Dear Royal National Orthopaedic Hospital NHS Trust,

NICE Quality Standard 204 on Fetal Alcohol Spectrum Disorder was published 16 March 2022 (https://www.nice.org.uk/guidance/qs204)

1. Please confirm, has this quality standard been circulated to each team and service in your network?

2. Which teams/organisations/ leads have identified that NICE Quality Standard 204 is applicable to them.

3. Please confirm if the Trust leads for a) children and young people (aged 0 to 25); b) children and young people with special educational needs and disability; c) safeguarding (all-ages); and d) learning disability and autism (all-ages) have to date included consideration of FASD and implementation of the NICE FASD Quality Standard 204 in their decision making about service provision and assessment of local need. If so, for each of the identified leads please explain how and provide any related documents.

4. If your NICE lead or other relevant person has created a review sheet, please provide that with a breakdown of every statement in the quality standard by structure, process and outcome measures.

5. If you don't have a review sheet, please indicate how your Trust is responding to the call for improvements in quality of care outlined in NICE Quality Standard 204.

6. How are you involving stakeholders and/ or tracking patient experiences of your response to the NICE Quality Standard 204?

7. Is there any other document your Trust has created that is related to improvement of quality of care regarding NICE Quality Standard 204? If so, please provide a copy.

8. Has your ICB commissioned a pathway for FASD diagnosis?

9. Please explain the process by which someone with possible FASD would be assessed in your Trust.

Yours faithfully,

Sandra Butcher
Chief Executive
The National Organisation for FASD