Welsh eating disorder services still a postcode lottery, new Beat report finds

Beat’s new report, ‘The Welsh Eating Disorder Service Review: 3 years on’, investigates progress made since the 2018 review was submitted to the Welsh Government.

The 2018 review revealed that eating disorder treatment in Wales was often only available to people who were severely ill, and that the availability and quality of services differed widely across the nation.

Beat’s report finds that while some progress has been made to expand and improve services for the 60,000 people in Wales with an eating disorder, this progress has been very uneven.

A lack of funding is one factor that has contributed to the uneven progress of eating disorder services in Wales.

Beat’s National Officer for Wales, Jo Whitfield said, “Eating disorders are serious, complex mental illnesses that can be extremely distressing for those with the illness as well as their families.

At Beat, we experienced over 220% more people from Wales contacting our support services between April 2020 and March 2021 in comparison to before the pandemic, and we are saddened that many individuals, carers and families across the nation are not getting enough support.

Workforce falling short of demand

There has been some additional investment since 2018, but over 55% of healthcare staff and volunteers who responded to Beat’s survey said that a lack of workforce funding was having a ‘significant’ or ‘very significant’ impact on the ability to treat every young person with an eating disorder.

Since 2018, some areas have broadened access to treatment by establishing new specialist teams for Child and Adolescent Mental Health Services (CAMHS) or by expanding adult teams.

However, in other areas in Wales, specialist support is still only available for people who are already severely ill, and access to treatment for binge eating disorder and avoidant/restrictive food intake disorder (ARFID) continues to differ dramatically across the country.

Quality treatment is needed now more than ever, with clinicians reporting that they have been seeing many more people with eating disorders during the pandemic.

Clinicians are also concerned about people deteriorating as they wait for treatment.

A key message of the 2018 review was that families and carers can play a vital role in their loved one’s recovery if they are fully informed, supported and empowered.

Responses from clinicians suggest that support for families differs widely across Wales, and Beat’s report finds that that there is still not a formal process in place to ensure that carers are always involved in the development of services.

Beat’s report also found that investment in specialist adult community eating disorder services increased by just 1% in real terms between 2018/19 to 2020/21, and health board spending on these services varied widely.

The way forward

To ensure equal progress and improvements in eating disorder services across the nation, Beat has created key recommendations for the Welsh Government and NHS Wales. These include:

• Publishing a new plan – complete with timelines –  for achieving the vision of the 2018 eating disorder service review, so that everyone affected can access effective help quickly.
• Extending the ‘National Clinical Lead for Eating Disorders’ position permanently. Dr Menna Jones, who held the position until the post ended in December 2021, provided valuable support to health boards, clinicians and services across the country. It is vital that this progress continues.
• Improving its guidance on the extra funding it provides for mental health services and holding health boards to account over their total investment in eating disorder services.
• Ensuring that people with lived experience of eating disorders, including families and other carers, are always involved in helping to improve services in Wales.

Jo added, “We know that accessing the right treatment quickly leads to the best chance of making a full recovery, and it is encouraging to see that some progress has been made.

“Implementing our recommendations would enable the Welsh Government and NHS Wales to transform these services across the whole nation, ensuring that everyone affected in Wales can access life-changing support quickly.”

Dr Menna Jones, the National Clinical Lead for Eating Disorders until December 2021 said, “There has been considerable improvement in services for children, young people and adults with eating disorders in Wales since the publication of the eating disorders service review in 2018.

This progress was accelerated further when the Welsh Government provided dedicated funding for the first time for a national lead role in eating disorders, and it has now been confirmed that funding will be continued for the next year for a national lead in eating disorders.

“Beat’s report is extremely helpful in identifying where there continues to be variability in what services are available in areas across Wales and helps to ensure that meeting the needs of all people with eating disorders and their families remains a high priority.”

Dr Jacinta Tan, lead author of the 2018 Welsh Eating Disorder Service Review, added, “The Welsh Government has demonstrated its continuing commitment to provision of excellent, equitable, effective and evidence-based NHS services for everyone who has an eating disorder in Wales and their families and loved ones.

“I would like to join Beat in calling for continued commitment to a permanent National Clinical Lead post for eating disorders to spearhead change at a greater pace with more consistency across Health Boards; greater commitment to the financial cost of achieving this; clearer timelines and milestones which will help clarify goals and reduce variation across health boards; and clearer involvement of experts by experience in all aspects of the national service changes.”

Resources

• NCMH leaflet | Eating disorders
• Beat Ed | Downloads and Resources

Read more

• NCMH | Eating disorders
• NCMH blog | Eating disorders: coping at Christmas
• NCMH blog | The rise of male eating disorders
• Beat blog | My only regret about treatment is that I didn’t access it sooner