Severely ill eating disorder patients getting least support, says leading expert

Dr Agnes Ayton, chair of the Royal College of Psychiatrists eating disorder faculty, told HSJ that although it was an achievement that services had implemented digital consultations so quickly, for the most severe and high-risk patients this would not work as well.

She also warned that some specialist eating disorder units across the country have had to run below full capacity. This is partly due to the limitations of poor estates, meaning there is a higher risk of infection from covid-19 for those in units.

Her warning comes after a leading charity for eating disorders, Beat, said it has seen a 35 per cent increase in calls to its national helpline since the pandemic began.

According to Beat, anorexia has the highest mortality rate of any psychiatric condition.

Dr Ayton said: “There is a silver lining, in that the transition to introducing technology has happened very quickly and relatively successfully.

“A significant proportion of patients will benefit from that, but patients who are more severe and high risk will have less support because of the danger of the hospital infection and because of the reduced capacity to take patients as an inpatient.”

Discussing the risks associated with specialist eating disorder inpatient units, Dr Ayton said: “With inpatients, the problem we have is a lot of the units, the vast majority, are not really appropriate for containing an epidemic. In my unit, for example, you have shared bathrooms and you can’t easily self-isolate people who are symptomatic.”

“In my unit we can’t run to full capacity because of the environment and if we had a different environment with single en-suite bedrooms and better ability to use hospital infection control strategies it would be easier.”

“I think NHS England will need to review all the estates for inpatient mental units in the future, as there are significant variations nationally.”

HSJ has asked trusts running an inpatient unit whether they have had to restrict admissions, but has yet to receive replies.

NHS England was also approached for comment.

A spokesman for NHS England said: ”The NHS has pulled out the stops to respond to the biggest global health threat in a century, while also ensuring people can still access the mental health support they need, including eating disorder services.

“Where people are discharged, it is to reduce their risk of infection and exposure to covid-19, but only when someone has been risk-assessed as safe to do so - with expert care continuing to be provided in the community, including via digital technology, and if patients are acutely unwell they can continue to access inpatient units.”

This story was updated at 10:55 on 3 May after HSJ recieved a comment from NHS England.