Eating disorder services review: summary recommendations

Context of the Scottish Eating Disorder Services Review

On 2^nd March 2020, Mental Health Minister, Clare Haughey announced that eating disorder services would be subject to a national review, designed to assess and improve support for people living with an eating disorder. This review follows on from the Mental Welfare Commission for Scotland's Themed Visit of the care, treatment and support for people with eating disorders in Scotland (1).

The Commission's report 'Hope for the future' was published in September 2020 and the current review was launched by the Minister on 16^th October 2020. The review was led by three clinicians from different clinical and geographical backgrounds.

• Charlotte Oakley is Clinical Lead for the Connect-ed eating disorder service for children and young people in NHS Greater Glasgow and Clyde.
• Jacinta Tan is a Consultant Child & Adolescent Psychiatrist in Wales and led the Welsh Government's review of eating disorder services in 2018.
• Stephen Anderson is a Consultant Psychiatrist in Eating Disorders, now working in NHS Greater Glasgow and Clyde, but formerly in NHS Forth Valley.
• The review was supported throughout by Katie Hughes, an Assistant Psychologist in NHS Greater Glasgow and Clyde Adult Eating Disorder Service.

The remit of the review can be found at 'National Review of Eating Disorder Services: terms of reference' (2) (Appendix 1) but in brief, was to:

• Provide a full picture of the current system of support for people with eating disorders and their families and carers across Scotland. The scope of the review includes support from primary care, through to specialist inpatient services and the third sector
• Provide detailed recommendations on how services and the wider support system should be constructed to ensure that the right treatment and support can be provided to those with an eating disorder, and their families

It is expected that this review will be a first step in a phased program, with a second phase of improvement work being guided by the review's findings and recommendations.

It should be noted that the review is running in parallel with the development of a Scottish Intercollegiate Guideline Network (SIGN) guideline on eating disorders which aims to publish later in 2021. The evidence base for treatment and interventions is being considered in detail by SIGN and will not be reviewed here.

In conducting this review, we engaged with key stakeholders, those with lived experience of eating disorders and their families, and with clinicians. We have met with representatives of Health Boards/Integration Authorities. Separate surveys for clinicians and for people with lived experience were distributed in December 2020 and January 2021 with around 500 responses received. We held 7 virtual workshops from November 2020 to January 2021 via Zoom, with around 40 participants at each. We were keen to ensure representation from a wide variety of clinical backgrounds, and not just from specialist eating disorder services and are very grateful to everyone who took part. Further information about the groups, and clinical backgrounds of participants can be found in in the main report. Details of themes from these events and from surveys can be found in Appendix 2, 3 & 4.

This document contains brief information about the background to the review and also a summary of the main recommendations. Full detail of the recommendations is provided in the main report to be published separately. In addition to the summary and main reports, a number of appendices are available. as follows:

• Appendix 1 Service mapping and scoping exercise
• Appendix 2 Themes from public and clinician workshops
• Appendix 3 Data from lived experience and public survey
• Appendix 4 Data from clinicians' survey
• Appendix 5 Hospital admission data

The full report was submitted to the Minister on 17^th March 2021.