The alarms should no longer be ignored: survey of the demand, capacity and provision of adult community eating disorder services in England and Scotland before COVID-19

The alarms should no longer be ignored: survey of the demand, capacity and provision of adult community eating disorder services in England and Scotland before COVID-19

Aims/method This national pre-pandemic survey compared demand and capacity of adult community eating disorder services (ACEDS) with NHS England (NHSE) commissioning guidance. Results Thirteen services in England and Scotland responded (covering 10.7 million population). Between 2016–2017 and 2019–2...

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Main Authors: David Viljoen, Emily King, Sophie Harris, Jonathan Hollyman, Kate Costello, Eimear Galvin, Melissa Stock, Ulrike Schmidt, James Downs, Murali Sekar, Ciaran Newell, Sam Clark-Stone, Amy Wicksteed, Caroline Foster, Francesca Battisti, Laura Williams, Roshan Jones, Sarah Beglin, Stephen Anderson, Thuthirna Jebarsan, Viviane Ghuys, Agnes Ayton
Format: Article
Language:English
Published: Cambridge University Press 2024-08-01
Series:BJPsych Bulletin
Subjects:
Adult community eating disorders services
referral rates
commissioning guidance
workforce levels
Ignoring the Alarms report
Online Access:https://www.cambridge.org/core/product/identifier/S2056469423000578/type/journal_article
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Summary:Aims/method This national pre-pandemic survey compared demand and capacity of adult community eating disorder services (ACEDS) with NHS England (NHSE) commissioning guidance. Results Thirteen services in England and Scotland responded (covering 10.7 million population). Between 2016–2017 and 2019–2020 mean referral rates increased by 18.8%, from 378 to 449/million population. Only 3.7% of referrals were from child and adolescent eating disorder services (CEDS-CYP), but 46% of patients were aged 18–25 and 54% were aged >25. Most ACEDS had waiting lists and rationed access. Many could not provide full medical monitoring, adapt treatment for comorbidities, offer assertive outreach or provide seamless transitions. For patient volume, the ACEDS workforce budget was 15%, compared with the NHSE workforce calculator recommendations for CEDS-CYP. Parity required £7 million investment/million population for the ACEDS. Clinical implications This study highlights the severe pressure in ACEDS, which has increased since the COVID-19 pandemic. Substantial investment is required to ensure NHS ACEDS meet national guidance, offer evidence-based treatment, reduce risk and preventable deaths, and achieve parity with CEDS-CYP.
ISSN:2056-4694
2056-4708

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