The HSE National Clinical Programme for Eating Disorders (NCP-ED) is a collaborative initiative between the HSE, the College of Psychiatrists of Ireland, and BodyWhys - the national support group for people with eating disorders. Eating disorders have the highest mortality and morbidity of all of the mental health conditions (Arcelus, 2011), and it is estimated that they will affect between 1 to 4% of the population at some point in their lives (NIMH, 2016). They are caused by a combination of genetic, biological and psychosocial factors and occur across gender, age, cultural, ethnic and socioeconomic groupings. Although not common eating disorders result in very high psychosocial and economic cost to individuals, families, healthcare and society when not treated or treated ineffectively (Butterfly Foundation 2012 and 2015).

Video: The National Clinical Lead for Eating Disorders explains what are eating disorders and the importance of early access to a specialist team. An actor from UCC Drama Society recounts the story of a young person developing an eating disorder and being unsure how or who to talk to about it. She describes her experience attending a specialist eating disorders team and moving towards recovery, returning to school and sports. Names and dates have been changed.

Scope of the National Clinical Programme

The National Clinical Programme for Eating Disorders is a HSE Mental Health Programme and it applies across the age range (child and adult). It is focussed on the four main eating disorders that are recognised in ICD11 and DSM5, which are:

• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorders (BED)
• Avoidant Restrictive Food Intake Disorder

Feeding disorders are outside of the scope of this programme.

People with eating disorders have complex needs and we work in close collaboration with other HSE Clinical Programmes where collaborative and integrated care solutions are needed in order to deliver the best clinical service to people with eating disorders and their families. This includes work with other clinical programmes in paediatrics, primary care, acute medicine, palliative care, emergency medicine, etc, consultation with primary care and of course our collaboration within the wider mental health service.

Aims and Objectives

The aims and objectives of the National Clinical Programme for Eating Disorders are:

Quality

• To improve the clinical outcomes and recovery of people with eating disorders in Ireland though the provision of evidence based practices by trained, skilled staff.
• To reduce the comorbidity and mortality associated with eating disorders through enhanced clinical risk management and early intervention.
• To remain patient centred by including service user feedback and input in the development of our eating disorder services.
• To evaluate the effectiveness of our services across clinical, activity and service user experience outcomes.

Access

• To support enhanced screening and early recognition of eating disorders in Ireland.
• To provide timely access to consultation for referrers.
• To reduce service user internal and external waiting times to initial assessment and treatment.
• To develop a stepped care model of service delivery based on different patient needs.
• To establish formal pathways between services that will enable more seamless transitions of people with eating disorders when it is needed.

Cost

• To reduce the significant long term health, economic and psychosocial cost of eating disorders through early intervention.
• To reduce the duration of illness and promote recovery through the provision of evidence based effective interventions.
• To reduce dependence on inpatient admission (numbers / length of stay) where clinically appropriate, though the provision of alternative less restrictive options for intensive treatment such as day and group programmes.
• To reduce relapse rates though all of the above measures.

Goals 2024

• Continue regular meetings of National Oversight Group to support implementation of the Model of Care
• Advance the development of the Eating Disorder Hub Network through the recruitment of additional specialist community Eating Disorder Teams across the HSE in line with the Model of Care and funding received
• Develop and pilot day programme strategy
• Update the ED data set and publish 2023 annual data from ED teams
• Develop transition pathways between CAMHS and Adult Eating Disorder Teams
• Update and review the ED Self Care app to ensure reliable valid sources of information readily available for people with eating disorders and their carers
• Enhance integrated care pathways between community eating disorder teams and acute hospitals
• Deliver our third National Eating Disorder Webinar during eating Disorder Awareness Week 2024
• Continue our formal and integrated working relationships with our partner agency BodyWhys and the College of Psychiatry Ireland
• Continue to utilise and develop Telehealth in service delivery
• Facilitate training, education and supervision with agreed Model of Care