Walsall review

The Black Country and West Birmingham CCG should ensure that practitioners are confident to identify the signs and risk of intra-familial domestic abuse and that referral pathways are identified when a victim is a parent, and the offender is an adult.

The Black Country & Birmingham West CCG should remind GPs that a referral made to a service should include a detailed description of a patient’s vulnerabilities (rather than rely on self-disclosure) and should be updated with any relevant new information affecting vulnerability and risk, if there is a significant delay between the referral and the patient’s first appointment.

The Black Country Healthcare Foundation Trust should ensure that ADHD services provided for children and adolescents recognise that when a patient of school-leaving age is discharged, there should be active consideration as to whether a patient should be referred to adult ADHD services and ensure that transition is achieved in line with NICE guidance. (This should also happen routinely, including where an adolescent is discharged and any subsequent ADHD provision within the next 12 months would more likely be provided by adult ADHD services.)

The Black Country Healthcare NHS Trust should ensure that practitioners at AAAS are able to access a comprehensive history detailing any involvement and assessments by other mental health teams when a patient is new to service and that they avoid an over-reliance upon patient’s self-disclosure.

The Black Country & Birmingham West CCG and The Black Country Healthcare Foundation Trust should ensure that current provisions of child ADHD services are age appropriate and should audit to identify the extent to which services meet the NICE Guidance in relation to identifying the impact of ADHD upon the whole family. These agencies should be able to describe how a ‘Whole Family ‘approach can be evidenced in ADHD services.

The Black Country and West Birmingham CCG and Black Country Healthcare Foundation Trust should ensure practitioners are aware of the heightened risks when they identify co-morbidities of adult ADHD and alcohol or drugs misuse and that they respond appropriately.

The Black Country & Birmingham West CCG and The Black Country Healthcare Foundation Trust should agree a protocol to ensure that every child or adolescent prescribed ADHD medication is offered a consultant-led review of the need for continued medication into adulthood.

Primary Care Services England should consider how GP2GP record transfers could be improved and the Black Country and West Birmingham CCG should also encourage as best practice direct conversations between GP practices where there are concerns that a vulnerable adult has changed practice.