To ask the Minister of Health (i) how many people sought (a) treatment; and (b) support for eating disorders, in each of the past five years; (ii) for his assessment of how successfully eating disorders are being identified and treated by his Department; and (iii) to outline the (a) challenges involved; and (b) future steps that will need to be taken to reduce and eradicate eating disorders.

how many people sought (a) treatment; and (b) support for eating disorders, in each of the past five years;

Community Adult Mental Health Referrals Accepted by Eating Disorder Services by Fiscal Year and HSC Trust, from 2018/19 to 2023/24 year to date (January 2024)

Sources: Monthly Non Inpatient Mental Health Returns from HSC Trusts

*Proxy Figures have been included for the Northern Trust figures for Adult Eating Disorders as shown in red. This is due to limitations in data availability arising from Information System migration from EPEX to PARIS:

2020/21 - Full Year effect based on data up to 24th February 2021 only.

2021/22 - Proxy figures for full year based on average of 3 years data.

2022/23 - Full year effect based on data for February and March 2023.

Proxy figures are include in the regional totals.

Child and Adolescent Mental Health (CAMHS) Referrals Accepted by Eating Disorder Services by Fiscal Year and HSC Trust, from 2018/19 to 2023/24 year to date (January 2024)

Sources: Monthly CAMHS MDS Returns from HSC Trusts

General Caveats /Notes - Please read

1.The figures provided above are the numbers of referrals accepted into Eating Disorder Services for Adults and Children, for the fiscal years 2018/19 to 2023/24 year to date (January 2024). Please bear in mind that figures in 2020/21 are likely to be impacted by COVID-19.

2. The information provided is in relation to referrals, not 'people'. It is not possible to determine whether there are multiple referrals for individuals as the information submitted by HSC Trusts is in an aggregated format and cannot be disaggregated.

3. Belfast Trust provides an Eating Disorder service for residents of the South Eastern Trust area.

for his assessment of how successfully eating disorders are being identified and treated by his Department;

There are currently four adult Eating Disorder Specialist Teams across the five Health and Social Care Trusts. The Belfast Trust and South Eastern Trust is represented by one team. These teams have developed community based psychological therapy services using evidence-based treatments as per National Institute for Clinical Excellence (NICE) guidance. They work to the Regional Care Pathway for the Treatment of Eating Disorders (2016). The care pathway outlines what people can expect if they are referred for treatment and provides summary of clinical advice derived from evidence-based practice. It also includes information to assist people with self-care and accessing other supports before, during and after treatment

The Regional Eating Disorder Network Group (REDNG) ensures local developments are coherent and standardised as far as possible. Representation on the REDNG is lifespan and includes individuals from Strategic Planning and Performance Group, Public Health Agency, Health and Social Care Trusts including, Eating Disorder Service Clinical Leads, Team Leads and Clinical Service Managers, Psychology nominee (nominated on behalf of psychology services in all Trusts) , experts of experience encompassing the voluntary sector, service users and carers, Trust service managers and Department of Health policy representatives. The role of the REDNG is to promote the uniformity of approaches to patients across Trusts and share best practice and learning from service developments. It provides a consistent and equitable approach across NI to the planning and commissioning of high quality, effective and accessible treatment for service users. Standards are based upon those laid out by the Royal College of Psychiatrists and NICE (National Institute for Clinical Excellence). REDNG does currently fulfil that function, aiming to:

improve outcomes for those who require Eating Disorder Services

promote collaborative working between the Strategic Planning and Performance Group, Trusts, Department of Health Policy, Statutory Services and the Community & Voluntary Sector

involve service users and carers in service developments

ensure workforce development and sustainability

address any teaching and training needs

establish/promote gold standard clinical practice

Currently a clinical lead and Network Manager are being recruited for the REDNG in order to support better eating disorder identification and treatment.

to outline the (a) challenges involved; and (b) future steps that will need to be taken to reduce and eradicate eating disorders

Trusts are experiencing challenges and significant pressures as a consequence of increased demands upon services, including increased numbers of new referrals, increased complexity and acuity of people presenting to the service and significant workforce pressures as the result of increased vacancy levels.

Action 29 of the Mental Health Strategy 2021-2031 commits to ensure there are specialist interventions available to those who need it. 29d commits to enhance the regional eating disorder service.

The Mental Health Strategy 2021-2031 notes provision of services for people with an eating disorder, recognising the benefits of REDNG, whilst acknowledging outcomes for these patients could be improved. In particular, evidence suggests that early intervention is key. This means supporting services to offer specialist treatment to all those who are presenting with eating disorders, including mild to moderate cases, without delay.

The Strategy highlights the need for further investment so that eating disorder services can achieve optimum staffing levels and skill mix to deliver effective care across the pathways, to include additional medical, nursing, dietetic, psychology, occupational therapy and social work staff working in the community, and providing in-reach to medical and mental health wards. The Strategy also highlights the need for local in-patient units, medical and mental health, with in-reach and clinical consultation and the need to ensure sufficient staffing levels for the management of high-risk patients with eating disorders.

A business case is in development in relation to Action 29 d and a number of workshops have been held with key stakeholders involved in Eating Disorder Services to shape direction and identify the case for change, based on the current service model, emerging need and setting future vision for the service.