FOI 1697 – ADHD Provision

Response

Date: 23 December 2022

FREEDOM OF INFORMATION – DECISION NOTICE

Dear Sir / Madam,

FOI Reference Number: 1697

I refer to your email of 3 November 2021 requesting information in respect of attention deficit hyperactivity disorder.

I can confirm on behalf of Derby and Derbyshire Integrated Care Board (DDICB), and in accordance with S.1 (1) of the Freedom of Information Act 2000 (FOIA) that we do hold some information in relation to your request but, given the broad scope of your request, the information that you have requested is not held in an easily retrievable format. Your request comprises a large number of questions requiring responses from several separate teams within the ICB and down to PCN level. We would be required to contact each individual PCN, of which there are 15, for their information in response to several questions, in addition to several different teams within the ICB. Consequently, the information you have requested is unable to be located, extracted and collated within the 18 hours set by the Act and is, therefore, refused in accordance with Section 12(1) of the FOI Act (2000).

In accordance with our responsibilities under Section 16 of the FOI Act, we can advise that we may be able to respond if you are able to reduce the amount and variety of questions that you have asked. Guidance from the Information Commissioner on the application of Section 16 advises that “it shall be the duty of a public authority to provide advice and assistance, so far as it would be reasonable to expect the authority to do so… although there will be occasions where there are no obvious alternative formulations of the request”. Under the circumstances it is not possible for us to be more specific with our advice, as it is not reasonable for us to presume which aspects of your request are most important to you.

Although excess costs remove the CCG’s obligations under the Freedom of Information Act 2000, as a gesture of goodwill we have supplied below (in blue text) the information that we were able to collate before it was established that this request would take in excess of 18 hours.

Q1 Demographics

We would like to know about commissioning arrangements for young people and adults with ADHD provided by integrated care boards (ICBs) across England, with a focus on primary care. 

Q1.1 Which NHS region is your ICB located within?
(One of: East of England, London, Midlands, North East and Yorkshire, North West, South East, South West)

Midlands

Q1.2 Which ICB do you represent?

Derby & Derbyshire Integrated Care Board

Q1.3 Please provide your details
a. Job Role: James Lewis
b. Name: Head of Joint Strategic Commissioning for Learning Disabilities & Autism
c. Email address: ddicb.enquiries@nhs.net
d. Phone number: 01332 868730

Q1.4 Please provide details of the person (if not you) within your ICB that is responsible for commissioning services to support the delivery of primary healthcare for young people and adults with ADHD.  For example, we are interested in: Mental health and social prescribing, Shared care arrangements and other locally enhanced services that may affect care provided for young people and adults with ADHD
a. Job Role:
b. Name:
c. Email address:
d. Phone number:
e. Comments:

Because there are several services listed in this question (mental health, neurodevelopmental, diagnostic), there are several different commissioners, including those responsible for General Practice and Primary Care.

Q2 Adult mental health services for ADHD

We would like to know about the healthcare available from adult mental health services (AMHS) for young people and adults with ADHD that are located in your ICS.
AMHS – Any adult mental health service including specialist ADHD teams.
Young people and adults with ADHD – Any young person with suspected or confirmed ADHD, aged from 16 years old and upwards
Q2.1 Is there an NHS funded AMHS that is available to provide healthcare (diagnosis and/or management) of adult ADHD for patients within your ICS?

Yes; this is expected in the NHS Community & Crisis Mental Health services. Furthermore, any non-NHS provided services are also expected to provide healthcare for adults with ADHD.

Q2.2 If yes, roughly how long is the waiting list for patients referred to this service?
a. 0 months, up to 6 months
b. 6 months, up to 12 months
c. 12 months, up to 24 months
d. 2 years or more
e. Do not know; waiting list length varies depending on the service.

Q2.3 In your ICB, can primary care providers refer patients using the ‘right to choose’ legislation to other adult healthcare services for ADHD (outside of your ICS footprint)? For example, commissioned private adult ADHD services that are available online.

Yes

Q2.4 If you would like to add anything on the ‘right to choose’ legislation, please comment below:
Q2.5 Do primary care providers in your ICS have shared care protocols/agreements in place with an AMHS to enable prescribing of adult ADHD medications through primary care?  ADHD medications – NICE guideline [NG87] recommended medications for adult ADHD. 
a. Yes
b. No
c. Do not know
d. Not applicable

Yes we do have a shared care protocol, and it includes ADHD.

Q2.6 If you would like to add anything on shared care provision for young people with ADHD, please comment below:

Q3 Primary Care services for ADHD

We would like to know about the support provided by primary care in your ICS for young people and adults with ADHD. 
This includes support from primary care providers or networks (PCNs), but not support from other services, such as secondary care, or voluntary sector organisations
The Integrated Care Board is looking to develop services for young people with ADHD (and wider neurodiversity) who are awaiting, receiving or following a diagnostic assessment.
Each PCN is different and developing alongside a bespoke CMHF offer and embedded ARRs practitioners. This varies by need for each PCN. The posts listed are commonly adopted but at individual level. This question falls outside of the time available to list by PCN.

Q3.1 Are any of the following additional roles being funded within your ICS (either via PCNs or directly)? If yes, please also indicate whether these roles are filled, in development, or if this varies by provider/PCN? There is space to provide any comments if necessary.
a. Care co-ordinator:
Yes, currently filled / Yes, in development / Yes either filled or in development (varies by PCN) / No
b. Health and wellbeing coach:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
c. Pharmacy technician:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
d. Occupational therapist:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
e. Physician associate:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
f. Nursing associate:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
g. Social prescribing link worker:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No
h. Mental health practitioner or counsellor:
Yes, currently filled / Yes , in development / Yes either filled or in development (varies by PCN) / No

Other (please specify):

Q3.2 Does your ICB have any enhanced services agreed with primary care providers for prescribing and monitoring of ADHD medication?
This question is asking about agreements to provide additional care (in place or in development), but not about shared care. 
a. Yes
b. No
c. Do not know
d. Not applicable
Q3.3 Does your ICB have any other enhanced services agreed with primary care providers for extended support or services for people with long term mental health conditions (such as ADHD)?
This question is asking about agreements to provide additional care (in place or in development), but not about shared care. 
a. Yes
b. No
c. Do not know
d. Not applicable
Q3.4 If yes to Q3.2 or Q3.3, please list the enhanced services agreed with primary care providers in your ICS (that are relevant for people with ADHD).
Q3.5 If you would like to add anything about enhanced services, please comment below.Q3.3 Does your ICB have any other enhanced services agreed with primary care providers for extended support or services for people with long term mental health conditions (such as ADHD)?
This question is asking about agreements to provide additional care (in place or in development), but not about shared care. 
a. Yes
b. No
c. Do not know
d. Not applicable
Q3.4 If yes to Q3.2 or Q3.3, please list the enhanced services agreed with primary care providers in your ICS (that are relevant for people with ADHD).
Q3.5 If you would like to add anything about enhanced services, please comment below.

Q3.6 Has your ICB identified any localities within your ICS where there are inequalities in access to healthcare services for young people and adults with ADHD? 
a. Yes
b. No; we have identified no inequalities specific to ADHD. There are general indicators which may inhibit people’s access to healthcare services (deprivation for example).
c. Do not know
d. Not applicable

Q3.7 If you would like to add anything about inequalities, please comment below.

Q3.8 Please list any barriers your ICB faces when commissioning effective services for young people (aged 16-25) with ADHD

Lack of prioritisation by NHS England/Department of Health & Social Care which means that there has not been any transformation funding.

Q3.9 If you would like to add anything to your answers, please comment below.

Q4.1 Thank you for taking the time to complete this survey. Would you like to be? 
Indicate Y for yes, N for No
a. Contacted about taking part in further research:

No.

b. Kept informed about results of this research:

Yes.

Q4.2 If you indicated yes at all in 4.1, please provide your contact details:
These will be stored securely and only used for the purposes you have indicated above.
a. First name:
b. Surname:
c. Email address:

Please see Q1.3 above.

I hope that this answers your queries with the information we currently hold, but if I can be of any further assistance please do not hesitate to contact me.

If you are dissatisfied with the handling of your request, you have the right to ask for an internal review. Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to:

NHS Derby and Derbyshire ICB
FOI Team
Scarsdale
Nightingale Close
Newbold
Chesterfield
S41 7PF

Or:

ddicb.foi@nhs.net

If you are not content with the outcome of our review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Derby and Derbyshire Integrated Care Board (ICB).

The Information Commissioner can be contacted at: Information Commissioners Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF, telephone 0303 123 1113, email casework@ico.org.uk.

Yours faithfully,

Kathryn Jacklin
FOI Officer
Derby and Derbyshire ICB

All information we have provided is subject to the provisions of the Re-use of Public Sector Information Regulations 2015. Accordingly, if the information has been made available for re-use under the Open Government Licence (OGL) a request to re-use is not required, but the licence conditions must be met. You must not re-use any previously unreleased information without having the consent from the ICB. Should you wish to re-use previously unreleased information then you must make your request in writing (email will suffice) to the FOI Lead via ddicb.foi@nhs.net. All requests for re-use will be responded to within 20 working days of receipt.