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 1-4% 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).
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:
- 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.
- 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.
- 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 2019 / 2020
- Establish a national oversight group to ensure the full implementation of the Model of Care.
- Continue the development of the Eating Disorder hub network through the recruitment of additional dedicated Eating Disorder Teams across the HSE in line with the Model of Care.
- Develop and pilot day programme strategy.
- Publish the evaluation of PiLAR family education programme with BodyWhys and UCD.
- Develop and pilot the NCP-ED outcome evaluation dataset and framework.
- Develop a HSE competency framework for our Eating Disorder Specialist Teams – core training and CPD.
- Collect data on the impact of FBT and CBT-E training on service users – access to evidence based treatment.
- Develop a NCP-ED website and associated App resource for professional and service user access.
- Develop service user information sheets on key aspects of eating disorders including bibliotherapy list for self-help.
- Develop collaborative clinical pathways / PILOT on:
- Transitioning between child and adult mental health services;
- Transitioning between mental health service and acute hospital (MARSIPAN/ J MARSIPAN based.
- Formalise and develop an integrated model of working between HSE eating disorder treatment services and Bodywhys support services.
- Develop model of pathways of care with primary care in collaboration with Student Health Department UCC.
- End of year annual report.
|National Clinical Lead:||Dr. Michelle Clifford|
|Programme Manager:||Ms. Rhona Jennings|
Planning & Oversight Group for Model of Care
|Dr. Michelle Clifford||National Clinical Lead for Eating Disorders|
|Ms. Rhona Jennings||Programme Manager - Mental Health National Clinical Programmes|
|Dr. Michelle Clifford||Consultant Psychiatrist (CAMHS) - Community Eating Disorders Team, Linn Dara|
|Dr. Sara McDevitt||Consultant Psychiatrist (CAMHS) - Community Eating Disorders Team, CHO 4|
|Dr. Caroline Maher||Consultant Psychiatrist - Adult Eating Disorders Team, CHO 6|
|Ms. Deirdre Dunne||HSE Health & Social Care Professions Office representative|
|Ms. Mary Hannon||HSE Office of Nursing & Midwifery representative|
|Ms. Harriet Parsons||BodyWhys representative|
|Dr. Aoife O'Sullivan||General Practitioner, Student Health Department, University College Cork|