securing "continuous improvement in the quality of services provided" to
individuals with Foetal Alcohol Spectrum Disorders "for or in connection
with the prevention, diagnosis or treatment" of FASD? We do not commission
services specifically for FASD. These services are monitored through our
NHS contracts which are held by dedicated contracting teams. Regular
meetings are scheduled with providers to discuss quality of care,
performance and productivity including key performance indicators. 

4)      What is the budget for commissioned services for FASD in the
current financial year? What was the budget in financial years beginning
in 2013, 2014, 2015, 2016 and 2017? This information is not held as our
services are not broken down in this way and most of our services to
support FASD are within a block contract or would be funded through
outpatient tariffs and paid for from our general hospital budgets.

5)      Please release any agreed plans for service expansion for future
years. There are no specific plans at the CCG to expand services for those
with FASD.

6)      Has your CCG conducted, commissioned or assisted the conduct of
research into any matters relating to the causation, prevention, diagnosis
or treatment of Foetal Alcohol Spectrum Disorders, as is in your powers
according to Section 5 NHS Act 2006 Schedule 1 (paragraph 13). No

7)      Does your CCG commission services from the National FASD Clinic?
If so, what is the budget for this in the current financial year?Haringey
CCG does not directly commission from the National FASD Clinic and there
is no budget. If local professionals working in Haringey felt that a child
needed to be seen in the national centre, then an individual funding
request would be submitted to the commissioner and be considered for
approval. The activity would be funded through a generic out of contract
activity budget line for children and young people (as this is a generic
budget it cannot be broken down specifically for FASD funding).

8)      Please release any information concerning ways in which your CCG
is fulfilling its duty (specified under Section 14Z, NHS Act 2006) to
promote education and training related to FASD? The CCG is a commissioning
organisation. Education and training would be provided by our service
providers e.g. maternity services, community paediatrics or mental health
as part of their service delivery model and as part of their staff’s
ongoing clinical continuous professional development. 

9)      Do you have a lead person in your CCG on FASD? Please provide the
name and role of the person responsible. There is no lead identified in
the CCG. FASD services cut across those  commissioned by the CCG and
council in Haringey including public health commissioning, children’s
commissioning, adults commissioning and mental health commissioning as
well as maternity commissioning. If there are any enquiries about FASD in
future, it is best to contact the generic Haringey email and your request
will be forwarded to the appropriate teams  for a
response [1][email address

10)     Please release any information concerning the steps are you taking
or have you taken (according to your duty under section 14Z2 of the NHS
Act, 2006), to involve individuals with FASD or their caregivers in
"planning commissioning arrangements; in the development and consideration
of proposals for change; in decisions affecting the operation of
commissioning arrangements where implementation would have an impact on
the manner in which services are delivered or the range of services
available."? We involve patients and carers in our commissioning through
generic parent, service user and carer forums such as Healthwatch and
Haringey
Involve. [2]http://www.healthwatchharingey.org.uk/  ...

If there was a specific piece of work for FASD then we would engage with
families who are affected as far as possible. No such specific detailed
work is taking place or planned. 

11)     How many inquiries/requests/letters have you received from medical
practitioners or patients/families in your area related to FASD in the
years 2013-2018? We have received none that we are aware of. 

 

If you require any further assistance, please do not hesitate to contact
me.

 

Most of the information that we provide in response to Freedom of
Information Act 2000 requests will be subject to copyright protection. In
most cases the copyright will be owned by the relevant CCG. The copyright
in other information may be owned by another person or organisation, as
indicated in the information itself. You are free to use any information
supplied for your own use, including for non-commercial research purposes.
The information may also be used for the purposes of news reporting.
However, any other type of re-use, for example, by publishing the
information or issuing copies to the public will require the permission of
the copyright owner.

 

 

FOI Reviews:

In the first instance, write to: If you remain dissatisfied
with the our response, you may
  write to:

   

FOI Team Information Commissioner's
Office
Haringey Clinical Commissioning Group (CCG)
Wycliffe House
4^th Floor, River Park House,
Water Lane
225 High Road
Wilmslow
Wood Green
Cheshire SK9 5AF
London
 
N22 8HQ                                
Telephone: 0303 123 1113 or
  01625 545745

Email: [4][Haringey CCG request email] [5]www.ico.org.uk

  

 

Best wishes

 

Brett

 

Brett Vallance

PALS, Complaints & FOI Manager

Haringey Clinical Commissioning Group (CCG)

4^th Floor River Park House

225 High Road

Wood Green

N22 8HQ

 

Secure email: [6][email address]

 

Tel: 020 3688 2724

 

Web: [7]www.haringeyccg.nhs.uk

 

 From: Sandra Butcher <[FOI #498139 email]>

Sent: 17 July 2018 17:26

To: Foi (NHS HARINGEY CCG)

Subject: Freedom of Information request - Services for Foetal Alcohol
Spectrum Disorders

 

Dear NHS Haringey Clinical Commissioning Group,

 

I am writing as a volunteer researcher for the National Organisation for
Foetal Alcohol Syndrome-UK (www.nofas-uk.org) to make a request for
information under the Freedom of Information Act. I am working in
cooperation with an ad hoc group of leaders from the organisation and
other experts to frame and shape this research project and to analyse the
information we receive.

Background

 

In February 2017, Lord Boateng asked the government “what assessment they
have made of the measures adopted in Scotland which provide guidance and
support for children and young adults affected by foetal alcohol spectrum
disorders.” Lord O’Shaughnessy replied that “Early intervention services
can help reduce some of the effects of Foetal Alcohol Spectrum Disorders
(FASD) and prevent some of the secondary disabilities that result.
Responsibility for commissioning these services lies with clinical
commissioning groups. [Hansard, Written Question HL5052, 10 February
2017.  
https://www.parliament.uk/business/publi...

 

This government policy was reiterated in July 2017 when Lord
Campbell-Savours asked the government “what support they are providing for
persons whose condition has been described as foetal alcohol spectrum
disorder.” [Hansard, Written Question HL500 and Written Answer, 18 July
2017,
https://www.parliament.uk/business/publi...
In response, Lord O’Shaughnessy for the government wrote that “It is
recognised that Foetal Alcohol Spectrum Disorders (FASD) can have a
significant impact on the early development of children, their behaviours
and their life chances. Early intervention services can help reduce some
of the effects of FASD and prevent some of the secondary disabilities that
result. Responsibility for commissioning these services lies with clinical
commissioning groups.” This was again repeated on 8 May 2018 by Steve
Brine, Parliamentary Under-secretary at the Department of Health and
Social Care. [Hansard, Written Question 139045, 8 May 2018.
https://www.parliament.uk/business/publi...

 

The following conditions fall under the Foetal Alcohol Spectrum Disorder
(FASD) umbrella: Foetal Alcohol Syndrome (FAS), Alcohol-Related
Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD),
Foetal Alcohol Effects (FAE) and partial Foetal Alcohol Syndrome (pFAS))
or neurodevelopmental disorders linked to prenatal alcohol exposure
(NDPAE)

 

Request for Information

 

In the light of these government statements that CCGs are responsible for
commissioning services I would like to ask:

 

1)      Please provide copies of any policies your CGG has on the
commissioning of services for those with an FASD.

2)      What services has your CCG commissioned to meet the ‘reasonable
requirements’, as is your duty under Section 3 NHS Act 2006, of those in
your area who have or may have Foetal Alcohol Spectrum Disorders as a
result of antenatal exposure to alcohol, and what is your CCG doing to
secure improvement in the physical and mental health of persons with
Foetal Alcohol Spectrum Disorders and for the prevention, diagnosis and
treatment of FASD (as is in your power under Section 3A NHS Act 2006)?
Please release any information you hold concerning provision for:

a.      prevention education following the Chief Medical Officers’
guidelines that the safest course is not to drink while pregnant or
attempting to become pregnant;

b.      diagnosis for both children and adults;

c.      post-diagnostic care in the years 2013- 2018 from professionals
including, but not limited to, paediatricians, GPs, nurses, psychologists,
occupational therapists, speech and language therapists, mental health
services and other disability support services to provide specialised
intervention services for patients on the FASD spectrum across their
lifespan?

 

3)      Please release any information concerning how is your CCG
exercising its duty (as specified under Section 14R NHS Act 2006) to
securing “continuous improvement in the quality of services provided” to
individuals with Foetal Alcohol Spectrum Disorders “for or in connection
with the prevention, diagnosis or treatment” of FASD?

4)      What is the budget for commissioned services for FASD in the
current financial year? What was the budget in financial years beginning
in 2013, 2014, 2015, 2016 and 2017?

5)      Please release any agreed plans for service expansion for future
years.

6)      Has your CCG conducted, commissioned or assisted the conduct of
research into any matters relating to the causation, prevention, diagnosis
or treatment of Foetal Alcohol Spectrum Disorders, as is in your powers
according to Section 5 NHS Act 2006 Schedule 1 (paragraph 13).

7)      Does your CCG commission services from the National FASD Clinic?
If so, what is the budget for this in the current financial year?

8)      Please release any information concerning ways in which your CCG
is fulfilling its duty (specified under Section 14Z, NHS Act 2006) to
promote education and training related to FASD?

9)      Do you have a lead person in your CCG on FASD? Please provide the
name and role of the person responsible.

10)     Please release any information concerning the steps are you taking
or have you taken (according to your duty under section 14Z2 of the NHS
Act, 2006), to involve individuals with FASD or their caregivers in
“planning commissioning arrangements; in the development and consideration
of proposals for change; in decisions affecting the operation of
commissioning arrangements where implementation would have an impact on
the manner in which services are delivered or the range of services
available.”?

11)     How many inquiries/requests/letters have you received from medical
practitioners or patients/families in your area related to FASD in the
years 2013-2018?

 

if you are considering rejecting this request on the grounds of the costs
of responding exceeding the statutory limits then please respond to as
many of the numbered items as possible within the limit, in the

order they have been presented.

 

Thank you in advance for your answers.

 

Yours faithfully,

 

Martin Butcher

 

show quoted sections