Agenda item

The Committee has asked for a further update on the Eating Disorder Service following consideration of a report and presentation at the June 2019 meeting.

Eating disorders continues to be a serious, often persistent, mental health disorders associated with high levels of impairment to everyday functioning and development, and a high burden on families and carers. They can be associated with life-long physical, psychological, educational and social impairment and in some cases can be fatal.

Discussion:

The Chairman announced that Michelle Dewar from Medway Parent and Carer Forum was in attendance for this report in view of the significant number of eating disorder service users who were children and young people.

This report provided details of a further update on the All Age Eating Disorder (AAED) Service following consideration of a report and presentation at the June 2019 meeting.

Representatives from the Council and NELFT (the service provider) were in attendance and the Head of Children’s Partnership Commissioning, Resources and Youth Justice and the Director the Director of Operations, NELFT gave a brief update on the service since the last meeting they had attended.

Officers and NELFT representatives responded to Members’ questions and comments as follows:

Gender mix and referral to the service – in response to a question relating to the prevalence of men suffering from eating disorders (but not using the service) and how the service was being promoted to men given they were hard to reach:

It was confirmed that the service was aware of the issue related to low referrals of males;

The main point of access to the service was through a GP referral, however, it was recognised that there was still a stigma for men to come forward;

It was noted that some work was being undertaken on the issue in schools through PSHE lessons. With regards to accessing the service in general, it was stated that further work with GPs and schools was required as well as the need to make improvements to the digital offer.

Relapse support – In response to a question relating to the level of support for those who suffered from relapses, the Head of Service for AAED, NELFT, stated that that there was a relapse pathway in place and that they were discussing the development of an early intervention and relapse programme with Commissioners.

Referral times – in response to a question regarding referral times, the Head of Service, NELFT, stated that there was a target for 95% of children and young people to be seen within two weeks of a referral, however, there were some reasons why this was not always met, for example, capacity at certain times or non-attendance.

Breakdown of age groups – in response to a question requesting further information on the breakdown of age groups, it was noted that this ranged from 5-64.  The service received very few young people under 8 and looked at other support but also those under 8 years old would consist of less than 5 children meaning that this would information would not be shared under GDPR guidance.

Members asked in the future the age break down could be 5-10, 11-17, 18-30, 31-64, 65+. This was agreed by the Service.

MARSIPAN risk assessment – in response to a question asking for a definition of MARSIPAN, the Head of Service for AAED, NELFT, stated that this was a NICE standard which provided an evidence based pathway to determine the level of need.

CAMHS – in response to comments regarding the need for more investment in this service, the Director of Operations, NELFT, and the Head of Children’s Partnership Commissioning, Resources and Youth Justice advised the Committee that a trailblazer bid was due to be submitted the following day, which, if successful, would enable there to be extra mental health provision in schools. 

Joint training – in response to a question regarding the need for joint training as highlighted in Appendix 1 to the report, the Head of Children’s Services, NELFT stated that internal training had been set up, and external training was in the process of being set up.

SEED (Severe and Enduring Eating disorders) Clinic – in response to a question as to where Medway residents attended this clinic, the Head of Service for AAED, NELFT, stated that this service was delivered from the CAMHS facilities in Medway, as well as in the home where appropriate.

Blood tests – in response to a question regarding assurances that GPs had the resilience to ensure that service users were encouraged to have their regular blood tests, the Head of Service for AAED, NELFT, stated that the service was now undertaking these blood tests.

Young people’s views – in response to a question which stated that no young people had been spoken to as part of the review, the Head of Service, AAED, NELFT, stated that it had not been possible to obtain consent from young people on the day of the review, however, other sources of  user feedback included 5X5 feedback surveys, routing outcome measures, quality reports and CQC reports.

8 week waiting list – in response to a question regarding the 8 week target and whether there was provision to reduce this in certain cases, the Director of Operations, NELFT, confirmed that each referral was triaged and people would then be seen depending on the level of severity and within what the existing resources would allow. She added that a scheme of 9 projects had been submitted to Commissioners, some of which was to improve immediate care.

Link Programme – it was suggested that further understanding and the outcome of the bid should form part of future reports to the Committee.

Telephone numbers and access to the building – In response to a question querying that there was only one phone number available for the service, the Director of Operations, NELFT, confirmed that there was just a single point of contact and that this number was available 24 hours a day. With regards to accessing buildings, it had not been possible to invest in separate accesses owing to limited resources, however, it was not considered that this was a major issue.

Grammar school children – in response to a question regarding why grammar school children had been referenced in the review document, the Head of  Service, AAED, NELFT, advised that this may have been in relation to some research which shows that one of the high risk groups were found in high achievers which why the report may have referenced the number of Grammar Schools.

Physical Health Check Nurses – in response to a question regarding the location of this service, it was confirmed that this would take place in certain GP practices.

Decision:

The Committee noted and commented on the update provided and that a further update be provided to the Committee in approximately 6 months’ time.