The Democratic Services Officer reminded the panel that in 2017/8 the Health Scrutiny Panel had examined the topic of Foetal Alcohol Spectrum Disorder (FASD). The panels final report on this topic was submitted to and approved by the Executive on 21 November 2017 and contained a number of recommendations. The Councils Health Improvement Specialist (Best Start & Families) and a representative from the FASD Network were in attendance at the meeting to provide the panel with an update on progress made against those recommendations.
In respect of the first recommendation that the Director of Public Health brought together professionals including appropriate representation from South Tees CCG, Public Health, South Tees NHS Foundation Trust, Safeguarding Childrens Services, CAMHS, Community/LAC Paediatricians, Educational Psychologists and the FASD Network to take this work forward in 2017/18 it was confirmed that progress had been made.
The panel was advised that a series of expert group meetings had been held on 28 November 2017 and 23 January 2018 with attendance from Public Health, Midwifery service, CAMHS, Pediatrics service, Educational Psychology, South Tees CCG and the FASD Network. The two meetings had allowed for discussion on some of the key issues around FASD, highlighting issues, problems and good practice locally. Three of the main issues identified were as follows:-
There was already work going on regionally around developing a diagnostic pathway for FASD. However progress had been slow, as there had been a lack of clinical and neuro psychologists in local areas to support proposed pathways.
A key area where it was felt that progress could be made was improving the sharing of maternal alcohol history, although this was challenging given the range systems used in health care settings.
It was acknowledged by the group that FASD was a condition that could not be diagnosed and / or supported in silo, therefore it was unrealistic to expect a specific care pathway for children with FASD. However, those who attended the group sessions agreed that more needed to be done to improve complex needs pathways so that those with FASD were better supported.
The group also mapped local provision against the recommendations of Public Health Englands Healthcare Needs Assessment, identifying gaps. Further discussions were, however, still required around how the gaps identified could be taken forward locally.
Further to the discussions that had taken place at the expert group meetings the decision was taken that a piece of local research, as recommended by the panel would not pursued, as it was unclear what the benefits locally would be of going ahead with the research. In terms of the panels recommendation that inclusion of the numbers of children in Middlesbrough with FASD be contained in the JSNA it was advised that the Childrens JSNA document was still in draft at present. The JSNA was also based on need and therefore if other childrens health and social care needs were identified as being of higher need locally, FASD would not be included in the final published version.
The panels recommendation that Adult Social Care needed to review its response to those affected by FASD and plan for future service provision was accepted. Work would be undertaken by Childrens, Adult Social Care and the CCG, as part of the work on SEND and transition from children to adult services. Issues relating to FASD had also been built into training in 2017/18 to facilitate identification of cases where FASD may be present, how to and when to seek more specialist input and appropriate responses to the disorder.
A strong theme that emerged during the panels review was that; there was a clear need to ensure young people were fully aware of the dangers that drinking during pregnancy could have on an unborn child. In response to the panels recommendation a toolkit for schools had been developed. This toolkit would work alongside the Alcohol Education Trusts Talk About Alcohol resource, which was an accredited curriculum for schools. Train the trainer sessions would be delivered to Middlesbrough schools on 4 May 2018. Schools that sent a representative to be trained would then be equipped with the knowledge, skills and resources to deliver sessions around alcohol / FASD to their pupils.
The panels recommendation that the Mayor wrote on behalf of the Council to the National Institute of Clinical Excellence (NICE) for recognition, referral, diagnostic assessment and post diagnosis guidance on FASD to be issued for clinicians was undertaken. The Director of Public Health had received a response from the Director, Centre for Guidelines at NICE about the need for guidance in FASD. It was confirmed that NICE would map out existing relevant guidance, some of which was still in development, as well as guidance on alcohol consumption in pregnancy and raise this important matter with the National Childrens Director for Clinical Services, as well as colleagues at NHS England and the Department of Health.
AGREED that the update be noted and a further update provided in six months time.