Suspected FII Protocols

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Dear Great Ormond Street Hospital for Children NHS Foundation Trust,

1. How many cases of Suspected Factitious Illness by mothers do you investigate each year?

2. How many cases do you investigate in the following departments? Out of how many new children each year
Psychiatry
Cardiology
Gastroenterology
Infectious Diseases
Renal
PICU

3. Do you have hospital wide protocols for the investigation of presumed FII? Please can you provide this

4. If so, have you performed regular audits on these protocols and has this been published?

5. In what percentage of cases is an organic diagnosis found that was originally missed?

6. If another diagnosis is finally found,
How is that diagnosis given to the family?
Would there be a face to face meeting? And how soon?
Should that information ever be left on an answer machine?
Should a request to meet to discuss care of this new diagnosis ever be refused for 6 months?
Should an apology be given to the family?

7. What support is given to the family during the investigation and after?

8. Have you done any research on the impact of false allegations of FII on mothers in particular but also on the wider family?

9. Have you done any research on the impact of disorganised communication between professionals leading to a delay in diagnosis?

10. Have you done any research on the impact of significant delays in diagnosis and the impact on anxiety in mothers ?

11. Have you done any research on how the lack of diagnosis and effect on maternal mental health impacts on how professionals judge the mother
12. FII is more commonly described in parents who are health care professionals. Have you done any research on the following:
a. Whether similar cases are more likely to be ascribed to FII by your staff when the mother is an HCP? ie a diagnostic bias
b. Whether because mothers who are HCPs are likely to be able to express what they think is wrong has an effect on perceptions of staff, particularly more junior staff or staff with a different expertise
c. Most HCPs who are parents who have worked in child health will know that they are seen as a 'risk factor'. Have you done any research on the impact of this knowledge on mothers’ mental health and behaviour when they have concerns regarding their child's health?

13. What impact does maternal physical illness have on perception of the possibility of FII in children? Would you contact the mother’s physician or surgeon or GP in order to find out more details? How would this be recorded? If a diagnosis is then made in the child do you get back to the adult team informing them of the diagnosis?

14. Where are records on communications written, email and telephone regarding suspected FII allegations with other professionals kept?

Yours faithfully,

Lena McCormack

Maria Bjorklund, Great Ormond Street Hospital for Children NHS Foundation Trust

2 May 2014
Our reference: FOIRQ2111

Dear Ms McCormack

Thank you for your e-mail of 30 April 2014, which we received on 30 April 2014.

Your request for information is being processed, and you should expect to receive a response by 30 May 2014. Should it be necessary to apply a fee for providing the information requested we will issue a fees notification before releasing any information.

If we anticipate any delays in responding to your request we will notify you in writing, stating the reasons for this and the date by which we expect to respond.

Your email will be used by Great Ormond Street Hospital for Children NHS Foundation Trust for the purpose of processing your request. The information you provide will be recorded for reference and may also be used to monitor and review our Freedom of Information systems, processes and policy.

Should you require any further information in the interim please do not hesitate to contact me.

Yours sincerely

Maria Björklund
FOI Co-ordinator
Great Ormond Street Hospital for Children NHS Foundation Trust
Great Ormond Street
London
WC1N 3JH

[Great Ormond Street Hospital for Children NHS Foundation Trust request email]
[email address]

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Maria Bjorklund, Great Ormond Street Hospital for Children NHS Foundation Trust

3 Attachments

Dear Ms McCormack

Please find attached our response to your request.

Yours sincerely

Maria Björklund
FOI Co-ordinator
Great Ormond Street Hospital for Children NHS Foundation Trust
Great Ormond Street
London
WC1N 3JH

[Great Ormond Street Hospital for Children NHS Foundation Trust request email]
[email address]

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