Scottish Government



National Review of Eating Disorder Services in ScotlandReview SpecificationBackgroundThe Mental Welfare Commission (MWC) is currently conducting themed visits of eating disorder services in Scotland. A report will be published in the coming weeks and will include a review of adult services, child and adolescent services, outpatient, NHS and independent eating disorder care in Scotland. This report will provide the basis for a full national review to take place. We believe that the report is likely to make a specific recommendation to the Scottish Government to commit to a full national review.Similarly to the review of perinatal mental health services, which was published in 2019, and the national review of early intervention in psychosis services, which is currently ongoing, this review will provide the Scottish Government with a full picture of the current system of support, including the care and treatment that is available for those with an eating disorder, and their families and carers, in Scotland. We want to ensure that the right package of care, services and support is in place to respond to the needs of those who suffer from an eating disorder, to help them recover and maintain healthy and productive lives. This should also take into account the needs of the family and support system for the individual too. This includes eating disorder support from NHS mental health services, primary care and the third sector (the latter two not being covered by the MWC’s themed visit report).We see this national review as a crucial first step in a phased programme of work to improve outcomes for people living with an eating disorder in Scotland. We want to see a second phase of improvement work, which will be guided by the review’s findings. Scope of the reviewThe scope of the review should include, but is not limited to, the following:The review should cover all eating disorder services for children, adolescents and adults, and consider the transition points between these services. This should also include inpatient provision.The review will include a needs assessment of services that are provided by the third sector and community eating disorder support across Scotland. This includes NHS community based services.The review should cross-reference its findings with the findings of the MWC report, so that we have a full picture of the current system of support that is available for those with an eating disorder and their families and carers. This should include current staffing levels in mental health services, and outline what training is provided in primary care services.Make recommendations for how specialist eating disorder services can best be provided in urban, semi-urban and rural areas. This should include how early intervention can be achieved through early referral systems in primary care, schools, third sector, etc.Make recommendations on the implementation of a public health approach to the prevention of eating disorders with Public Health Scotland.Make recommendations as to how data for eating disorders can be collated consistently across services in Scotland. This should include recommendations for a minimum data set to assess eating disorder referrals and diagnosis, referral to treatment time and outcome data.Make recommendations for what age range, if any, an eating disorder service should cover. This should take into consideration the views of individuals who have had an eating disorder and their families, and be outcomes-focused.The Scottish Government is committed to ensuring those with lived experience of our mental health services are involved in policy that impacts them. Therefore, it is crucial that this review includes the views of those with lived experience of eating disorder services, and their families.It is important that this review provides a full picture of how eating disorder services in Scotland are currently providing support and treatment to those that require them, taking into account the different geographies in Scotland. This will ensure that the eventual recommendations of this review are in line with the expectations of those who will use these services. It is therefore likely that the Review will need to establish a working group or an advisory group to support its ongoing work.Beat, the national eating disorder charity, have offered to support this engagement, and we would expect the Lead of this review to work closely with Beat’s National Officer in Scotland throughout the lifespan of the review. We would also expect the Lead of the Review to work closely with relevant stakeholders in Scotland, such as the CAMHS Eating Disorder Steering Group and Scottish Eating Disorder Interest Group (SEDIG). The review will take into consideration the development of the Scottish Intercollegiate Guidelines Network (SIGN) guidelines on eating disorders that are currently being developed. These guidelines will cover referral, management of medical and mental health risks, choice of treatments and management of transitions.Due to the time-limited nature of this review, it is unlikely that full engagement with every area in Scotland will be possible. Instead, the review may wish to consider engaging with a sample of urban, semi-urban, and rural areas, with these findings informing the next steps and recommendations of this review. Review monitoring and reportingThe Scottish Government’s Young People’s Mental Health Team will provide the Lead of the review with support and guidance throughout its lifespan. We will meet at least monthly with the Lead to agree progress updates.The Lead will present an outline report containing initial findings, issues and priorities to the Scottish Government by early 2021. The final iteration of the review will be published by Scottish Government in Spring 2021.We have outlined the following proposed milestones, with the review being time-limited to a period of 6 months:Key MilestonesDatePublication of the MWC ReportSeptember 2020 (Date TBC)Proposed review start and submission of project plan to Scottish GovernmentOctober 2020Monthly Catch UpsTo be confirmed with Lead once recruitedDraft Report to Scottish GovernmentEarly Spring 2021 –Date TBCFinal Report PublishedSpring 2021BudgetThe Scottish Government will provide a budget of up to ?25,000 to support the Lead of the review and their work. This budget will be allocated in financial year 2020/21. Lead of the ReviewWe are seeking expressions of interest for the Lead of this review who will deliver the work according to the specification above. In your note of interest, please outline why you are best placed to deliver the review according to the specification.Please send your expressions of interest or any queries to the following contact address by close of day on 14 August 2020:Sophie AveryYoung People’s Mental Health TeamDirectorate for Mental HealthScottish GovernmentSophie.Avery@gov.scot ................
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