Health Minister Simon Hamilton today welcomed the delivery of a preliminary report on eating disorder services in Northern Ireland.
The report, which was commissioned by the Minister in October 2015, concludes that there is a definite need for further development of eating disorder services here. Whilst there is the potential for a specialist inpatient unit, more evidence-gathering is required to allow for an informed recommendation to be made, and further study is required.
The report was co-authored by the Health and Social Care Board and the Public Health Agency, with input from the Regional Eating Disorders Network Group, which brings together commissioners, clinicians and experts by experience to examine eating disorder services in Northern Ireland.
The Minister said: “I am very grateful to the members of the Regional Eating Disorders Network Group who contributed to this preliminary report.
“It is clear that we need more provision for eating disorders in Northern Ireland. The potential for a specialist eating disorders unit remains, but further enhancements to community services could be an attractive alternative. I am therefore grateful to the clinicians and experts by experience who will contribute to the next phase of the study."
As an illustration, the first phase of the study found that in the five years between 2010 and 2015, 169 adults receiving input from Trust eating disorder teams were treated as medical and / or mental health in-patients in local hospitals or in specialist units in England or Scotland.
However, analysis of a sample of these cases found that around two-thirds are associated with other significant medical/clinical issues that warrant care within a general medical facility.
This Minister said: “In a time of budgetary challenges, we have to ensure that limited funding is spent in the best way possible. A specialist unit remains a possibility, but the report also makes a good outline case for prioritising early intervention care in community-based settings, or intensive day support, whilst continuing to treat the most serious cases in existing inpatient facilities, with specialist in-reach as at present.
“There is also the possibility that enhancing early intervention and day support services could reduce the number of patients having to travel outside Northern Ireland to benefit from specialist treatment.
“This is a complex issue. The second phase of the study will review and assess the most recent policy, medical and service developments, cases, reasons for transfer to Great Britain, local best practice, and gaps in current service, to determine whether the landscape is such that a specialist unit is necessary. Serious consideration will be given to the comparative benefits of enhancing community-based services, such as increasing the number of specially-trained primary care eating disorders therapists.
“Importantly, phase two will also examine whether patients from outside Northern Ireland could potentially benefit from a specialist unit.
“There is much to consider. It is therefore appropriate to take some more time to look at all of the evidence.”
The second phase of the study is intended to conclude by the end of 2016.
Notes to editors:
- Minister Hamilton announced the study on 7 October 2015.
- Eating disorder services are provided through a stepped care approach which ranges from early detection and intervention, to community-based treatment, to specialist inpatient provision.
- A total of £2million is allocated to specialist eating disorder services every year. This has been the case since 2008/09. This figure does not include inpatient care or the cost of treatment for eating disorders provided outside Northern Ireland.
- Across Northern Ireland there are over 40 (whole time equivalent) funded specialist eating disorders practitioners, covering children’s and adult services. These include consultant psychiatrists, eating therapists and dieticians. This compares with a figure of less than one (whole time equivalent) practitioner in 2005.
- In a relatively few cases, a patient may require more intense specialist treatment for anorexia, which is not available in Northern Ireland, and Trusts can access beds in England, Scotland and Ireland through the Extra Contractual Referral (ECR) process. Recent figures are as follows:
Year - No of ECRs for eating disorders
- 2012/13 - 8
- 2013/14 - 11
- 2014/15 - 15
- The first phase of the study sought to provide a strategic overview of services available at present, and review the outline cases for and against a specialist unit.
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