Quality statement 1: Early assessment and treatment

Quality statement

People with suspected eating disorders who are referred to an eating disorder service start assessment and treatment within 4 weeks for children and young people or a locally agreed timeframe for adults.

Rationale

People with eating disorders have better recovery rates and a reduced risk of relapse when they receive early intervention in eating disorder services. Early intervention may also reduce the need for hospitalisation, which would be cost saving. Delays in starting assessment and treatment can affect response to treatment, with a longer delay having a greater effect on outcomes.

Quality measures

Structure

Evidence that local referral pathways are in place for people with suspected eating disorders to start assessment and treatment within 4 weeks for children and young people or a locally agreed timeframe for adults.

Data source: Local data collection, for example, service specifications. NHS England's 2015 commissioning guide Access and waiting time standard for children and young people with an eating disorder includes details of referral to assessment and treatment times for children and young people with suspected eating disorders.

Process

a) Proportion of children and young people with suspected eating disorders who start assessment and treatment within a maximum of 4 weeks from first contact with a designated healthcare professional.

Data source: Local data collection, for example, audit of electronic records. Mental health services dataset (MHSDS) v3.0 and Strategic Data Collection Service include data items on access and waiting time for children and young people. NHS England's 2015 commissioning guide Access and waiting time standard for children and young people with an eating disorder includes details of referral to assessment and treatment times for children and young people with suspected eating disorders.

b) Proportion of adults with suspected eating disorders who are assessed and start treatment within locally agreed timeframes.

Data source: Local data collection, for example, audit of electronic records. 

Outcome

a) Length of time from referral to assessment and start of treatment at an eating disorder service for children and young people with suspected eating disorders.

Data source: Local data collection, for example, audit of electronic records. Mental health services dataset (MHSDS) v3.0 and Strategic Data Collection Service include data items on access and waiting time for children and young people. NHS England's 2015 commissioning guide Access and waiting time standard for children and young people with an eating disorder includes details of referral to treatment times for children and young people with suspected eating disorders.

b) Length of time from referral to assessment and start of treatment at an eating disorder service for adults with suspected eating disorders.

Data source: Local data collection, for example, audit of electronic records. 

c) Rate of recovery for people with eating disorders.

Data source: Local data collection, for example, using the eating disorder examination questionnaire (EDE-Q 6.0).

What the quality statement means for different audiences

Service providers (such as community eating disorder teams and secondary adult mental health services) ensure that referral pathways are in place for people with suspected eating disorders to access assessment and treatment services within 4 weeks for children and young people, or within a locally agreed timeframe for adults. Service providers should also ensure that healthcare professionals have training in assessment and treatment referral, and have supervision with monitoring of competency.

Healthcare professionals (such as specialists within community eating disorder teams) ensure that children and young people with suspected eating disorders who have been referred to an eating disorder service start assessment and treatment within 4 weeks; adults should start assessment and treatment within a locally agreed timeframe.

Commissioners (such as clinical commissioning groups, NHS England and local authorities) ensure that they commission eating disorder services with the capacity and expertise to deliver assessment and treatment within 4 weeks for children and young people referred to the service with suspected eating disorders. Adults should start assessment and treatment within a locally agreed timeframe.

Children and young people with suspected eating disorders who are referred to an eating disorder service have an assessment of their symptoms and risk factors and start treatment within 4 weeks.

Adults with suspected eating disorders who are referred to an eating disorder service have an assessment and start treatment within a time agreed by the local service.

Source guidance

Eating disorders: recognition and treatment (2017) NICE guideline NG69, recommendations 1.2.1 and 1.2.10

Equality and diversity considerations

People with eating disorders may feel vulnerable when accessing care. Equal access to services and treatment (including through self-referral) for people with eating disorders and their parents or carers (as appropriate) is therefore important regardless of considerations such any physical or mental health problems or disabilities.