The Royal College of Psychiatrists (RCPsych) has identified plans that would result in funding cuts for children and young people’s eating disorder services across more than half of England.
RCPsych’s analysis found that 24 out of 42 Integrated Care Boards (ICBs) have planned changes that, if enacted, would result in real terms spending cuts totalling more than £835,000 for these services in the current financial year (April 2024 to March 2025). The reductions in funding range from £3,000 to £112,000 across individual ICBs.
According to analysis of NHS Digital figures by RCPsych, the planned spending cuts come amid a backdrop of children and young people’s eating disorder services seeing:
• A 13% increase in referrals (from 7,008 to 7,933) in the last 12 months
• High thresholds to access services results in more young people being in crisis
• 787 urgent and 5,310 routine referrals still waiting for treatment at the end of December 2024
• 81% of urgent referrals being seen within a week, and 82% of routine referrals within four weeks, far from the 95% NHS England target which has never been met across England as a whole
In addition, the RCPsych Workforce Census 2023 shows a 30% true vacancy rate for all eating disorder consultant psychiatrist positions across England as of March 2023.
Mortalities and more serious illness are preventable
Eating disorders have among the highest rates of mortality of any mental disorder yet are treatable. Eating disorder services are having to prioritise the most unwell children and young people due to rising demand, staff shortages and a lack of resources. There are young people who meet the threshold for specialist eating disorder services yet are having to wait too long for care. As a result, they can become more ill while their treatment is delayed and are increasingly in crisis before they access care.
Every child with an eating disorder can be treated effectively if seen early enough.
The RCPsych is calling for the creation of a national strategy for eating disorders in England. This must ensure that services are sufficiently funded to improve the care that children and young people, as well as adults, receive and address the significant challenges facing eating disorder consultant psychiatrists and the wider eating disorders workforce.
Dr Ashish Kumar, Chair of the Royal College of Psychiatrists’ Faculty of Eating Disorders Psychiatry, says: “Eating disorders, in particular anorexia nervosa, have high rates of mortality, yet are treatable conditions and with the right care and support in a timely manner most patients can make a full recovery. However, if these planned cuts come to fruition, it would result in the NHS cutting funding for these vital services in many areas across England.
“There is a significant gap between the children and young people in need of care and those who can access treatment, with many awaiting suitable treatment, and this will only get worse unless we take urgent action to address this crisis.
“We need a national eating disorders strategy that prioritises the recruitment and retention of the mental health workforce. This must be backed by adequate funding so that services have the resources they need to deliver the care our children and young people deserve.
“We also need more research into eating disorders to improve care. The dedicated funding for children’s eating disorder services as planned by NHSE must reach frontline services so that vulnerable young people receive the best and timely care.”
Alarm bells ringing
Saffron Cordery, Interim Chief Executive of NHS Providers, says that these findings will start alarm bells ringing for Trust leaders for have consistently raised their concerns about the mismatch between the soaring demand for services and their ability to provide them. This produces a significant knock-on effect to patient flow and the overall productivity and efficiency, with an increasing number of children and young people with eating disorders presenting in emergency departments and being admitted to adult hospital beds.
“The scale of the challenge is really worrying with one Trust leader telling us of a 127% increase in referrals to eating disorders in their Trust in 2022/23 compared to 2019/2020,” she says. “While there has been welcome investment in eating disorder services for children and young people, it’s clear more needs to be done to improve performance against access and waiting time targets.”
