The NHS is failing patients with eating disorders
The Government must urgently order a review of eating disorder services, says Baroness Parminter
Eating disorders are serious mental illnesses, affecting an estimated 1.25 million people in the UK. They are not a ‘diet gone wrong’ or a ‘lifestyle choice’. They can cripple lives and ultimately take them – anorexia has the highest mortality rate of any mental illness. These devastating illnesses – which effect men, women and people of all ages and ethnic backgrounds – deserve better recognition and treatment.
If not caught early, like cancer, eating disorders are much harder to treat. While there is a national waiting time target for children and young people accessing services there is still no target for adults. A recent report by the Royal College of Psychiatrists found that people with eating disorders can wait up to 41 months for treatment, with adults waiting on average 30% longer than under 18s.
The House of Commons’ Public Administration and Constitutional Affairs Committee followed up last year on the Parliamentary and Health Service Ombudsman’s 2017 inquiry into the treatment of adults with eating disorders. It confirmed the urgent need to achieve parity with services for children and young people if further tragedies, like the death from anorexia of 19-year-old Averil Hart, are to be avoided.
I welcome the Government’s commitment in the NHS Long Term Plan to pilot a waiting time standard alongside new models of care for adults with eating disorders. But when those pilots end next year the funding for adult mental health care until 2024 includes no ringfenced monies to deliver a national access and waiting time standard for adults with an eating disorder. It’s already been three years since the PHSO reported on how NHS services are failing patients – when is the Government going to adopt a sense of urgency to address these deficiencies?
“Anorexia has the highest mortality rate of any mental illness”
Better training of medical staff is also needed. Research by Dr Agnes Ayton showed less than two hours on average is spent on teaching about eating disorders in UK medical schools, with one in five providing no teaching at all. A survey of medical schools by the General Medical Council (GMC) echoed Dr Ayton’s conclusion that doctors are not sufficiently prepared to manage patients with eating disorders. Even psychiatrists have no obligation to gain competencies during their training. The Government must keep the pressure up on the GMC, medical schools and colleges to improve training.
Moreover, whilst there are excellent examples here in the UK of clinical based treatments, we still don’t have a full understanding of what causes eating disorders or how best to treat them. More public funding of research is needed. Comparisons with levels of public funding of research for physical diseases show we are a long way from achieving parity of esteem for mental health, enshrined in law by the Coalition Government.
And risks to patients are growing. Pressure, particularly on adult services, is now so high there are problems with recruitment and retention. In England of the only 80 psychiatric posts in eating disorder services, 12 were vacant last year. This directly impacts on the wait for treatment and risks more unnecessary deaths.
Those risks are exacerbated by dangerously low levels of inpatient capacity: 19,000 people needed hospitalisation in England last year for eating disorders. That figure has doubled over the last decade but there has been no rise in the number of NHS beds – England has just 649. It means units are regularly receiving patients with a BMI below 12 as sufferers wait for beds to become available. It means patients, often children, are being sent hundreds of miles away from their families for months on end.
That is why I am calling for a review of all eating disorder services – informed by prevalence data. Currently the NHS doesn’t even have accurate data on the number of people suffering from an eating disorder throughout the UK.
This Government – which has already made some very welcome initiatives – must act more urgently to improve the care for sufferers of these cruel diseases.
Baroness Parminter is a Lib Dem peer. Her debate on improving the care offered to sufferers of eating disorders is scheduled for Tuesday 4 February