Lack of staff meant eating disorder patients were told they were not ill enough for treatment

PUBLISHED: 09:52 09 April 2019 | UPDATED: 14:52 09 April 2019

Beat charity CEO Andrew Radford.

Beat charity CEO Andrew Radford. Picture: ANTONY KELLY

Archant Norfolk 2016

A national eating disorder charity which is based in Norwich has slammed the organisation which treats adults in Norfolk for telling patients they are not ill enough for treatment.

Dr Ian Hume. Photo: ArchantDr Ian Hume. Photo: Archant

Beat, which is based in Rosary Road, made the accusation ahead of Norfolk County Council’s Health Overview and Scrutiny Committee (HOSC) meeting on Thursday.

The charity took aim at the fact the Norfolk Community Eating Disorder Service (NCEDS) is only able to accept patients who are classed as having a severe eating disorder, due to a lack of staff.

The decision was made in November last year in order to keep patients safe.

But in practice this means patients must have a body mass index (BMI) of below 15 in order to qualify for treatment

Sarah Middleton who has suffered with anorexia for 30 years. Photo: Neil DidsburySarah Middleton who has suffered with anorexia for 30 years. Photo: Neil Didsbury

And even then there are long wait times to be seen, leaving GPs in an “insidious position” of being responsible for patients they may not be equip to treat.

A document prepared by Beat said: “We are seriously concerned about access to treatment for adults with eating disorders and their carers in Norfolk, as well as the staff of NCEDS who must be under immense pressure, given the low capacity of the service.”

Documents revealed NCEDS, which is run by Cambridge and Peterborough Foundation Trust (CPFT) had struggled to recruit therapists for around 12 months. There had been four unsuccessful recruitment campaigns and temporary staff were also in short supply.

But a fifth round had found new members of staff, and NCEDS hoped to lift restrictions on access by July.

However for now Beat said: “The limited capacity of NCEDS means that in practice most adults with an eating disorder in Norfolk will be unable to access specialist treatment. We would like to highlight to the commissioners that when treatment is only accessible to the most severely ill, this sends a terrible message to people with eating disorders that they are not ill enough to deserve treatment.

“Access based on BMI can encourage those who are desperate for help to try to lose more weight. It is also a false economy because of the severe deterioration that is likely as people wait for treatment, often leading to planned or emergency hospital admissions.”

Sarah Middleton, 62, and from Norwich has lived with anorexia for more than 30 years.

She previously said there was a chasm where patients were not deemed ill enough to access help, but too ill for support from charities.

She said: “You’ve just got nothing between the really low end of the scale of help and hospital. Unfortunately we’re playing with death. You have to get your body down to a weight which is dangerous and almost shuts down to get help, I don’t particularly want to get down to that.”

The charity said this meant those not able to get treatment relied on GPs or other non-specialists, who might not be able to spot the signs of deterioration.

Dr Ian Hume, medical director at Norfolk and Waveney Local Medical Committee (LMC) - which represents GPs - also highlighted “significant inadequacies” with the service.

He said as on January 3 this year there were 27 patients waiting to be assessed, with an average wait of 60 days. Some 55 patients were waiting for treatment, with an average wait of 25 weeks.

There were 91 patients in treatment and 10 patients who needed a specialist in-patient bed, but none were available.

Dr Hume said: “The service waiting times for assessment and treatment have become extreme because of the staffing shortage and therefore the decision was made in November to raise the threshold of the service.

“This decision passes the workload and responsibility to manage these vulnerable patients to general practitioners and is risking them working over and above their levels of competency.”

He said the LMC felt it put GPs in an “insidious position” and was a “clear risk to patient safety”.

A spokesman for the clinical commissioning groups added: “We are pleased that CPFT has successfully recruited new clinical staff and therefore we expect the service to resume its normal operating criteria by the summer. This is good news for patients and we would like to thank our GPs for assisting with the situation of recruitment issues at a specialist level.”

A CPFT spokesman said: “We have no direct comment to make on any statements made by Beat, but we work very closely with all organisations involved in the support of people with eating disorders.

“Our Norfolk Community Eating Disorders Service is a small but highly specialised team, and our dedicated clinicians prioritise patients according to need and clinical risk.

“Eating disorders, such as anorexia and bulimia, are a complex area of mental health and while recovery is possible research has shown that around 20pc of people continue to suffer chronically. The recruitment of experienced, qualified staff is also challenging, not just for us but for trusts across the country.

“It should be noted that figures from NHS Digital recently showed the number of hospital admissions for eating disorders had doubled in six years, with 16,000 people admitted in the year to April 2018.

“While we continue to lobby at the highest level for improved resources, the issues around eating disorders are more than just an NHS problem to solve. It will take all those with an interest in eating disorders to work together to reduce the worrying increase in the number people requiring support.”

What is BMI and is it helpful?

BMI is worked out using your age, weight and height, giving you a score.

The measure was first created in the 1800s and by the late 1900s had been adopted by governments as a way to assess weight - the NHS says a BMI of between 18.5 and 24.9 is healthy.

But researchers and health experts have increasingly said it is not the perfect measure. A 2016 study by scientists at UCLA found tens of millions of people whose BMI showed they were overweight or obese were perfectly healthy.

They also found 30pc of people with healthy BMI scores were not actually in good shape.

It has also been questioned whether using BMI as a indicator of an eating disorder was helpful.

MP Wera Hobhouse said last year: “Judging an eating disorder by BMI isn’t good enough.”

And she added doctors relying solely on BMI guidelines were “failing patients”.

CPFT was approached for comment.

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