All eating disorder referrals will be triaged for appropriateness and offered specialist assessment if indicated. We can also provide a liaison service to referrers for advice and consultation.
Assessments are conducted by an eating disorders specialist clinician and are reviewed by the team at a weekly assessment meeting. The assessment procedure includes:
- Biopsychosocial assessment
- Diagnostic and aetiological formulation
- Assessment of motivation and readiness for change
- Psychiatric and medical risk assessment
- Assessment of carers' concerns and needs (where appropriate)
- Formulation of an appropriate care plan, utilising and liaising with primary and secondary services as appropriate
Once assessment has been done, we meet with the patient for a follow up appointment to inform of the outcome of assessment and treatment plan. Following this we send a written assessment report including the care plan to the patient and the referrer and/or GP. Those with sub-clinical eating disorders are offered an assessment letter, advice and self-help book, and where appropriate, treatment recommendations for primary or secondary care.
Patients offered treatment at the Vincent Square Eating Disorder Service will be placed on the waiting list for outpatient, day patient or inpatient treatment as appropriate. The GP/referrer is asked to maintain responsibility for their patient’s psychiatric and medical care until start of treatment at the service. Advice, a self-help book, and where appropriate, treatment recommendations for primary or secondary care will be offered whilst the patient is waiting for treatment.
The service has a liaison team available to referrers for consultation and advises about initial assessment and management, appropriateness of referral and management of risk. The team consists of a consultant psychiatrist, clinical nurse specialists and occupational therapists. Joint assessments and shared care arrangements are facilitated as required. The team can also provide regular training events for primary and secondary care professionals in the assessment and management of eating disorders.
The liaison team provides outpatient care for difficult to engage patients, and people who are struggling to manage medical or psychiatric risk safely. The model of care combines elements of assertive outreach, supportive clinical management, motivational interviewing and cognitive analytic therapy to provide a structured approach to harm minimisation, engagement and therapeutic change.
The service is highly flexible and responsive, with capacity to provide urgent interventions with greater intensity than once a week appointment due to the newly established intensive community treatment team. The style and frequency of sessions is determined by clinical need. For all patients, the goal of this work is to facilitate engagement in a process of active change and not simply to support patients remaining unwell.
Whilst for some patients a complete episode of care may be conducted within the liaison team, others will progress to utilise other elements of the service.