Eating Disorders - FOI Response Register

I am writing to you under the Freedom of Information Act 2000 to request information regarding intensive community and day patient treatment programmes for patients with eating disorders. [If this request is forwarded internally, please do not cut out the introductory wording before the questions].

A note for clinicians/services involved in responding to this request

We are conducting this survey to help us understand how widely available these forms of treatment are across the UK. The top-level findings will be published in a report, in which individual services/providers will not be named. Instead, we will report the findings in terms of the proportion of providers or areas that offer intensive community and/or day patient treatment programmes for people with eating disorders.

We recognise that eating disorder services are under extreme pressure and are facing major challenges in recruiting and retaining the staff they need. This request will form part of a wider Beat project that will aim to understand and help overcome the barriers that the NHS faces in expanding access to these innovative service models. This will include challenging policy makers and commissioners to provide the required resources.

Background

Intensive community and day patient treatment programmes offer increased contact hours for the patient compared to traditional outpatient treatment. The patient returns home at night and therefore is not an inpatient. Such treatment programmes can help minimise inpatient admissions and reduce length of stay when admission is necessary.

Day patient treatment programmes (sometimes called ‘day care’) tend to be run as a group programme, with patients attending the service during the day and returning home for evenings and weekends. Such programmes could potentially be delivered partially or wholly online/virtually. Some intensive community treatment programmes include home treatment, whereby a clinician visits the patient’s home to support meals and snacks and offer psychosocial intervention. There are other models of intensive community treatment aside from home treatment and we are very interested in hearing about these approaches too.

Questions

1. Does the NHS Board provide any intensive community and/or day patient treatment for eating disorders (or refer patients on to receive such treatment from another NHS or non-NHS provider)? This may include day patient treatment, home treatment, or other innovative model/s. We are interested in programmes for children and young people, and/or adults.

 Yes

 No, and the NHS Board has never provided such a service

 Please note, NHS Shetland has a service level agreement with NHS Grampian to provide this service

 No, but the NHS Board did provide such a service in the past [Please provide more information below, including what led to the closure of this service/s]

If you answered “No” to question 1 (either of the two options), that is all that is required, thank you for your response.

If you answered “Yes” to question 1, please answer the remaining questions below. If the NHS Board provides more than one model of intensive community or day patient treatment and/or has separate programmes based on age or any other criteria, please provide separate answers for each treatment programme and specify which programme is being referred to. If the NHS Board refers patients on to receive intensive community or day patient treatment from another NHS or non-NHS provider, please state the name of this provider, and cover this treatment programme within the answers you give to questions 2-8.

2. What model/s of intensive community or day patient treatment for eating disorders does the NHS Board provide (or refer patients onto)? (Examples include day treatment or home treatment, but we are keen to hear about any other forms of intensive treatment too aside from inpatient care.) In your answer, please specify whether these are provided in-person or online/virtually.

3. What is the intensity of this/these model/s of intensive community or day patient treatment for eating disorders?

a) Please provide the information requested below. (If the NHS Board provides, or refers patients onto, more than one intensive community or day patient treatment programme please provide separate answers for each):

•           Number of hours per day (if applicable to model)

•           Number of days per week (if applicable to model)

•           Number of contacts per week and minimum duration of those contacts (if applicable to model)

•           Is supervised meal support provided? (If so, for how many meals per day?)

b) Please provide any more information that we should know about regarding the intensity of treatment provided by this/these programme/s.

4. Are families or other carers engaged with (when appropriate) in the treatment provided by this/these intensive community and/or day patient treatment programme/s for eating disorders? If so, please describe or attach further information outlining this engagement.

5. Is/are the intensive community and/or day patient treatment programme/s for eating disorders time limited, or is the length of this treatment based on clinical need? If it is time limited, what is the maximum length of treatment?

6. What are the referral criteria for patients to access the intensive community and/or day patient treatment programme/s for eating disorders? In your answer, please detail any exclusion criteria (e.g., age, type of eating disorder/diagnosis, BMI, comorbidity, or otherwise).

7. What is/are the geographic catchment area/s for referrals to the intensive community and/or day patient treatment programme/s for eating disorders (including any such programmes provided outside the NHS Board’s usual geographic area)?

8. Please state the size of the caseload (number of accepted referrals) at the NHS Board’s intensive community and/or day patient treatment programme/s for eating disorders on the dates below:

•           31 March 2023

•           30 September 2023

(If the NHS Board provides more than one intensive community or day patient treatment programme, please provide the size of the caseload separately for each and specify whether the programme is for over 18s or under 18s.)

9. Please tell us what the NHS Board is proud of about its intensive community and/or day patient treatment programme/s for eating disorders and outline the challenges and opportunities the NHS Board has experienced in providing this/these programme/s.