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Eating Disorders Services

Our vision

In our vision we said we wanted to develop a comprehensive system of care in the region that is accessible, equitable, appropriate, integrated and comprehensive.

There are several different forms of eating disorders: anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS). They share a common basis in that the way they relate to food is an expression of an individual’s emotional distress. Commonly people with eating disorders often have low self esteem which is based on overvalued ideas around weight and shape and the need to control their eating. The average duration of an eating disorder is 6 to 7 years.  The type of eating disorders a sufferer experiences may change over time.

 

How we currently provide eating disorders services

Most people with an eating disorder are first seen by their family doctor and are then referred on to more specialised care. This specialised care can be out-patient, day-patient and/or in-patient services.

The current service within the East Midlands region is based on a hub and spoke model with the spokes offering specialised, locally based, community care for people with eating disorders. Each county has one or more spokes. The hub provides a specialised in-patient facility for those individuals who are extremely severe. There is one hub within the region.

Each county team (spoke) has a specialised out-patient service that provides assessment, treatment and psychological therapy. These county teams vary with some teams offering a service to most people with eating disorders whilst others only offer a service to people with very severe anorexia nervosa. Each of the out-patient services also aims to develop links to any voluntary organisation providing support to sufferers of eating disorders in their neighbourhood. Not all areas have voluntary groups, most voluntary groups are also supported by b-eat, the national self-help organisation for people with eating disorders.

Each county has access to in-patient beds for those patients with anorexia nervosa who need to be admitted for treatment. Currently specialist in-patient treatment for patients within the East Midlands is provided by the Leicestershire Partnership NHS Trust within the Brandon Mental Health Unit on the Leicester General Hospital site.  This unit provides 15 beds for the region. It offers a highly specialised intensive care weight restoration and group treatment programme. During the patient’s admission staff from the relevant out-patient service maintain contact with their patient and provide further support once the patient has been discharged from the unit. Due to the varying demand, accessibility and availability of in-patient eating disorders services other in-patient services are also used both from the public and private sector. 

 

Why eating disorders services need to change

Although we have a model of service provision, in practice there is wide variation in the support available to patients, depending on what part of the region they live in. Some counties have well-developed and comprehensive out-patient services, while others have relatively newly established services and are in the process of expanding.

A similar picture exists with our in-patient service where the quality of care received varies as the spoke services have relied on using the independent sector and other NHS specialised in-patient services outside the region to provide enough beds to meet local demands.

Although not considered to date, it is important to note that access to treatment offered by the child and adolescent services also varies with some counties having a dedicated service and good communication between child and adolescent services and adult services. In other counties the service is more limited.  There is no specialist in-patient eating disorders service for this group within the region. When in-patient services are required they tend to be admitted to adolescent psychiatric services in the region.   

 

How we're improving services for patients

We are committed to making the following improvements to local eating disorder services to improve the quality of care we are able to provide:

  • Removing the current inequalities that exist in accessing services because of where people live in the East Midlands

  • Ensuring services for sufferers with eating disorders meet the NICE guidelines

  • Ensuring that the pathway of care between services for people with eating disorders  is well co-ordinated

  • Decreasing the time it takes from going to the GP and being diagnosed with an eating disorder to getting the appropriate level of help at the time when clients are motivated to address their difficulties

  • Limiting the number of people who die because of having an eating disorder or who are left with long term health conditions as a result

  • Treating people with eating disorders as locally as possible and reducing the number of people who have to go outside the East Midlands to access services.

  • Promoting and supporting self-help groups for people with eating disorders.

 

To achieve this we are proposing to further develop the hub (regional, specialised in-patient services) and spoke (specialised, community-based county services) model for adult services and to ensure the development of appropriate services for children and adolescents.

food

Other useful links:

Improving eating disorders therapy in Leicester