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. 2019 Jul 12;5(4):e59. doi: 10.1192/bjo.2019.48
Primary care versus secondary care
The ideal service for individuals with eating disorders and family/friends:
  1. the ideal professional:
    1. has sufficient knowledge and experience of eating disorders,
    2. is professional and confident,
    3. is available and consistent and respectful, empathic and trustworthy,
    4. is a person to build a therapeutic relationship with;
  2. the ideal setting/technique:
    1. is somewhere that feels safe and supportive,
    2. offers an individualised, yet collaborative approach to treatment,
    3. is consultative yet directive with individuals with eating disorders and family/friends.
Specialist versus complexity of eating disorders:

  1. eating disorders are both specialised and complex in nature, thus immediate referral to specialist care is generally considered the ‘best’ approach;

  2. but over-referring can result in long waiting lists, delays and limited access;

  3. this ‘best’ expectation of specialist care as superior undermines all other services;

  4. a better system, which can be available to all, requires a multidisciplinary, shared-care approach;

  5. this approach requires services across the interface to be more responsive to each other, and upskill a range of professionals to fit with the ‘ideal’ vision of services proposed by individuals with eating disorders and family/friends.