From Dr Dan Poulter MP Parliamentary Under Secretary of State for Health Department Richmond House of Health 79 Whitehall London POCS 887782 SWIA 2NS Teli Mr D Winter Senior Coroner Civic Centre 0 3 SEP 2014 Bourdon Road Sunderland SR2 ZDN 0 8 SEF O_ A Thank you for your letter following the inquest into the death of Nathan Healer. In your report You conclude that the medical cause of death was Neonatal Encephalopathy and Intraventricular Haemorrhage (Grade 4), and Poorly Controlled Gestational Diabetes. Nathan'$ mother had gestational diabetes, and kept regular contact with medical professionals throughout her pregnancy: You noted that Nathan was born on 3rd February 2014 at 7.18am without complications, and his APGAR test results were However; his colour was not all that it ought to have been, and he was cold and slow to feed. It was also reported that his eyes were bulgy, he had jittering arms and excessive startle reflux. You further noted that Nathan's blood glucose was measured for the first time at almost five hours from his birth, registering at 0.2mmol/L. Although intervention began at this point; Nathan died two later on 5th February 2014. You raise the following matters of concern: The 2008 National Institute for Health and Clinical Excellence (NICE) Guideline CG63 'Diabetes in Pregnancy in essence recommended a pre 2"d feed blood glucose test at between 2-4 hours. Although the severity of Nathan '$ condition was not appreciated, and he was not given the opportunity of a more timely blood glucose test, you understand that new guidance from NICE is in contemplation but has not yet been 2014 ~x, good. days

finalised, and would like to know what stage this is at and whether it can be expedited We understand that NICE Guideline CG63 is currently under review: Draft guidance is due to go out for consultation on 11th September 2014, ending October 2014. The finalised guidance is expected to be published in February 2015. Further details about this work can be accessed on the NICE website at the following address: http:Lwww nice org uklguidancelindevelopmentIGDD-CGWaveRL0Z Given the imminence of the new guidance, advice from Departmental policy officials is that there is no scope for this process to be expedited. However; as NICE is an independent body, advise you contact it directly with any further questions You may have about the review of this guidance. I hope that this response is helpful and am grateful to you for bringing the circumstances 0f Nathan'$ death to my attention_ Sa8 DR DAN POULTER 23rd 6