All eating disorder referrals are triaged for appropriateness and offered a specialist assessment if indicated. We can also provide a community-based consultation service to referrers who need advice or support.
Assessments
Assessments are completed by an eating disorders specialist clinician and reviewed at the weekly assessment meeting. The assessment process includes:
- Biopsychosocial assessment
- Diagnostic and aetiological formulation
- Assessment of motivation and readiness for change
- Psychiatric and medical risk assessment
- Consideration of carers' concerns and needs where appropriate
- Development of a care plan, in collaboration with primary and secondary services as required
After the assessment, the patient is offered a follow-up appointment to discuss the outcome and treatment plan. A written assessment report and care plan is then sent to the patient and their referrer and/or GP. People with sub-clinical eating difficulties are offered an assessment letter, advice, a self-help book and, where appropriate, recommendations for management in primary or secondary care.
Those offered treatment at the Vincent Square Eating Disorders 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 the patient’s psychiatric and medical care until treatment at the service begins. While waiting, patients will be offered advice, a self-help book and recommendations for care where needed.
Community Team
The community team provides advice and consultation to referrers regarding assessment, management, suitability of referral and risk. The team includes a consultant psychiatrist, clinical nurse specialists and occupational therapists. Joint assessments and shared-care arrangements can be offered where required. The team also delivers regular training events for primary and secondary care professionals on the assessment and management of eating disorders.
The community team provides outpatient support for people who are hard to engage or who are struggling to manage psychiatric or medical risk safely. The model of care incorporates elements of assertive outreach, supportive clinical management, motivational interviewing and cognitive analytic therapy. This supports harm minimisation, engagement and meaningful therapeutic change.
The service is flexible and responsive, with capacity to provide urgent or more intensive support through the newly established intensive community treatment pathway. Session style and frequency are determined by clinical need. The aim is to support patients to actively engage in change rather than remain stuck in cycles of illness.
For some patients, the full episode of care may be provided within the community team. Others may move on to access other parts of the service depending on their needs.