Eating disorders: national network minutes – June 2024

Attendees and apologies

• Cathy Richards, chair of the network, Scottish Government
• Fiona Duffy, clinical advisor of the network, Scottish Government
• Katherine Morton, clinical advisor of the network, Scottish Government
• Marita Brack, attending on behalf of Fiona Calder, NHS education for Scotland (NES)
• Alex Jones, national lead Scotland, Beat
• Stephen Anderson, consultant psychiatrist, NHS Greater Glasgow and Clyde
• Carol Morgan, Dudhope carer’s worker, Dudhope
• Susan Hynes, CAMHS programme director, NHS North of Scotland
• Diane Waugh, operations director, SupportED
• Ellen Maloney, lived experience peer researcher, University of Edinburgh
• Shridevi Gopi-Firth, attending on behalf of Agnes Louise Johnston, NHS Forth Valley
• Rachael Smith, consultant clinical psychologist, NHS Grampian
• Officials from the Scottish Government were also in attendance

Apologies

• Ruairidh McKay, psychiatrist, NHS Lothian
• Lesley Pillans, associate specialist, NHS Grampian
• Sam Aitcheson, consultant clinical psychologist, NHS Grampian
• Louise Johnston, psychiatrist, NHS Grampian
• Fiona Calder, consultant clinical psychologist, NHS Greater Glasgow and Clyde
• Charlotte Oakley, dietician

Items and actions

Welcome and update from the chair 

The chair opened the first meeting of the national eating disorders network and invited members to introduce themselves. The recruitment for the national eating disorders clinical advisors is completed. Strong applications were received and Dr Fiona Duffy and Dr Katherine Morton have been appointed. 

The chair gave an overview of capacity within Scottish Government to support the network and explained that they are in this role for 48 days a year and each clinical advisor for 24 days a year. The policy manager for eating disorders within the Scottish Government can support the network but their role is wider which also limits their capacity. 

The network’s membership has a range of people who were involved in the national review for eating disorders in Scotland and subsequent implementation group and have also invited clinicians who chair and/or represent wider networks within the eating disorders field. However, there are still gaps in dietetics and adult mental health nursing representation. 

Members of the network are expected to represent wider networks they are part of and it was highlighted that members must keep their other networks updated on the work of this network. The national eating disorder network will have around 20 members with working groups being formed to progress tasks.

Terms of reference (ToR)

There has been enthusiasm to join the network but there has been a misunderstanding of the purpose of the network being similar to a managed clinical network (MCN). The chair clarified that this is not the case, however, it is likely that we will create smaller sub-groups which will have wider representation. 

Action

The chair is seeking advice regarding inviting additional members to represent dietetics and adult mental health nursing, ideally from the west or south east or west of Scotland. 

The chair asked members to consider how best the network could communicate its purpose effectively. If members have links to other relevant groups that would be beneficial for network members to attend, please inform chair and Scottish Government.

Action

Members to feed back to chair and Scottish Government what networks and groups they are part of that would be good for the network members to attend.

The draft ToR was presented to members, including responsibilities for members of network.

No concerns were raised by members and all were content with the draft ToR. Therefore, the ToR is agreed by members. 

A point was made around ensuring timely payment of members of network where appropriate. Scottish Government officials confirmed appropriate payment of members was being arranged.

National specification for the care and treatment of eating disorders in Scotland 

The chair gave an overview of the process for consultation analysis up until now. 

A summary of analysis of consultation was given. In terms of next steps, feedback from the consultation, the lived experience panel, and Scottish Government’s core mental health standards will be collated and applied to draft specification. This will be shared with the national specification working group and the network before final publication in autumn 2024. 

It is recognised that the specification is ambitious and was written with the view that this is the care that patients should expect to receive, and acknowledged existing current resource and workforce pressures to take forward implementation of the Specification.

Priorities of network and work plan for 2024-2025

The network was asked to think about how to make the most of the budget to support delivery of specification within the current means.

Any communication to clinicians and service providers needs to acknowledge the ambition and reality of the specification delivery and the challenge of doing this under current pressures. Some clinicians are positive about the specification being published and the support this will provide them with, to work towards improvement in service delivery and collaboration between services. 

Expectations need to be managed in terms of patient expectations and public communication around this. As explained previously by the national review of eating disorder services, this will be an implementation plan spanning over the next ten years. Chair suggested that it would be beneficial to share good practice that is happening across Scotland to support services. Suggestions include:

• newsletter on network to explain its purpose, current focus and workplan, and share what is going on across Scotland. Communication and sharing of excellent work happening currently under pressures, promote and support sharing of positive practice and how we can support boards to improve services. SupportED is keen to support communication around good work and to highlight what they do/support with. ScotFED would be good forum to attend to communicate the work of the network
• support facilitation of three regional meetings over this financial year to bring together people working on eating disorder services
• public communications to explain that we are preparing for publication of specification
• NHS inform to improve and update patient facing information. NHS inform will set a day to work on pages over coming months

Actions

• members were asked to think about how best the network could communicate its work and advise of any colleagues who would be willing to support
• members to consider being involved in this work, or get in touch with colleagues who would be willing to support. If interested, email the chair and Scottish Government officials

Training and education: to improve access to training across Scotland via Turas website. The NES matrix has just launched for eating disorders with descriptors and information for different disorders. There might be an opportunity to draw on some of that work which has already been done and also to support consistency in messaging for NHS inform. Turas is available for everyone, not just NHS staff. Highlighted that ‘MyApp: my mental health within right decisions Scotland’ will have eating disorder information available nationally once app is live. Similarly, there is an Australian national eating disorders collaboration webpage which is a transparent central point for everyone including people with lived experience through to clinicians. Also, the peace pathway website includes support for people with lived experience and information and resources for different populations.

Need to be conscious about communication and message around division between webpages/information available for lived experience, and those for clinicians. Discussed what the network’s priorities would be and what would the aim be in next year; developing the Turas and the NHS inform webpages are found to be achievable relatively quick. 

Digital work update – NES

NES provided update on Turas options in terms of creating page for eating disorders education and training. The specification will be sent to NES to build the Turas page. A quality assurance process will need to be developed around this and a small advisory group could possibly be established to support that. Need to consider longer term plans for maintenance and update when required. 

Medical and physical monitoring work also needs to be considered and how that is supported. Current provision and gaps in provision in training and education need to be considered as well as identify what is currently available on Turas. Benefit of Turas is that training can be monitored in terms of what staff have undertaken what training.

Action

Members were asked to consider being part of a training and education working group to take forward this work.

Any other business and close of meeting 

The chair will be in touch with members to form working groups to progress tasks before the next network meeting in September. 

Working groups which we hope to form as soon as possible are:

• NHS Inform working group (general eating disorders, anorexia, bulimia, binge eating disorder) 
• training working group

The chair closed the meeting.