Risk, demand and capacity in adult specialist eating disorder services in the South of England – before and since Covid-19

Abstract

Aims and Method: This is a longitudinal cohort study describing the demand and capacity for specialist inpatient treatment of patients with severe eating disorders covering a population of 3.5 million. We compared the impact of the pandemic and the outcomes between different inpatient services. Results: Between July 2018 and 1 November 2020 there were 293 referrals. 97% were female. 93% had a diagnosis of anorexia nervosa. 19.5% of referrals were below BMI 13, and a further 40% had extreme malnutrition. Referrals and emergency admissions to acute hospitals have increased by 20% since the pandemic. Waiting times have doubled from 33 to 67 days. A novel integrated CBTE model has shown better outcomes and shorter length of stay compared to traditional eclectic treatment. Clinical Implications:The pandemic has worsened the mismatch of demand and capacity, causing increasing serious risks and this needs to be addressed as a matter of urgency.