Agenda item

This report provides an update on Eating Disorders for Adults within the All-age Eating Disorder Service delivered by North East London NHS Foundation Trust (NELFT) within Medway.

Discussion:

Members considered a report which provided an update on Eating Disorders for Adults within the All-age Eating Disorder Service delivered by the North East London NHS Foundation Trust (NELFT) within Medway.

The following issues were discussed:

·       Tier 4 Specialist Eating Disorder Beds – noting that bed use was 70% in Sussex and 30% in Kent and Medway, the reasons for this disparity were queried. The Committee were advised that the total numbers were small and most people were treated at home. Subject to NELFT joining with Sussex on a provider collaborative basis, bed use would be reviewed on a monthly basis. The preference though was to attract more money to treat people in the community. NELFT were also exploring whether day care facilities could be provided in Kent and Medway. The fact that the beds were located in south London probably also affected who used them. In response to the latter point, a comment was made that this was an example of proximity to a service affecting access to it for Medway residents and of another mental health service that Medway had lost. It was argued that NELF should explore with KMPT opportunities for providing beds at least in Kent if not in Medway for very complex cases, given how debilitating the disease could be for everyone in the household. NELFT advised the best model for beds would be reviewed next year and if more were needed for adults then the Commissioners were open to this discussion.

·       93% female caseload – how this compared to national trends and whether this figure informed spending and the nature of outreach work was questioned. Members were advised that NELFT did not have the national data on this. Research was being carried out to better understand the reasons behind the take up figures for females and males and also the prevalence of eating disorders amongst men. This information would then be used to shape services.

·       Community monitoring -  in response to questions about the effectiveness of monitoring patients in the community, NELFT responded that while there could be challenges, the Team was well trained and experienced. The safety of patients was monitored through physical health clinics. Any patient classed as high was notified to the whole team. If a patient lived with other people in the household then the Team would try to educate them.

·       Awareness of GPs – Members were advised that NELFT was contractually responsible for physical health monitoring. GPs were informed of care plans and kept updated. When a patient was stable they became the responsibility of GPs with an open door back to NELFT if needed. In response, a point was made that this relied on GPs looking at blood test results in a timely way and understanding their importance, which was hampered by a shortage of GPs in Medway. NELFT advised the Committee that patients were not discharged if at high risk. In addition, NELFT worked very closely with KMPT and was developing an adult liaison role to work with GPs and KMPT.

Decision:

The Committee agreed to:

a)    note the report;

b)    request a briefing paper on current and soon to be introduced pathways.