NHS eating disorder services ‘failing to hit waiting time targets for children’

NHS eating disorder services are failing to hit key waiting times targets for children and teenagers, new analysis shows.

Experts from the Royal College of Psychiatrists warned that children are falling through the gaps and becoming much more unwell while they wait for treatment.

Delays to getting help are causing children with eating disorders “physical and mental harm”, while services are not always set up properly to manage their needs, the college said.

It argued that psychiatrists were able to identify many of the root causes of eating disorders, including neurodevelopmental conditions such as autism and attention deficit hyperactivity disorder (ADHD), but a lack of capacity in the system prevented this from happening.

NHS England set a target that, by 2020/21, some 95% of children and young people with an urgent eating disorder referral would be seen within a week, and 95% of less urgent cases would be seen within four weeks.

But analysis by the Royal College of Psychiatrists found these standards had not been achieved nationwide across England since they were introduced.

From October to December 2023, some 63.8% of children and young people needing urgent treatment from eating disorder services were seen within one week, while 79.4% of less urgent cases were seen within four weeks.

Between April and December 2023, on average 6,073 children and young people per quarter were referred to Child and Adolescent Mental Health Services (CAMHS) specialist eating disorders services by their GP – some 2,512 entered treatment on average.

The college warned that long waits were being made worse by a shortfall in the number of trained therapists and eating disorder psychiatrists.

Dr Ashish Kumar, chairman of the Royal College of Psychiatrists’ eating disorders faculty, said: “We know that early intervention is essential if children are to make a full recovery from an eating disorder, but we simply do not have the resources.

“It is dreadful that so many children are becoming seriously ill while they wait for eating disorders services.

“We need a renewed focus on recruiting and retaining child and adolescent psychiatrists, including those who specialise in eating disorders and neurodevelopmental conditions.”

Dr Kumar told the PA news agency there were many children’s eating disorder services who had no psychiatrist working in their teams.

While Government money in the last few years had been aimed at recruiting more staff to meet demand, the cash was not reaching the front line, he added.

“As a result, we are lacking in training staff, we are lacking in recruitment of newer staff and trained psychiatrists – the psychiatry workforce is dwindling because of lack of investment in training placements,” he said.

“And there is a lack of workforce in psychology, therapy, nursing, dietetics and cognitive behavioural therapy (CBT). If you do not have all the team functioning together, you cannot treat these complex disorders.

“This is like a chicken-and-egg situation: if you do not invest, you do not have expansion of the services and you do not meet the targets.

“And if you do not do that, then the patient waiting list increases and there is damage to patients, their families, society and our economy as well.”

Dr Kumar said patients waiting too long for treatment for conditions such as anorexia and bulimia could suffer damage to their bodies, such as heart problems, severe digestive issues, depression and anxiety.

He added: “This has a severe, adverse impact on their education, their jobs, their personal life, social life and their family life.”

According to the charity Beat, 1.25 million people in the UK have an eating disorder.

Tom Quinn, Beat’s director of external affairs, said: “Eating disorders, if not treated quickly, can have life-changing consequences and we must make sure every child gets the help they deserve.

“The NHS’s own survey shows the massive increase in eating disorders: from 0.8% of 17 to 19-year-olds in 2017 to 12.5% in 2023.

“Clinicians are going above and beyond to care for as many patients as possible, but eating disorder services are hugely overstretched and simply don’t have the funding or staff to meet this increase in demand.”

An NHS spokesperson said: “Over the last year, referrals from young people for eating disorders increased by almost half, and the NHS is clear that improving care for people with an eating disorder is vital.

“That’s why, since 2016, investment in children and young people’s community eating disorder services has risen every year, with an extra £54 million per year since last year.

“Extra funding continues to enhance the capacity of community eating disorder teams across the country and that is in addition to rolling out hundreds of NHS mental health teams in schools to help improve early access to support.”