How NHS eating disorder services are failing patients

The Parliamentary Health Service Ombudsman has published Ignoring the alarms: how NHS eating disorder services are failing patients.

This is the report from an investigation that found Averil Hart’s death from anorexia would have been avoided if the NHS had cared for her appropriately. It highlights five areas of focus to improve eating disorder services:

  • The General Medical Council should conduct a review of training for all junior doctors on eating disorders, informed by research being conducted by the Faculty of Eating Disorders at the Royal College of Psychiatrists;
  • The Department of Health and NHS  England (NHSE) should review the existing quality and availability of adult eating disorder services to achieve parity with child and adolescent services;
  • The National Institute for Clinical Excellence (NICE) should consider including coordination as an element of their new Quality Standard for eating disorders;
  • Health Education England should review how its current education and training can address the gaps in provision of eating disorder specialists we have identified. If necessary it should consider how the existing workforce can be further trained and used more innovatively to improve capacity. Health Education England should also look at how future workforce planning might support the increased provision of specialists in this field;
  • Both NHS Improvement (NHSI) and NHS England (NHSE) have a leadership role to play in supporting local NHS providers and CCGs to conduct and learn from serious incident investigations, including those that are complex and cross organisational boundaries. NHSE and NHSI should use the forthcoming Serious Incident Framework review to clarify their respective oversight roles in relation to serious incident investigations. They should also set out what their role would be in circumstances like the Hart’s, where local bodies are failing to work together to establish what has happened and why, so that lessons can be learnt.

Full report: Ignoring the alarms: How NHS eating disorder services are failing patients

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Body dissatisfaction causing long lasting consequences for young people

Body dissatisfaction can start as young as six and lead to depression, anxiety and eating issues | Youth Select Committee

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The Youth Select Committee, a British Youth Council initiative, is supported by the House of Commons and has 11 members aged from 13 to 18. This week, the committee is launching its report, A Body Confident Future which looks at the issue of body image, an issue highlighted as an area of concern in a recent poll of thousands of young people.

The Committee’s key recommendations include:

  • Government sponsorship of an annual ‘National Body Confidence Week’ which would be supported by all relevant departments.
  • Introduction of minimum standards for social media companies in relation to content moderation, to be enforced in the forthcoming digital charter.
  • Measures to improve the diversity of advertising campaigns.
  • Adequate funding for schools so that pupils are supported in their wider wellbeing, including on issues related to body dissatisfaction.
  • Greater focus on body image in online resources aimed at young people, teachers and parents.

Full detail at British Youth Council

See also: BBC News: Young people out of love with their own bodies, says report

Big rise in male hospital admissions due to eating disorders

An analysis of NHS Digital data by The Guardian shows the number of men being hospitalised with an eating disorder has risen by 70% since 2011 | OnMedica

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It reveals that the number of hospital diagnoses in male over-19s rose from 480 in 2010-2011 to 818 between April 2015 and March 2016.

The rate of increase was slightly higher among older men, at 70% for the 41-60 age group, compared with 67% in the 26-40 category and 63% among 19- to 25-year-olds. In the same period, there was a 61% increase among women aged 19 to 25 and a 76% rise among middle-aged women.

Dr William Rhys Jones, from the Royal College of Psychiatrists’ eating disorders faculty, told the newspaper that pressure for body perfection is on the rise for men of all ages, which is a risk factor for developing an eating disorder. “Images of unhealthy male body ideals in the media place unnecessary pressure on vulnerable people who strive for acceptance through the way they look.”

Read the full commentary here

Male eating disorders rise

There has been an increase across the UK of men and boys suffering from eating disorders, according to research by BBC Panorama | BBC News

There has also been a rise in the number of under-18s seeking help. But less is spent on services to treat people of both genders with eating disorders in Wales than in England, a BBC Wales investigation found.

The UK’s largest eating disorder charity, Beat, said people with eating disorders “deserved better”. Panorama investigated the scale of the problem across the UK by asking every mental health trust and board how many men were referred to eating disorder services for a first assessment. From those that responded, it showed in 2016 there were 871 referrals, an increase from 2014 of 43%.

It also found a 42% rise in under-18s of both genders receiving help in 2016 compared to 2014, as well as a postcode lottery when it came to waiting times with lengths varying from less than a week to almost a year.

Read the full news story here

NICE Bites – Eating disorders: recognition and treatment

This guideline covers recognition and treatment of eating disorders including anorexia nervosa, binge eating and bulimia nervosa for children, young people and adults | NICE

NICE Bites is a monthly prescribing bulletin published by North West Medicines Information centre which summarises key recommendations from NICE guidance. NICE Bites No 98 June 2017 includes one topic: Eating disorders: recognition and treatment. It includes the following sections: Identification and assessment, referral, treatment and management, anorexia nervosa, dietary advice for anorexia nervosa, low bone mineral density and anorexia nervosa, other specified feeding and eating disorders, medication risk management, health monitoring, diabetes.

NICE Bites: Eating disorders: recognition and treatment

New data shows work needed to hit eating disorder treatment standard

More than a third of children with urgent eating disorders are not beginning treatment within a week as required under a new standard, NHS England data has revealed | HSJ

  • New data shows two-thirds of children and young people with an urgent eating disorder had treatment within a week
  • NHS England data also shows nearly three-quarters of routine eating disorder referrals began treatment within four weeks
  • The data is the first published on children and young people’s eating disorders
  • NHS is expected to treat 95 per cent of urgent cases within a week and 95 per cent of routine cases within four weeks by 2020-21

Rad the full article here

Prevention of eating disorders: A systematic review

Khanh-Dao Le, L. et al. (2017) Clinical Psychology Review. 53,(4) pp. 46–58

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Image source: Jasmine Parker – Wellcome Images // CC BY-NC-ND 4.0

Highlights:

  • The review described 13 ED preventive interventions spanning universal, selective and indicated preventive interventions.
  • A bias adjusted meta-analysis is undertaken of 112 articles that evaluated eating disorder prevention interventions.
  • Promising preventive interventions for ED risk factors/ behaviours included cognitive dissonance, cognitive behavioural therapy and media literacy.
  • Combined ED and obesity prevention interventions require further research.
  • Insufficient evidence supported the effect of ED prevention interventions on pre-adolescent children and adults.

Read the full abstract here