1. The Eating Disorders The eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified (EDNOS)) are biologically based serious mental disorders which individually typically acquired in mid- adolescence as a developmentally sensitive time; about 90% of those affected are female Lifetime prevalence rates for anorexia nervosa in the general population range from.9 to 4.3% for females, and from 4 to 7% for bulimia nervosa Eating disorders have major psychological, physical and social consequences, The mortality in anorexia nervosa is high, Eating disorders also exert a high burden on families and other carers.

2. Current service provided by NSFT The Adult Eating Disorders team, East and West Suffolk, is a small tertiary service that does not take direct referrals from GPs, The Children’s service is well established in the east of the county but in the west there is no dedicated service and patients are seen as part of the generic CAMHS service, Both adults and children requiring hospital admission have to go out of county to receive a service, or into private sector beds, There is good work being done by both Adult and Children’s services with patients, Both services have won recognition for the excellence of service.

3. Why change the current services? Recognised nationally that specialist eating disorder services best serve the needs of this patient group, There is inequity east and west especially for young people, The condition spans the age range between adolescence and young adulthood, Pooling the resources and increasing the flexibility between the teams at a time of increasing financial restraint makes sense financially, GPs tell us that they struggle to manage eating disorders in primary care.

4. What the proposed service will offer An age inclusive Specialist Eating disorder service for people presenting with symptoms of Anorexia Nervosa, bulimia nervosa and other related conditions, An effective, patient centred pathway of care towards full recovery, Removal of the barrier of different thresholds of access and ensuring interventions and support are delivered according to assessed individual need, A tiered approach to service provision with consultation and support in to primary care provided by specialist trained link workers and access to wellbeing and psychological therapies, supported by the specialist team working across the age range, Out patient treatment from the specialist team who will manage all aspects of the individual’s mental health needs, Intensive home treatment to support the individual and carers, Admission to an acute hospital paediatric bed for joint care between the Specialist Eating Disorder Service and the acute paediatric service to stabilise acute medical problems and facilitate timely discharge back to community based support and interventions

5. How GPs can be supported Guidelines for GPs including the Kings college guidelines, the SCOFF questionnaire, Support from specialist Primary Care link workers in GP surgeries to triage patients who may need a service, Onward swift and direct referral to the right level of service, Consultation for GPS from the specialist team.