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Problems across care pathways in specialist adult eating disorder services

Glenn Waller

*Eating Disorders Service, Vincent Square Clinic, Central and North West London NHS Foundation Trust, Osbert Street, London SW1P 2QU, and Institute of Psychiatry, London, e-mail: Glenn.Waller{at}iop.kcl.ac.uk

Ulrike Schmidt

SLAM Eating Disorders Service and Institute of Psychiatry, London

Janet Treasure

Guy’s Hospital and Institute of Psychiatry, London

Katie Murray and Joana Aleyna

Institute of Psychiatry, King’s College London

Francesca Emanuelli

Department of Psychology, University of East London

Jo Crockett

Department of Psychology, University College London

Maria Yeomans

Audit Information and Analysis Unit, London, Kent, Surrey, Sussex, Essex, Bedfordshire and Hertfordshire

Declaration of interest

None.

AIMS AND METHOD

Despite considerable knowledge of outcomes for patients who complete treatment for eating disorders, less is known about earlier stages in the treatment journey. This study aimed to map the efficiency of the anticipated patient journey along care pathways. Referrals to specialist eating disorder services (n=1887) were tracked through the process of referral, assessment, treatment and discharge.

RESULTS

The patient mortality rate was low. However, there were serious problems of attrition throughout the care pathways. Of the original referrals where a meaningful conclusion could be reached, in approximately 35% the person was never seen, only half entered treatment and only a quarter reached the end of treatment.

CLINICAL IMPLICATIONS

This study demonstrates considerable inefficiency of resource utilisation. Suggestions are made for reducing this inefficiency, to allow more patients the opportunity of evidence-based care.




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