RISE Child & Adolescent Eating Disorder Service

Introduction

Eating disorders are very common in adolescence

If detected early and specialist treatment is provided, the prognosis is very good. However, if left untreated for a long period of time, the disorder can become chronic and can result in hospitalisation and less successful sustained recovery

Our Service

The RISE Eating Disorder (ED) Service was developed to encourage early intervention, reduce hospital admissions, and improve long-term outcomes for young people and adolescents with eating disorders

RISE ED accepts referrals of suspected eating disorders from GPs and other professionals. We recognise the high morbidity and mortality rates associated with eating disorders, in particular anorexia nervosa, and the evidence that early intervention leads to the best possible outcomes as outlined in the NICE guidelines

Specialist assessments and treatment are provided across Coventry and Warwickshire.

Our service is staffed by a consultant psychiatrist, specialist nurses, clinical psychologists, psychological therapists, dietitians, family therapists, and an assistant psychologist

Referral Acceptance Criteria

• Children and young people under the age of 18
• Registered GP in Coventry or Warwickshire
• Suspected eating disorder as primary concern, i.e., anorexia nervosa, bulimia nervosa, binge eating disorder. Symptoms include avoidance/restriction of food, loss of weight, fear of weight gain, bingeing/purging, and over-evaluation of weight or shape

Referral Rejection Criteria

The service is not currently commissioned to see young people with:

• Obesity
• Vomit phobia
• Avoidant Restrictive Food Intake Disorder (ARFID)
• Feeding or eating problems related to other diagnoses, such as anxiety, depression, or ASD where the core problem is not an over-evaluation of weight and shape

Making a Referral

If you suspect an eating disorder, we recommend you make an early referral to our Community Eating Disorder Service

Please complete all sections of the standard RISE referral form with as much detail as possible Please include:

• Weight – most recent and three previous measurements if possible, to assess change
• Height
• Blood pressure
• Pulse rate
• Recent blood results: FBC, U&Es, LFT, bone profile, thyroid, phosphate, and magnesium
• ECG (if there is a clinical need to carry one out)  Please refer to the Medical Emergencies in Eating Disorders (MEED) guidance
• Eating disorders symptomatology

Please note, whilst the young person is awaiting an assessment with our service, you will still hold medical responsibility for your patient, therefore, will need to act on any abnormalities regarding blood results and ECG results as per the MEED guidance

The information above is essential for us to prioritise risk and assess effectively

Please note that without this information, we will not be able to accept and process the referral

If there are no recent blood results available, please send for blood tests at the same time you make the referral

A referral form can be downloaded at: https://cwrise.com/how-to-refer-to-services.

The referral should be returned to:

RISE Navigation Hub, Paybody Building, Stoney Stanton Road, Coventry, CV1 2FS.

Tel: 0300 200 2021

Once the referral has been received by the RISE Navigation Hub team, it will be passed to the RISE Eating Disorders Service

Urgent Referrals

If the matter is urgent e.g., rapid weight loss, very low weight, complete food and fluid refusal, we recommend that you contact the service directly on the above number and then back it up with a written referral to the service marked URGENT

In the case of a physical health emergency, the young person should be referred immediately to Paediatrics

The best guideline for the assessment and management of physical risk in eating disorders is the MEED guidance: Medical emergencies in eating disorders (MEED): Guidance on recognition and management (CR233) (rcpsych.ac.uk).

Communication

Following the initial assessment, you will receive a letter outlining a summary of the assessment and a treatment plan. After this, you will be updated as necessary.RISE Eating Disorder Service

Treatment and Management

If after assessment the young person is accepted for treatment within the Specialist Eating Disorder Service, they will receive individualised care including dietetic, nursing, psychological, psychiatric, and family therapy input as appropriate

We will continue to liaise with you and may need to request further medical monitoring and/or nutritional supplementation where appropriate

We will also inform you of discharge from our service as and when this happens

Contact:

RISE Eating Disorder Service, Ground Floor Paybody, City of Coventry Health Centre, Stoney Stanton Road, Coventry CV1 4FS

Tel: 02476 961578

Useful resources:

Medical Emergencies in Eating Disorders Guidance: Medical emergencies in eating disorders (MEED): Guidance on recognition and management (CR233) (rcpsych.ac.uk)

NHSE Access and Waiting Time Standard for Children and Young People with an Eating Disorder 

BEAT (Beating Eating Disorders Charity)

NICE Eating Disorder Guidelines NG69

CW RISE Referrals