Eating disorders: national network minutes - September 2024

Attendees and apologies

• Cathy Richards, Chair
• Katherine Morton, Clinical Advisor to the Network
• Fiona Duffy, Clinical Advisor to the network
• Alex Jones - Beat (National Lead for Scotland)
• Linda Keenan, Manager, MCN for Eating Disorders - North Scotland.  Representing North of Scotland
• Sam Aitcheson. Consultant Clinical Psychologist & Chair of Lead Psychologists in Adult Eating Disorder Services in Scotland (LPAEDS)
• Ruairidh McKay, Consultant Psychiatrist, REDU
• Fiona Calder, Head of Programme CAMHS 
• Carol Morgan, Carers Support worker, Dudhope CAMHS
• Tina McGilton, NHS Grampian
• Diane Waugh, SupportED
• Louise Johnston, NHS Grampian
• Rachael Smith, NHS Grampian
• Lesley Pillans, NHS Grampian

Items and actions

Welcome & introduction

The chair opened the meeting and welcomed attendees. Leah Christmas, who is working with Scottish Government from UK Government fast stream was introduced and is attending for observation purposes.

Specification update

The group was updated on the service specification in light of consultation responses and feedback from lived experience panel. Some concerns were shared around the timeline for delivery of the specification. This has led to clarification of the timeline for the specification being up to ten years to be fully delivered with an expectation that boards and regions will have annual plans re the improvement in order to deliver the specification .

An update was also shared from scottish government on the process of the signing off the specification, including updating the minister and organising publication.

Chair updated plans to launch specification with stakeholders and holding an event to do this. The development of an implementation plan will begin in this meeting , including possible tests of change, comparison to other examples of working across UK.

How the specification relates to eating disorder  services and also around the self-referral element of eating disorder services were discussed.

Specifics of transitions all age services will be considered and discussed during implementation planning. The chair made point that scottish government would not want to direct NHS boards on how to do this, but rather ensure support and guidance is in place for boards to deliver appropriate care for their population.

Communication plan

Chair sought network’s views on how we communicate with stakeholders about the work of the network. The chair also highlighted that we should communicate the network chair and clinical advisor resource of 0.4wte when engaging with stakeholders in order to manage expectations re capacity.

Newsletter

Chair shared that she will be producing the newsletter from the network and that there has been a very positive response when asking for content from colleagues. The hope is that a new newsletter will be produced to coincide with each meeting of the network highlighting improvements and communicating the work of the network. It will also include training offers that are available in order to raise awareness of them.

The network agreed that the newsletter was useful with interesting and valuable content and will help with raising awareness of different work going on around the country.

Chair agreed that it would be very helpful to flag the existence of the newsletter to relevant 3rd sector groups both in terms of sharing the content with them and also offer them the opportunity to contribute content for the newsletter.

Regional Meetings

Katherine Morton (KM) updated the network on regional meetings. Meetings are being considered in south east and west scotland with an aim to develop local networks representing CAMHS and adult eating disorder services in regions to share good practice, quality improvements and consider a more collective approach to problem-solving. The regional meetings will also be an opportunity to create more informal connections. The planned dates for the first meetings are 14th November for the south east and 28th november for west.

KM asked the network to consider if the meetings should be held in person, online via teams or hybrid. It was agreed that online meetings would work the best due to travel restrictions and also the challenges of hybrid meetings.

Action 

The network was asked to suggest any individuals (including members of the network) from CAMHS and adult mental health from regions who could help to plan an initial agenda.

Chair suggested the Alex Jones (AJ) and Diane Waugh (DW) should be involved. It would also be useful to learn from the north scotland MCN and their experience of regional meetings. The network would facilitate the november regional  meetings with a view to them being handed over to regions if  the regions think they add value.

Action

The chair asked the network members to share any exiting networks and stakeholder groups that they are aware of that chair, KM or Fiona Duffy (FD) could be invited to share the work of the network.

Diane Waugh informed the network of a meeting of the supportED eating disorder advisory group on 26th september and to contact her if anyone was interested in attending.

Action

Chair asked the nework to continue to consider further how we may effectively communicate the work of the network across scotland and if they are aware of any individuals or organisations that would be particularly helpful to pass that on. Fiona Calder (FC) highlighted the possibility of engaging with higher education and particularly edinburgh university to see if they may be able to support communications.

Action Fiona Duffy to follow up with Edinburgh university

NHS 24 update

Chair and Advisors working to update NHS Inform eating disorder webpages. This includes working with NHS Inform staff to update information in line with SIGN 164 and highlight 3rd sector supports available to service users and carers. The content developed will be reviewed by the lived experience panel.

This update will also allow for information specifically targeted at carers to be developed as previously there has been limited information available to them on NHS Inform eating disorder webpages.

Training Update

NES

The network was updated by Fiona Calder (FC) on the work of NES CAMHS and adult psychological therapies Team. The update included slides that will be shared forwarded on to the network members.

Action

Fiona Calder to share slides from her presentation with the network

Over past few years they have been trying increase supervision capacity and qualified practitioner capacity in some of main evidence based interventions for children, young people and adults with eating disorders. As part of this, boards with  gaps in training and supervisors have been asked to select clinicians for training and making sure they have time in job plans to access the training.

• Family based treatment for children and young people with eating disorders – 175 completed introductory training since 2021 with 25 having done the year long practitioner training and 12 completed to supervisor level.
• CAMHS CBT eating disorder training has been completed by 165 participants

IPT has also been invested in as it has an evidence base for children and young people with eating disorders. Aiming to have individuals trained to supervisor level. The core CBT training diploma takes approximately 2 years and is a good base before going on to CBT eating disorders.

In 2019 a one-year development programme was created to fill gaps for staff coming into CAMHS. It covers parenting, trauma, physical health, learning disability, behaviour activation, risk assessment. This resource also has a session on eating disorders led by an eating disorders specialist.

• since 2019, 289 clinicians have commenced this training. It has been very popular training with another cohort being planned.

Resources on TURAS have also been refreshed with updated videos on eating disorders, management of wards in paediatric settings and introduction to psychological interventions with children and young people. These will all be useful to CAMHS. There are also large numbers of webinars available on trauma, self-harm, suicide, neurodiversity that were commissioned by the neurodiversity team.

EEATS

Lesley Pillans (LP) updated the network on EEATS and shared that 42 members have completed accreditation and that there are currently 31 trainees and 27 supervisors. Those undertaking the training come from a wide range of speciality areas and also geographic regions. Supervisors meet once per year and there are two trainee days per year which act as a great knowledge sharing and peer support opportunity for participants. The training is also now moving from paper to digital with the website close to going live. This accreditation is largely self-funding with participants paying or their boards paying £400.

 

Linda Keenan (LK) updated on plans for the MCN training date on 3rd November which will have a focus on neurodiversity and eating disorders. FD will be presenting and there will also be a speech and language therapist presenting and presentations on autism and eating disorders. NHS Tayside will also share information on new pathway on autism. Linda will send information on to the Network to allow members to join the training event online and chair also suggested adding the URL of the recording of the event to the newsletter.

Action 

Linda Keena to share MCN training day URL to Network to attend online and link for the recording after the event

BEAT training

Alex Jones (AJ) provided an update on BEAT training to the network. At this time they are focusing on raising awareness and providing short training and resources for primary care and for a wider range of people in the community. The length of time that it takes for people to come into treatment after they become unwell is a concern and they are hoping to help shorten that time through the awareness and training they are doing.

The BEAT website has a selection of short training modules that are pitched at the while multidisciplinary team. These modules could also be shared on TURAS or NHS inform.  

There are also resources for schools and higher education. A press campaign is going to be launched at the start of the university year to encourage university support staff to take up the training available.

There will also be an offering of a one day or 2 half day course called “beyond the symptoms” aimed at primary care mainly rather than eating disorder specialists. Focuses on basic understanding on symptoms of major eating disorders and how that can impact on somebody’s life. Understanding barriers to treatments, why someone may not want to be treated or be reluctant to engage with treatment and how to communicate around that and spot the signs.

• 278 people have completed this training with 145 currently booked in for the next training day.

Training is also commissionable by health boards.

Eating Disorders Network Webinars

Webinars are being organised to align with the ED service specifications . The 1st Webinar is planned for 25th November and will focus on integrating research into practice. FD requested that the members of the Network to share any ideas for future webinars and suggest speakers.

Action

Network to send ideas for webinar topics and speakers to Fiona Duffy

Lived Experience Panel

The network was updated on the lived experience panel by AJ. The panel is tasked with creating a patient and carer friendly version of the national specification so patients and carers can share feedback and input on resources of NHS inform. The panel is currently in the process of finishing recruiting and inducting the panel. Going to be 15 people with 7 from the previous eating disorders panel and 8 new recruits. The first training session will take place on October 8th and first meeting October 15th. The panel will have nine meetings over its lifetime which are to be completed by the end of the current financial year.

Action

Chair to meet with AJ to consider how best to involve the lived experience panel in network meetings.

Eating Disorders / Personality Disorder pathway work

The network was updated by Louise Johnston on the work being carried out around the eating disorders/personality disorders pathway. The response from colleagues around the country has been very positive with a lot of engagement. There have been a number of meetings with stakeholders across the country. A draft of the pathway document is currently underway although there are some gaps around lived experience which AJ has offered to help with. The network will be updated as progress is made on the draft.

Implementation plan

To help the Network input thoughts and views on how best to implement the service specification Fiona Duffy, created a Padlet that network will be able to access over the next few weeks to add their thoughts.

FD asked the Network to consider what needs to be prioritised and how can examples of good work currently underway be drawn on. What resources, data, and best practices are there that can help implementation.

Action – network members to contribute to Padlet shared by Fiona Duffy thoughts on supporting implementation planning for specification  

Rachel Smith (RS) shared information on the mental health remote digital platform. This is a national digital remote health care programme used to gather information from patients as part of remote health pathways. Worked with scottish government to develop service aimed to support mental health service users to submit clinical outcome measures digitally to enable clinicians to monitor treatment outcomes and recovery. Services will be able to enrol patients to complete one or more outcome measures. In theory works across different health boards. subsequent set of measures being considered for potential incremental build to include EDEQ and ED50.

Action - Chris Wright to be invited to the next eating disorders meeting to discuss data and the mental health remote digital platform.

Della Robb (DR) updated on digital infrastructure and data improvement work with NHS GGC that was commissioned a couple of years ago. This work was to ensure more consisted data collection and DR confirmed she would contact Scottish Government colleagues for an update on the CAMHS and psychological therapies national dataset (CAPTND) to share at the next network meeting.

Action

Della Robb to ask mental health directorate data colleagues to attend next network meeting and/or provide update via email to network on CAPTND data collection and eating disorders data within that

Early intervention is important and to help with this in the north of scotland is was ensured that carers had access to the same information. This was done through a padlet and creating a working group which included lived experience carer.

Action

The Chair to include description of padlet in newsletter to share more widely.

AOB and Close of Meeting

Chair closed the meeting requesting that network members take some time to add thoughts to the Padlet shared by FD. The network was also asked to forward ideas for agenda items for the next meeting to the chair.