For GPs · Printable
FASD Referral: A Guide for GPs
When and where to refer a child for FASD assessment, based on NICE QS204 and SIGN 156.
FASD Compass · fasdcompass.co.uk/for-your-gp/
This family has brought you this page because they are concerned their child may have Fetal Alcohol Spectrum Disorder (FASD). You are not being asked to diagnose FASD. You are being asked to consider a referral for assessment.
When to Refer
NICE QS204 Statement 3
"Children and young people with probable prenatal alcohol exposure and significant physical, developmental or behavioural difficulties are referred for assessment." (NICE QS204)
SIGN 156 also recommends referral, made sensitively, when there are significant physical, developmental or behavioural concerns and probable prenatal alcohol exposure (SIGN 156).
SIGN 156 also recommends referral, made sensitively, when there are significant physical, developmental or behavioural concerns and probable prenatal alcohol exposure (SIGN 156).
Probable prenatal alcohol exposure
- Reliable clinical observation
- Self-report, or report by a reliable source
- Medical records documenting positive blood alcohol concentrations
- Treatment for alcohol-related problems
Significant difficulties
For example problems with learning, attention, memory or language, poor problem solving, difficulty learning from consequences, social difficulties, small head circumference, or vision or hearing impairment. "Significant" means the difficulties disrupt the ability of the child or family to manage daily life.
Where to Refer
Local services
NICE suggests referral to community paediatrics, a child development centre or CAMHS, for assessment by a professional with additional training in FASD. Please state the prenatal alcohol history in the referral letter and ask for FASD to be considered. It is often missed in children already diagnosed with ADHD or autism.
If there is no local pathway
Many areas do not yet commission an FASD pathway. UK clinical guidelines for alcohol treatment note that children can be referred to the National FASD Clinic (Surrey and Borders Partnership NHS Foundation Trust), which accepts referrals from across the UK. Check its website for current referral and funding arrangements.
Recording and Coding
SNOMED CT codes for FASD
Please record the history of prenatal alcohol exposure in the child's notes and share it with other professionals when referring. NHS England introduced these codes in April 2024 (NHS North East and North Cumbria):
- FASD with sentinel facial features: 1894471000000108
- FASD without sentinel facial features: 1894461000000101
- At increased risk of FASD: 2078801000000102
Further Reading
For clinicians
- NICE QS204: Fetal alcohol spectrum disorder
- SIGN 156 full guideline and SIGN information for clinicians
- National FASD: GPs and healthcare professionals
- The FASD Compass clinicians page summarises the SIGN 156 diagnostic criteria
Sources: NICE QS204: nice.org.uk/guidance/qs204 · SIGN 156: sign.ac.uk/media/1092/sign156.pdf · National FASD Clinic: sabp.nhs.uk/fasd · UK alcohol treatment guidelines: gov.uk/guidance/clinical-guidelines-for-alcohol-treatment · FASD coding for GPs: northeastnorthcumbria.nhs.uk/media/w3yn5qy0/fasd-coding-for-gps.pdf · National FASD for GPs: nationalfasd.org.uk/learn-more/practitioners/gps-and-healthcare-professionals
Last reviewed: November 2026 by Dr Inyang Takon, Consultant Neurodevelopmental Paediatrician. For information only. Clinical decisions remain with the treating clinician.