National Review of Eating Disorder Services Implementation Group minutes: August 2021

Attendees and apologies

In attendance:

Co-chairs:

• Dennis Robertson and Dr Charlotte Oakley

Members:

• Dr Stephen Anderson
• Dr Annabel Ross
• Dr Fiona Calder
• Mirin Craig
• Gerard Donnelly
• Dr Fiona Duffy
• Dr Joy Olver
• Diane Kane
• Dr Karen McMahon
• Dr Paula Collin
• Dr Helen Smith
• Susan Hynes
• Dr Lesley Pillans

Invited guests:

• Kevin Stewart MSP (Minister for Mental Wellbeing and Social Care)
• Emma Broadhurst and Samantha Turton from Beat

Officials from the Scottish Government were also in attendance. 

Items and actions

Welcome and introductions from Co-Chairs

The Co-Chairs opened the first meeting of the National Review of Eating Disorder Services Implementation Group.

They invited Members to introduce themselves and to provide a brief description of their background and interest in taking forward the recommendations from the National Review of Eating Disorder Services.

Welcome from the Minister for Mental Wellbeing and Social Care

The Minister for Mental Wellbeing and Social Care, Kevin Stewart MSP, gave an introduction and welcomed the Members to the first meeting of the Implementation Group. The Minister emphasised the importance of implementing the recommendations from the National Review of Eating Disorder Services and the importance of lived experience being at the heart of any actions that the Group takes forward. 

Overview of National Review of Eating Disorder Services and recommendations

The Chair gave an overview of the National Review of Eating Disorder Services. They outlined the short, medium and long term recommendations from the Review, highlighting Recommendation 2: Implementation Planning, which is the focus of the Group’s work:

The Implementation Group should take forward the task of planning the implementation of the recommendations with all stakeholders. This should be informed by the data provided in the appendices. The Implementation Group should provide clear plans and timelines for:

• developing quality standards in eating disorders for Scotland
• develop a skills and competency framework and training strategy
• finalise the costing of the changes recommended
• agree a national eating disorder dataset
• plan for consistent data collection across Scotland

They highlighted the National Review’s vision for eating disorder services and reiterated that this should be at the forefront of member’s minds as the Group’s work progresses:

The review’s vision for eating disorders includes the following principles:

• there is early identification of everyone with eating disorder symptoms and clear signposting to the right level of intervention to prevent disease progression
• there is a whole system approach to treating and supporting those with eating disorders and their families and carers
• there is an emphasis on self-management and peer support available to all
• the physical, as well as mental, health aspects of care are seamlessly and robustly treated
• specialist treatment is equitably available across Scotland, is easy to access and is focused in the community. It should be of the highest quality based on best available current research evidence and fully equitable to all and not dependent on diagnosis, weight or other severity measures
• all services work with people with eating disorders holistically, as individuals, maintaining hope irrespective of illness duration and other diagnoses
• families and carers are given a high level of support from the start of their loved ones eating disorder, and for as long as they need it
• services, including different specialties, work efficiently together to support comorbidities, putting the patient at the forefront of care

They emphasised that the implementation group’s job is to enable the implementation of the recommendations  and the group will not revisit any of the extensive work already undertaken in making the recommendations. They explained that after the Implementation Group’s work has concluded, the remit of work will be handed over to a National Eating Disorder Network, to be set up by the Scottish Government.

Discuss and agree terms of reference

The group discussed the draft terms of reference.

It was queried whether the lived experience panel will be represented in the group.  The co-chairs outlined that the lived experience panel would be able to nominate a representative to contribute to the Implementation Group.  

Scottish Government officials will act as the Secretariat for the group and support with project management.

It was confirmed that all group documents and meeting minutes will be approved by members before being published online.  

Members were encouraged to share and consult with their professional groups and networks maintaining wider engagement for the work of the implementation group. 

Members agreed that they were happy to approve the draft terms of reference.

Overview of Scottish Government funding to Beat

Emma and Samantha from Beat gave a presentation on the services that Beat are working to provide over the next year.

Beat emphasised that they provide non-clinical support, taking lived experience into account and building evidence-based support and resources. Their focus is on early intervention.

Scottish Government Funding will support the following new services: 

• a dedicated helpline for Scotland which will be active from 4 October 2021
• Nexus, support for carers by Beat advisors
• Synergy, direct advisor support to under 18s and their families
• Solace, additional clinician-led weekly peer-support Zoom groups for carers and loved ones
• Motivate, coaching support for people with anorexia and bulimia who are unable to access services
• Bolster, coaching support for adults with disordered eating unable to access treatment

Two training courses:

• Coping with Celebrations (two sessions over Zoom for carers to help plan the challenges which come with celebration days, meal planning etc)
• Developing Dolphins (five weekly sessions for carers to find out more about eating disorders and recovery)

Beat clarified that the above courses are free at the point of access and they are open to advice on how places on the services will be allocated. They advised that they could easily move allocated places between services, to ensure that if one service is more popular than another then more can access that service. This will be monitored throughout the year. 

It was raised that equity of access to the above services should be addressed and considered.

Beat are also able to collect and share data with the Implementation Group. It was raised that the early intervention nature of Beat’s services should be taken into account when analysing any national eating disorder data.

A member raised that Beat might want to link in with the University of Edinburgh in relation to the monitoring and evaluation of the services to ensure that the services that are provided can be effectively measured. 

A member raised that it would be important to understand other local support available to those with an eating disorder and their families. Due to in person support groups offering different support to what Beat is providing. It is important to understand how we connect this type of support together and to understand the pathways between, so that people can access the right type of support for them. 

Overview of Scottish Government funding to NHS Boards

The Chair confirmed that NHS Boards have been informed of funding allocations and allocation letters will be issued to Boards shortly, and that feedback from this funding would be shared with the Group as we receive it. 

Priorities for the Group over the next year

The Chair identified areas where establishing working groups might be beneficial. These were based on the 5 actions that were mentioned previously, and included workforce, training and data. 

The secretariat confirmed that funding was available to support working groups to progress their aims and also outlined that they were available to support these working groups too.

In relation to discussions around eating disorder training the representative from NES raised that it would be useful to understand frameworks that have already been progressed for Children and Young People’s Mental Health and Mental Health in general, so as to not duplicate work. They also raised that it would be useful to focus resource going forward on a critical elements training plan based on the best available evidence base and information from relevant frameworks and guidance.

Members also raised that it was important to include representatives from Public Health, Education and the Third Sector in the group too. The co-chairs confirmed additional agenda-specific guests will be invited to future working groups to address potential knowledge gaps.

The co-chairs asked members to think about the different working groups and which they could contribute to. Members were asked to send their feedback to the secretariat of the Group by 8 September.

Members confirmed they were happy with the priorities identified.

AOB and close of meeting

The Co-Chairs thanked the members for their participation and advised that the minutes and associated papers would be sent to members in the coming week.

The meeting closed at 11:30.