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.

Journal article

Viljoen, D., King, Emily, Harris, S., Hollyman, Jonathan, Costello, Kate, Galvin, Eimear, Stock, Melissa, Schmidt, Ulrike, Downs, J., Sekar, Murali, Newell, Ciaran, Clark-Stone, Sam, Wicksteed, Amy, Foster, Caroline, Battisti, Francesca, Williams, Laura, Jones, Roshan, Beglin, Sarah, Anderson, S., Jebarsan, Thuthirna, Ghuys, Viviane and Ayton, A. 2023. 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. BJPsych Bulletin. https://doi.org/10.1192/bjb.2023.57
AuthorsViljoen, D., King, Emily, Harris, S., Hollyman, Jonathan, Costello, Kate, Galvin, Eimear, Stock, Melissa, Schmidt, Ulrike, Downs, J., Sekar, Murali, Newell, Ciaran, Clark-Stone, Sam, Wicksteed, Amy, Foster, Caroline, Battisti, Francesca, Williams, Laura, Jones, Roshan, Beglin, Sarah, Anderson, S., Jebarsan, Thuthirna, Ghuys, Viviane and Ayton, A.
AbstractThis national pre-pandemic survey compared demand and capacity of adult community eating disorder services (ACEDS) with NHS England (NHSE) commissioning guidance. 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. 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.
KeywordsWorkforce levels; Adult community eating disorders services; Referral rates; Commissioning guidance; Ignoring the Alarms report
Year2023
JournalBJPsych Bulletin
ISSN2056-4694
Digital Object Identifier (DOI)https://doi.org/10.1192/bjb.2023.57
Official URLhttps://www.cambridge.org/core/journals/bjpsych-bulletin/article/alarms-should-no-longer-be-ignored-survey-of-the-demand-capacity-and-provision-of-adult-community-eating-disorder-services-in-england-and-scotland-before-covid19/03BFEA3BEDDA43057DD96DB048B8C700
Publication dates
Online01 Aug 2023
Publication process dates
Deposited30 Aug 2023
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