Eating disorders: NHS reports surge in hospital admissions

This aricle was taken from: https://www.theguardian.com/society/2018/feb/12/eating-disorders-nhs-reports-surge-in-hospital-admissions

By Sarah Marsh

Exclusive: Experts say NHS services are failing those in need of help as admissions nearly double in six years

The number of admissions to hospital of patients with potentially life-threatening eating disorders has almost doubled over the past six years, amid warnings from experts that NHS services to tackle anorexia and bulimia are failing to help those in need.

The number of admissions with a primary or secondary diagnosis of an eating disorder reached a peak of 13,885 in the year to April 2017, up from 7,260 six years earlier in 2010-11, according to figures seen by the Guardian. The latest data shows admissions are the highest they have been in at least a decade.

A surge in the number of teenage girls and women in their early 20s lies behind this dramatic rise. The admissions for those aged under 19 for anorexia went from 1,050 to 2,025 over the period examined.

The figures, obtained by the Guardian from NHS Digital, come as the UK’s leading eating disorder charity, Beat, said that calls to their helpline were likely to reach 17,000 in the financial year ending March 2018, up from 7,000 the year before.

Doctors, campaigners and MPs have warned that the rise in admissions indicated outpatient treatment was not working effectively. This was resulting in more people ending up severely unwell and needing to be admitted to hospital.

They also warned that patchy coverage of services meant people were relocating and even selling their homes to get effective care. The Guardian heard from one young woman who had to relocate to Gloucestershire with her mother because she could not return home due to a lack of effective community support.

“What is clear is that the system is not working at the moment. What we desperately need is more money put into community services so people can get support close to home when they need it. This means we can intervene earlier and stop people ending up in hospital,” said Caroline Price, Beat’s director of services.

She added that the admissions data was likely to be the “tip of the iceberg” in terms of how big the problem had become. “We can only get a true handle on this when services improve and assessment for these disorders gets better and GPs refer everyone, not just basing it on their body mass Index (BMI). People are often turned away as they are deemed not ill enough,” she said.

Frances Connan, consultant psychiatrist and member of the Royal College of Psychiatrists described the NHS data as shocking.

“It’s deeply concerning that access to high quality comprehensive community and outpatient eating disorder service remains a postcode lottery. In some areas there are excellent services but in others there is very little and there is no standardised offer across the country … Hospitals should only be for a medical crisis and the mainstay of care should be at home. There is no strategy nationally,” she said.

Concern has also been raised by some parents about the care patients receive while in hospital. Becki Copley, 38, from Newcastle, who now supports other parents after her daughter experienced anorexia, said: “A common problem nationally is that neither parents nor patients are taught about relapse prevention. It is all too often the case children get admitted to inpatient units, who feed them up, and send them back off home. But they don’t give them the coping mechanisms to manage when they are back in the real world.”

She added: “The cycle of discharge and readmission is compounded by inconsistent quality of community-based care teams around the country.“

Experts also noted that social media could be fuelling the rise in eating disorders. “It does not help because of the ways in which it fuels low-self esteem and makes people feel bad about themselves. We all know rationally that whatever goes on social media is the shiny part of someone’s life and beneath that everyone has stuff going on … but when we look only be we can easily feel inadequate and envious,” Connan said.

Price said: “Eating disorders are complex and there is no one particular factor that means you get one, but we feel eating disorders are on rise partly because of the challenges of today’s society. This includes social media and exam pressure. They don’t cause eating disorders; someone will be predisposed to be the type of personality who will develop an eating disorder … Then the challenges of social media and pressure to go to university all those things can compound so someone really does suffer with it.”

Barbara Keeley, shadow mental health and social care minister, called on Conservative ministers to act immediately and halt what she called the “worrying trend” by investing in and ring-fencing mental health budgets so that money reaches the frontline.

Luciana Berger, the Labour MP for Liverpool Wavertree, said: “Record numbers of hospital admissions and a sharp rise in calls to Beat indicates that so much more needs to be done to adequately support people with eating disorders.

“The government must act urgently to reduce waiting times and provide the necessary resources for specialist and intensive community treatment services to prevent patients having to access inpatient care,” she said.

A Department of Health and Social Care spokesperson said: “We are committed to ensuring everyone with an eating disorder has access to timely treatment. We know the numbers seeking treatment are rising and it’s encouraging to see an increase in patients getting routine care within four weeks, as well as a significant improvement in treatment times compared to last year.

“Inpatient treatment should be seen as a last resort, that’s why we have set out plans to expand community-based care for eating disorders – 70 dedicated community eating disorders services are being developed and recruitment to get the teams up to full capacity is under way.”