University Hospitals Birmingham NHS Foundation Trust (UHB) completed a merger by acquisition of Heart of England NHS Foundation Trust (HEFT) on 1st April 2018. UHB includes Birmingham Heartlands Hospital, the Queen Elizabeth Hospital Birmingham, Solihull Hospital and Community Services, Good Hope Hospital in Sutton Coldfield and Birmingham Chest Clinic.
For the purposes of this request we have answered on behalf of the whole Trust.
Freedom of Information Request: 0268
Background
In February 2017, Lord Boateng asked the government “what assessment they have made of the measures adopted in Scotand 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/publications/written-questions-answers-statements/written-question/Lords/2017-01-27/HL5052/]
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/publications/written-questions-answers-statements/written-question/Lords/2017-07-05/HL500/] 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/publications/written-questions-answers-statements/written-question/Commons/2018-04-27/139045/]
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 light of the above information I would like to ask you to provide:
1) Copies of any policies that the Trust has on the prevention of FASD, and on the diagnosis and post-diagnostic care pathway for patients with an FASD. Also your policy on the training of Trust personnel to manage patients with FASD.
Please see attached: Substance misuse in Pregnancy
2) Any information you hold on services your Trust provided for FASD for:
- a) prevention education following the 2016 Chief Medical Officers’ guidelines that the safest course is not to drink while pregnant or attempting to become pregnant;
Please see attached: Substance Misuse MW training
The Trust delivered training on the midwifery day 2017-2018 and discussed alcohol use in pregnancy. The fast screening tool was discussed and staff were advised of current UK Government guidelines regarding alcohol consumption was to avoid completely in pregnancy.
As part of the group work delivered as part of the session, one of the questions was:
Miss A attends the delivery suite via ambulance after consuming five bottles of wine.
Miss A is admitted due to vomiting.
What action do you take?
If alcohol misuse is reported we would complete a Neo natal alert form.
- b) diagnosis for both children and adults;
We do not hold this information. Some children are seen to look for Foetal Alcohol Syndrome, but we do not carry out in depth psychological profiling to look for FASD.
- c) post-diagnostic care in the financial years beginning 2013, 2014, 2015, 2016, 2017 and 2018.
We do not hold this information. It is not possible to disaggregate from other care.
3) Information on the number of Doctors in your Trust who currently provide diagnostic and/or post-diagnostic services for FASD? Please provide their names and posts. Whether your Trust employs specifically trained professionals, including but not limited to nurses, psychologists, occupational therapists and speech and language therapists, to provide specialised services for patients on the FASD spectrum? If so, in what specialties, and how many? Please provide their names and posts.
The Trust employs 3 consultants and 1 specialty doctor who currently provide diagnostic and/or post-diagnostic services for FASD.
4) Information on training provided to personnel in your Trust on FASD, or provided by others and accessed by your personnel.
1 of our consultants recent attended a WMBACCH lecture. Another consultant prepared and gave a CPD lecture to Birmingham Community Paediatrics Team. Relevant journal articles and DSM % criteria were circulated around the Community Paediatrics Team.
5) Information you hold on whether your Trust sends patients for FASD diagnosis to the National FASD Clinic in Surrey (https://www.fasdclinic.com/)? Did your refer any patients to the National FASD Clinic in 2013, 2014, 2015, 2016 and 2017, and in 2018, and if so, how many in each year?
There is no direct referral pathway into FMU.
6) What was your budget for services for FASD in each financial year since that starting in 2013 and including the current financial year?
We do not hold this information. There is no specific budget for FASA.
7) Please provide copies of any agreed plans you have to expand the budget or services in coming years.
We do not hold this information. There is no specific budget for FASA.
