Written Statement: Review of Welsh Eating Disorder Services

In 2018, I commissioned Dr Jacinta Tan of Swansea University to review eating disorder services in Wales and to determine what changes need to be made to improve services and outcomes for patients. Dr Tan submitted her report to Welsh Government in November 2018. The report provides a detailed analysis of current eating disorder services, outlines national and international evidence, and makes 22 recommendations to improve services. The recommendations are significant and reflect what services could achieve in the longer term.

We have considered the recommendations and, as part of that process, commissioned the NHS CAMHS and Eating Disorders Network to conduct a workshop with clinicians. The workshop, which was held in May 2019, aimed to engage clinicians in the content of the review and to begin to test some of the key recommendations.

Following the workshop conclusions, I have written to health boards to set out the actions I expect to be taken to start the process of moving eating disorder services in Wales towards the vision set out in the review. The changes required will not happen overnight, and given the breadth and scale of the recommendations, there is clearly a need for further engagement and analysis to consider what can be achieved in the short, medium and long term. However, I have been clear that there are actions that I expect health boards to start working towards immediately. These are to:

• Consider the review, provide feedback and identify where key incremental changes could be made to ensure that longer term service planning can align with the ambition of the review;

• Work towards achieving the NICE standards for eating disorders within two years;

• Develop plans to achieve  a  four week waiting time across adult and child services recommended in the review within two years; and

• Reconfigure services towards earlier intervention

In order to support this work, we will put in place a central resource to assist health boards in developing plans in a way that has been fully considered by clinicians and managers from across the service, and in a way that does not destabilise existing provision. I have also provided targeted and recurrent investment of over £700,000 this year to support health boards to make eating disorder service improvements – this will increase to around a £1million next year. This investment, supported by our budget agreement with Plaid Cymru, builds on work over recent years where we have invested £1.75million specifically to support eating disorder services for adults and young people. I want to ensure that patients who need treatment are able to access that treatment at the appropriate time, and that thresholds for treatment do not push services into missing the opportunity to intervene at an early stage.

Whilst I recognise that this is the start of a longer process, these actions are an ambitious launch pad to take forward the recommendations outlined in the independent review. In setting out these actions to health boards, I have taken on board the content of the review, the perspective of clinicians and the views of patients. I am grateful for this continued engagement on such an important issue.

These improvements to specialist services should not be viewed as outside mainstream provision.  They are supported by improvements in primary care as a result of local primary mental health support services under the Mental Health (Wales) Measure 2010.  They are also supported by more specialist mental health services in Child and Adolescent Mental Health Services (CAMHS) and adult mental health which enables more people, including those with eating disorders, to receive treatment in their home and local community without the need for admission to hospital.

In addition to the actions I have already set out, we continue to make good progress in some areas identified in the review. This includes our ‘whole school approach’ where we are intervening in a systematic way at a critical point of the development young people to support improvements to emotional health and well-being and to enable access to support at an earlier stage.  

The recommendations provide a vision of how eating disorder treatment could look in the longer term with a strong focus on moving provision towards earlier intervention. I have shared the executive summary of the review with health boards and published this document online.

I am very grateful for the effort that went into developing the review into eating disorder services, both from the review team and the many individuals that took the time to contribute to the research. The review sets out an ambitious analysis for how eating disorder services should look in Wales in the future, and I am committed to ensuring that our services are shaped by the recommendations.

Read the executive summary of the Eating disorders service review 2018.