Staff involved in the care of a patient with an eating disorder should place greater emphasis on how they coordinate treatment with one another, according to new guidance.
The new Eating Disorder Quality Standard has been published by the National Institute for Health and Care Excellence (NICE) following consultation on previous guidance.
”Failure to coordinate between services can put patients’ lives at risk”
It follows a critical report by the Parliamentary and Health Service Ombudsman (PHSO) – Ignoring the alarms: How NHS eating disorder services are failing patients – published in December 2017.
The PHSO report looked at the case of student Averil Hart who died in 2012 after her anorexia rapidly worsened. She was found collapsed at university and taken to hospital but died several days later.
The ombudsman found her death could and should have been prevented. It recommended that NICE guidance be updated to include a section on coordination of services.
As a result, the new NICE guidance includes the recommendation: “People with eating disorders who are being supported by more than one service have a care plan that explains how the services will work together.”
There is also a new focus on waiting times set out in the following recommendation: “People with suspected eating disorders who are referred to an eating disorder service start assessment and treatment within four weeks for children and young people or a locally agreed timeframe for adults.”
”This guidance will help ensure better coordination of care between NHS organisations treating people with eating disorders”
Dr Dasha Nicholls
NICE says waiting times have improved for children and young people with 81% now starting treatment within four weeks. The aim is for that to increase to 95% by 2020/21.
The guidance also states that healthcare professionals should have a discussion with eating disorder patients about their options for psychological treatment.
“Eating disorders can be absolutely devastating for people and their families,” said Dr Dasha Nicholls, a consultant psychiatrist at Great Ormond Street Hospital for Children. “If left without clinical attention, a person’s condition has a tendency to become worse and harder to treat.”
She added: “We are very excited to include a statement in the NICE quality standard emphasising this need to get children and adults seen by specialists as soon as possible and to recommend a suitable timeframe.”
Rob Behrens, the Parliamentary and Health Service Ombudsman, said: “Our 2017 report highlighted cases where NHS services had failed patients with eating disorders, resulting in avoidable harm and even death. This guidance will help ensure better coordination of care between NHS organisations treating people with eating disorders and help prevent the same mistakes happening to others.”
The guidance was also welcomed by eating disorder charity, Beat.
“These standards recognise the importance of ensuring early appropriate and coordinated treatment for all kinds of eating disorders and that is very encouraging,” said Tom Quinn, Beat’s director of external affairs.
“Failure to coordinate between services can put patients’ lives at risk and it is significant that the new standards recommend patient care plans and risk assessments to avoid this.”
However, problems remain with a lack of resources for frontline NHS eating disorder services resulting in a postcode lottery for access and quality of treatment, Mr Quinn said.
He added: “Although the NICE standard states that children and young people referred to an eating disorder service should start assessment and treatment within four weeks, there are still no national waiting times targets for adults despite research showing adults wait longer at every stage for treatment.”
NICE quality standards are not mandatory but the health and social care system has to take account of them when planning and delivering services.