Child and adolescent eating disorder services have never achieved NHS waiting time targets, and are not able to meet significant demand, according to analysis by the Royal College of Psychiatrists.
Psychiatrists can identify and address many of the root causes of eating disorders, including neurodevelopmental conditions such as autism and ADHD. However, a current lack of capacity prevents this from happening.
Due to a lack of resources, even children who meet the threshold for specialist eating disorder services are often in physical and mental health crisis by the time they are seen. Delays in treatment cause children with eating disorders physical and mental harm.
NHS England set a target for 95% of children and young people with an urgent eating disorder referral to be seen within a week, and for 95% of routine referrals to be seen within four weeks. These standards have not been achieved nationwide, since they were introduced in 2021.
RCPsych analysis of the latest data shows that just 63.8% of children and young people needing urgent treatment from eating disorder services were seen within one week. Only 79.4% of children and young people with a routine referral were seen within four weeks.
The College also warns that there is an unacceptable gap between the number of children being referred to specialist eating disorders services, and those being seen. This is driven by a shortfall in the number of trained therapists and eating disorders psychiatrists.
Between April and December 2023, on average 6,073 children and young people per quarter were referred to CAMHS specialist eating disorders services by their GP. However, only 2,512 entered treatment on average.
The NHS has made more funds available for children’s eating disorders services, but it is taking too long for this funding to reach frontline services in some places.
For Eating Disorders Awareness Week, the Royal College of Psychiatrists is calling on Government and Integrated Care Boards to invest in targeted support for children and young people to reverse this eating disorders crisis. The call is backed by the UK’s eating disorder charity Beat.
Dr Ashish Kumar, Chair of the Royal College of Psychiatrists’ Eating Disorders Faculty, said:
“We know that early intervention is essential if children are to make a full recovery from an eating disorder, but we simply do not have the resources. It is dreadful that so many children are becoming seriously ill while they wait for eating disorders services.
“We need a renewed focus on recruiting and retaining child and adolescent psychiatrists, including those who specialise in eating disorders and neurodevelopmental conditions.
“We cannot carry on like this. Prevention is better than cure – it is high time that we provide preventative care for children who are showing signs of a problematic relationship with food.”
According to the eating disorder charity Beat, 1.25 million people in the UK have an eating disorder, many in secret. The charity saw a 300% increase in the number of people contacting them for help at the height of the pandemic.
Tom Quinn, Beat's Director of External Affairs, said:
“The situation is clear: immediate action is needed to ensure that access to treatment doesn’t become even more restricted in coming years. Eating disorders, if not treated quickly, can have life-changing consequences and we must make sure every child gets the help they deserve.
“The NHS’s own survey shows the massive increase in eating disorders: from 0.8% of 17 to 19-year-olds in 2017 to 12.5% in 2023. Clinicians are going above and beyond to care for as many patients as possible, but eating disorder services are hugely overstretched and simply don’t have the funding or staff to meet this increase in demand.
“Now is the time for urgent investment to help the NHS meet this need and ensure that children and young people aren’t denied the best chance to make a full recovery from their eating disorder.”
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