Table 3.

Survey responses on whether the 13 adult community eating disorder services met the NHS England commissioning guidance for adults with eating disorders⁶

Survey statement	Able to meet standard?
	Yes	Partially
Referrals of all presentations of eating disorders are accepted, regardless of length of illness, severity or BMI	31%	0%
Evidence-based treatment, care and support is offered for all eating disorders, including BED, ARFID and OSFED	54%	0%
The service has capacity for managing risks safely	62%	38%
The service has capacity to follow-up patients (e.g. who are not engaging, not attending appointments) and avoids inappropriate discharge	46%	54%
The prevalence of eating disorders and demand for services in the local area has been assessed using e.g. the Public Health Fingertips Tool	15%	15%
The service/trust offers intensive day-patient treatment for patients with eating disorders	85%	0%
The service received an increase in annual recurring investment over the last 5 years since 2014–2015	38%	0%
Access to care is equal regardless of whether a person presents for first time or with a long-term eating disorder	77%	23%
Individuals can self-refer to access the service, including when re-presenting at first sign of relapse	23%	8%
The service has a waiting list for treatment	92%	8%
Commissioners develop and implement local plans in collaboration with people with experience, service providers and partner agencies	54%	15%
The service has the capacity to take responsibility for outreach, follow-up and engaging with people who are reluctant to receive treatment	46%	8%
If a patient is reluctant to engage, and there is evidence of recent deterioration or severe risk, support is offered indirectly by engaging patients’ families, partners, carers or members of their support network	77%	8%
The service provides full medical monitoring (including blood tests and ECGs with same-day results)	38%	31%
The service has an agreed protocol with primary care services to ensure physical assessment and monitoring of patients	23%	62%
The service has support from acute medical care, including emergency admissions	54%	46%
The service remains the lead in providing care, working closely with in-patient staff from the start of the admission to discharge, to ensure persons receive appropriate levels of treatment	54%	46%
Intensive community treatment is offered as an alternative to in-patient treatment	38%	46%
For age-based transitions, the service works with the relevant CEDS-CYP team for a minimum of 6 months before planned transitions	38%	39%
The service has sufficient capacity to ensure seamless transition for people needing in-patient and day treatment, including admission and discharge planning, i.e. with psychological therapy and social components included	38%	46%
For geographical transitions, the service has capacity to work closely with primary care providers, ACEDS in other areas, and university mental health services to ensure seamless transitions and avoid gaps and delays in handovers of ongoing care and treatment, including for students during holiday times	38%	31%
Staff have specific training and skills to support patients with diabetes and diabulimia	23%	54%
Treatment is available and can be adapted for those who experience comorbid conditions, such as autism, substance misuse or personality disorders	38%	62%

BMI, body mass index; BED, binge-eating disorder; ARFID, avoidant/restrictive food intake disorder; OSFED, other specified feeding or eating disorder; ECG, electrocardiogram; CEDS-CYP, child and adolescent eating disorder services; ACEDS, adult community eating disorder services.