ADHD service review, 2014 to 2017

Children and young people

On 16 January 2017 North Tyneside Council Cabinet considered the recommendations of the Scrutiny Report on support for ADHD in North Tyneside Read the report to cabinet and the recommendations of the scrutiny committee

We wrote to North Tyneside CCG in June 2017 to follow up our request that the CCG work with colleagues in the council to establish a multi-agency ADHD group to carry out the functions in NICE guidelines and oversee the implementation of the Cabinet decisions.

Heathwatch England published a report and recommendations on support for children and young people with autism in March 2017. Work by local Healthwatch was considered when writing this report. Read the report

Background

In February 2015 the Children, Education and Skills Sub-committee agreed to set up a group to lead this review.

In 2015/16 we:

• provided support to the Parents Group in the development of a survey and report.
• supported the parents group to attend a special meeting of the committee set up by Overview and Scrutiny to evaluate ADHD services (in response to a HWNT request)
• sponsored a member of the parents group to attend the NICE standards committee on ADHD

The local parents support group had told us they very much appreciate the joint working which takes place between health and the local authority. However, they had concerns about the level of joint working and believe this can, and should, be significantly increased to secure better outcomes for their children. Anecdotal evidence from parents suggested a less optimistic view about the outcomes for their children, in comparison to those of professionals.

For that reason the group asked for an audit of service provision and how that impacts on young people’s outcomes. Without this baseline assessment they felt it would be difficult for the local NHS and the council to assess the effectiveness of their current interventions and to determine how best to use their resources in the future.

The main issues have been:

• There are ‘missing’ children if only 560 are known to services. NICE estimate 3-9% prevalence so there are likely to be over 1500 children in North Tyneside.
• There is a real lack of data collected about how many children with ADHD involved in exclusions or ‘managed moves’ between schools. This is important because children with ADHD are more likely to have social, behavioural and learning difficulties and much more likely than average to end up with a criminal record.
• There is a lack of data and information generally
• Lots of agencies are involved, and processes mean parents rely on them working together, but they are notalways joining up very well. For example, to get a diagnosis of ADHD, certain behaviours need to be present in more than one setting. This means that the school need to recognise those behaviours and confirm them to the specialist. If the school doesn’t recognise the symptoms, or lack capacity to have proper involvement for any reason, the diagnosis can’t happen.

What is ADHD?

ADHD/ADD is a neurodevelopmental disorder which frequently co-exists with other disorders – ASD, dyslexia, co-ordination difficulties etc, and one that is poorly understood by many, including some professionals. The symptoms of ADHD/ADD will be familiar to many people – inattention or hyperactivity and impulsiveness. However, to meet the diagnostic criteria a specialist assessment is required and can only be given when an individual shows moderate or severe impairment in at least two areas of their life – education, social relationships, employment etc. Without proper diagnosis and adequate support, many children and young people, fail to achieve their potential and struggle to maintain or sustain positive relationships.