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Freedom of Information -HWHCT 015

Our ref: HWHCT-015

12 May 2022

Request:

Request for Information on ADHD and ASD Services for CYP (5+) and Adults (18+) for areas covered by NHS Herefordshire and Worcestershire CCG

I am currently carrying out a benchmarking of waiting times and waiting lists in ASD and ADHD services across the country, and would appreciate information on the following under the Freedom of Information Act 2000 on your local ADHD and ASD services

ADHD

  1. What were the average wait times between referral and the start of assessment for CYP (5+) with ADHD between 1/1/21 and 31/12/21
  2. What were the average wait times between referral and the start of assessment for Adults (18+) with ADHD between 1/1/21 and 31/12/21
  3. How many CYP (5+) were on a waiting list for ADHD assessment and diagnosis between 1/1/21 and 31/12/21
  4. How many Adults (18+) were on a waiting list for ADHD assessment and diagnosis between 1/1/21 and 31/12/21
  5. How many referrals were received for CYP (5+) ADHD assessments between 1/1/21 and 31/12/21
  6. How many referrals were received for Adults (18+) ADHD assessments between 1/1/21 and 31/12/21
  7. How many assessments were carried out on average per month for CYP (5+) with ADHD between 1/1/21 and 31/12/21
  8. How many assessments were carried out on average per month for Adults (18+) with ADHD between 1/1/21 and 31/12/21
  9. What is the cost per head for CYP (5+) ADHD assessment and diagnosis
  10. What is the cost per head for Adults (18+)ADHD assessment and diagnosis
  11. What is the staff/skill mix and total WTE of staff directly involved in assessment and diagnosis for CYP(5+) with ADHD

What is the staff/skill mix and total WTE of staff directly involved in assessment and diagnosis for Adults (18+) with ADHD

ASD

  1. What were the average wait times between referral and the start of assessment for CYP (5+) with ASD between 1/1/21 and 31/12/21
  2. What were the average wait times between referral and the start of assessment for Adults (18+) with ASD between 1/1/21 and 31/12/21
  3. How many CYP (5+) were on a waiting list for ASD assessment and diagnosis between 1/1/21 and 31/12/21
  4. How many Adults (18+) were on a waiting list for ASD assessment and diagnosis between 1/1/21 and 31/12/21
  5. How many referrals were received for CYP (5+) ASD assessments between 1/1/21 and 31/12/21
  6. How many referrals were received for Adults (18+) ASD assessments between 1/1/21 and 31/12/21
  7. How many assessments were carried out on average per month for CYP (5+) with ASD between 1/1/21 and 31/12/21
  8. How many assessments were carried out on average per month for Adults (18+) with ASD between 1/1/21 and 31/12/21
  9. What is the cost per head for CYP (5+) ASD assessment and diagnosis
  10. What is the cost per head for Adults (18+) ASD assessment and diagnosis
  11. What is the staff/skill mix and total WTE of staff directly involved in assessment and diagnosis for CYP(5+) with ASD
  12. What is the staff/skill mix and total WTE of staff directly involved in assessment and diagnosis for Adults (18+) with ASD

Trust response:

ADHD

Questions 1, 3, 5, 7, 9, 11 - Worcestershire

The Trust Community Paediatric Team is commissioned to provide U18 ADHD services for Worcestershire.  They do not have separate waiting lists for ADHD; the children are embedded within the work of the community paediatric team and we are unable to extract this from data held centrally (although information may be held within individual patient records - see below *)

Questions 2, 4, 6, 8

See attached spreadsheet (AMH ADHD Pathway Services Data – Summary) for referrals and activity for the AMH Attention Deficit Hyperactivity Disorder (ADHD) Pathway Service.

Please note adult ADHD response information relates to Worcestershire only as we are not commissioned to provide this service in Herefordshire.

Question 9:We are unable to provide the cost per head for CYP (5+) ADHD assessment and diagnosis as it is based on the child’s needs and therefore varies

Question 10: We are unable to provide the cost per head for ADHD Adults (18+) ADHD assessment and diagnosis as it is based on the individual’s needs and therefore varies

Question 12:

0.6 WTE (ADHD Practitioner)

0.4 WTE (Cognitive Behavioural Therapist)

ASD

We do not have a specific service for adults with ASD as we are not commissioned for this, therefore questions 2, 4 6, 8 10 and 12 are not applicable to this Trust.

The data provided below for the assessment of ASD for CYP 5+ relates to assessments undertaken in Worcestershire by the Umbrella Pathway Team, which is part of the Trust Community Paediatrics Team commissioned to provide ASD services for Worcestershire - see Trust website for further information: Our Services | Herefordshire and Worcestershire Health and Care NHS Trust (hacw.nhs.uk). 

The Umbrella Pathway team are not part of the Worcestershire CAMHS, and any assessment of ASD undertaken as part of a CAMHS intervention is not included in the figures provided in our response.  This information is not recorded separately by CAMHS and we are unable to extract it from data held centrally (although information may be held within individual CAMHS patient records - see below **).  Therefore, the data in our response does not include all ASD assessments for CYP 5+, only those undertaken as part of the ASD Assessment within the Umbrella Pathway.

Please note the data included in our response spreadsheet relates to Worcestershire only, see below * for Herefordshire.

Questions 1, 3, 5, 7 - Worcestershire

See attached spreadsheet (ASD FOI  Request -10-5-21) for the following tables in response to your request:

Table 1 - Referrals per month to the service

Table 2 - Wait to Planning meeting - initial contact

Table 3 - Number of patient seen in month for the planning meeting. Initial contact. May not be a full assessment. Linked to table 2

Table 4 - Wait from being referral to being seen in this month and receiving a diagnosis

Table 5 - Number of patients who have been seen in month and given a diagnosis (Linked to table 4)

Table 6 - Current patient on the pathway at the end of each month.  These are total numbers - they could be just referred in or been in the service for 5 months and seen number of times but not yet received a diagnosis.

Question 9: We are unable to provide the cost per head for CYP (5+) ASD assessment

and diagnosis as it is based on the child’s needs and therefore varies.

Question 11 - Worcestershire

The WTE is 4.8 staff including admin staff.The skill mix is: Speech and language therapists, Occupational therapist (ACP), Clinical psychologists and clinical psychology assistant, Consultant community paediatrician, Admin assistants.

*Questions 1, 3, 5, 7, 11 - Herefordshire

Herefordshire CAMHS is commissioned to assess for ADHD for Children and Young People CYP aged 7+ and ASD for CYP aged 10+, so we deliver only part of the assessment requirement in Herefordshire on behalf of the CCG.

Until very recently, we did not have separate caseloads or the recording of diagnosis for CYP with ADHD or ASD and we are therefore unable to provide this information without a **manual trawl of all patient records. The ADHD and ASD assessment offer has been part of the ‘core’ offer and so we are unable to filter out the required information.

** The Trust does not centrally record this information and estimates that it would take a significant amount of time to gather the information requested. Therefore, we are refusing this section of your request for information pursuant to section 12 of the Act on the grounds that we estimate that the cost of complying with the request would exceed the appropriate limit.

The appropriate limit at the present time is £450.00 which equates to eighteen hours of work by a member of staff at the rate of £25 per hour

Please be aware that although this information is accurate at the time it is provided, it may not be in the future and should not be relied upon.