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Short-Staffed Eating Disorder Services 'Unable to Meet Growing Demand'

Eating disorder services were being "flooded" with referrals for children and young people, leading to long waiting times and risks to health that "beggars belief", mental health specialists said.

Every region in England was failing to meet the Government's target for 95% of urgent cases being seen within 1 week, and routine cases within 4 weeks, the Royal College of Psychiatrists (RCP) warned. Workforce shortages continued to undermine capacity in eating disorder services and needed to be addressed, it said.

According to the College:

  • The number of children referred for urgent care had increased by 66% since 2019
  • The number of young people referred for routine care rose by 48% over the same 3-year period
  • There had been an overall increase of 51% of patients requiring both routine and urgent specialist care since 2019

In London, children and young people faced the shortest waiting times in the country for urgent referrals, but the longest waiting times for routine referrals. The RCP analysis said that despite the situation, money for services in the capital was being trimmed by £300,000, or 2.6% of the budget.

Recruitment and Retention

Dr Agnes Ayton, chair of the Eating Disorders Faculty at the RCP, said: "It's simply not acceptable that waiting times have increased when we are seeing record levels of referrals for children and young people. This is a warning that we gave 3 years ago and it beggars belief that nothing has changed."

A report by the College in 2020 stated that the number of consultants specialising in eating disorders was "clearly insufficient to meet the needs of the patient population". Almost 3 years on, it said psychiatrists were reporting high workloads and poor work-life balance, making older consultants more likely to quit. According to the College, since 2017, there had been a 30% increase in vacant or unfilled consultant posts in England, with child and adolescent psychiatry, as well as eating disorders psychiatry, showing the highest number of vacancies.

The RCP called on the Government to provide adequate funding to retain and recruit psychiatric specialists as part of its forthcoming NHS workforce plan. This should include an increase in medical school places to 15,000 by 2028-29, with priority for shortage specialties, and support for NHS trusts to meet an annual 4% improvement target in retaining mental health staff.

Speaking to mark Eating Disorders Awareness Week, Dr Ayton said: "Admissions have been sharply rising since even before the pandemic, [and] under 19s now account for 30% of hospital stays for eating disorders, with no sign of abating. We know that delays cause patients to become even more unwell, with potentially life-threatening consequences. Overstretched services are already struggling to meet demand, so how can we continue to subject these children and young people to a postcode lottery?"

The Department of Health and Social Care said it was committed to improving mental health services. A spokesperson said: "Almost £1 billion is being invested in community mental health care for adults, including eating disorders, by 2024 and we’re providing an additional £54 million per year in children and young people's community eating disorder services to increase capacity across the country.

"We're also expanding the number of trainees and qualified practitioners able to deliver treatment for people with eating disorders. Health Education England has developed training for primary care staff, and the General Medical Council is working to improve recognition and treatment of eating disorders."