Eating Disorders

Children and Young People

Eating disorders are a major focus within the Children and Young People’s Mental Health and Wellbeing programme. From April 2017, there is a national requirement for community eating disorder services for children and young people to meet access and waiting time standards, providing NICE concordant treatment in line with relevant guidance. The role of the Clinical Networks is to support commissioners and providers to ensure their services are prepared to meet these standards. Clinical Networks also provide a link into the assurance process led by NHS England, acting as a support mechanism for any identified improvement.

The main focus of this initiative is the running of events and workshops, aimed at working collaboratively to achieve a recovery-focused pathway for eating disorders across the patch. The events focus on different key elements in achieving this, including the principles of the pathway, service user and carer perspective, transitions (in the broadest sense) and the community pathway. Read the report from the Eating Disorders Recovery Pathway event held in April 2016.

The Clinical Networks are also working in partnership with NHS England in Cumbria and the North East to implement the recommendations of a local Health Care Needs Assessment of Severe Eating Disorders. This programme of work encompasses all ages.

Eating Disorders Health Care Needs Assessment (HCNA) Implementation Group

A HCNA for adults with severe eating disorders was commissioned by NHS England Specialised Commissioning Team through Public Health England, which ran April – October 2015. The HCNA aimed to ascertain whether the current service provision is meeting the needs of this population, to understand if variation in service usage exists and to identify any unmet need. It was developed with input from a number of organisations including: Northumberland, Tyne and Wear NHS Foundation Trust, Tees, Esk and Wear Valleys NHS Foundation Trust, NIWE Eating Distress Service and the Northern England Clinical Networks.

The HCNA made 10 recommendations, and an implementation group, comprised of the original contributing organisations, including the Clinical Network’s Children and Young People’s Mental Health workstream, was developed to undertake these recommendations. A key recommendation was to develop an all-ages recovery focused model for eating disorder services. This poses a significant challenge but also an opportunity to shape and develop eating disorder services for the future. Indeed current national policy seeks to transform the mental health system via a wider shift to prevention and promotion, and early identification and intervention, to enable patients to cope when doing well and to get the right level of help when not doing well (NHS Five Year Forward View for Mental Health; Future in Mind).

The implementation group led three events designed to explore our current eating disorder services and gain perspective from clinicians, service users and carers:

1) a clinical event for clinicians to understand the current pathways within ED services;

2) a service user and carers event to understand their perspective and view of existing ED service and what would make them better;

3) a transition event to understand current transitions within ED services and transitions they can be improved.

To date, we have already seen a number of successes. The HCNA group also maintains close communications with specialised services via a regional bi-weekly teleconference where cases and referrals are discussed. We have received positive informal feedback from staff on our implementation of this approach, which is also fostering better working relationships with our commissioned services. We also maintain monthly teleconferences with our independent providers (in our case we occasionally purchase beds in Scotland). This forum has a similar format to the above teleconference, and we also discuss repatriation of patients back to our region. Having these new processes in place has helped to reduce the number of inappropriate admissions as alternatives have been explored, and the resulting open dialogue has also led to improved ways of working in terms of how we better transition patients between services.