What happens after the GP makes a referral?
A duty clinician will review the referral to ensure it is appropriate and meets our service criteria. We may get back in touch with the GP or referrer for additional information before we can accept the referral. If the referral is appropriate at this stage, the duty clinician will then telephone a parent/guardian to gather further information about the current concerns. This information will then be discussed with the multi-disciplinary team, and we will decide whether to offer an assessment or whether other services might be more appropriate.
On some occasions, we may review the information from the GP and ask them to do a direct referral to a hospital paediatric department for an admission, where we feel there is evidence of current severe risks to health. In these cases, we might delay our assessment until physical health is more stable but will still check in and support during a hospital stay.
How soon will my first appointment be?
Once a referral is received, the team will use the information from the referral and discussions with family/professionals to decide on risk and urgency. We aim to see urgent cases within one week from the date of receipt of the referral, and routine cases within four weeks. High risk cases will be seen the next working day (where possible).
If you are very unwell and this is identified at referral or at your initial appointment, you may need to be directly and immediately referred to the paediatric/medical team at your local Hospital or A&E department.
What will happen at my first visit to the team?
We will invite you to join our team for an assessment. Prior to the assessment we will send you some forms and questionnaire which we would ask you to fill out and bring with you to the appointment. This helps us make sure we have the correct details for you and gather more information about your difficulties.
When you arrive, you will be seated in reception and the team will be notified you’re here. Firstly, you will see one of our nurses who will complete physical health checks. This includes taking your weight, height, blood pressure (both sitting and standing), temperature and blood sugar levels. We will also require some bloods to be taken and an ECG to be completed. The ECG will then be reviewed by our doctor during your assessment and the bloods will be sent off to the lab.
Following this, you will be seen by 2/3 members of our team to complete an assessment. This will involve sitting together for a discussion where we will ask about home life, school, emotional wellbeing and eating difficulties. We will also give some time for parents/carers and the child/young person to see a clinician on their own. The assessment will take around 1 hour.
Following this, we will leave you to have a snack and a cup of tea/drink whilst the team have an MDT meeting and discuss your assessment and the physical health information to plan for your ongoing care. This can take 20/30 minutes, and we will then return to you to share the plan with you and discuss what ongoing support will look like.
On rare occasions where young people are very poorly at assessment, we may require you to attend the hospital to be assessed by a paediatrician directly from our assessment.
What if my child/young person also needs support with their mental health?
Often mental health difficulties and eating difficulties can present together and we will work jointly with our CAMHS colleagues where appropriate, either through joint sessions or offering consultation to our CAMHS colleagues where eating difficulties present.
We may also identify through assessment that a mental health difficulty is driving the disordered eating, and we will refer you to appropriate services to manage this, where traditional eating disorder treatment may not be effective.
There are alternative services that can support with lower level mental health needs such as mild anxiety, low mood or low self-esteem, which you can read more about and self-refer to via the Stay Well CYP website.
If you feel your child or young person requires input from CAMHS services, you can refer through the Children and Young Families Single Point of Access (CAFSPA) by telephone: 0808 178 0611 - option 2. Our working hours are Monday-Friday, 9am-5pm. You can also self-refer via the MPFT CAMHS Single Point of Access webpage.
For any immediate or urgent concerns about your child’s mental health wellbeing which occur out of hours, you can contact the All-Age Mental Health Access Team on 0808 196 3002.
In an emergency where there is imminent risk to self, we would advise to call 111/999 or to present to A&E.
What if I know/suspect that my child/young person is neurodiverse?
Often eating difficulties will co-occur in people who are neurodiverse and as a team we have expertise in working with neurodiverse individuals and aim to tailor sessions to meet the needs of the young person and family, whether this has been formally diagnosed or not.
Unfortunately, our team is not commissioned to diagnose neurodiverse conditions. But where we suspect that a child or young person may be neurodiverse, we will advise on how to refer for further assessment from CAMHS Services and the Children and Young People’s Autism Service (CYPAS) alongside our work. Where needed, we work closely with CYPAS and CAMHS services to access advice on assessment, ways of working, reasonable adjustments.
Unfortunately, we are not commissioned to work with ARFID at present.
What if I am concerned my child/young person has Avoidant/Restrictive Food Intake Disorder (ARFID)?
Unfortunately, our service is not currently commissioned to support children and young people with ARFID so would not be able to accept a referral. We are aware there is a gap in service provision and are in the planning stages of developing an ARFID service, but we are not able to give a timeline of when this will be open to referrals.
If you have concerns regarding your child’s weight and/or nutritional status (i.e. deficiencies) we would advise that you seek support from your GP, community paediatrics or community dietetics. Regular physical monitoring is advisable and potential prescription of nutritional supplements if accepted.
Support can be accessed from the following external services:
- BEAT Eating Disorders – Endeavour carer support group. This is for parents/carers of young people aged 5-15, with an ARFID (Avoidance/Restrictive Food Intake Disorder) diagnosis and/or displaying ARFID behaviours and presentations. Visit the group's page on the BEAT Eating Disorders website.
- Cognitive Behavioural Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR): Patient and Family Workbook (Cambridge University Press) – This is a free to download CBT workbook designed for older adolescents and adults with ARFID however parents may wish to use some of the principles with their younger children. It can be downloaded from the Cambridge University Press website.
- FEAST – A support and educational community with resources and support groups for parents of children with ARFID. Visit the FEAST website.
What happens if a young person is approaching their 18th birthday?
Most young people open to our service go on to recover prior to their 18th birthday and do not require transition to adult services. However, for those who come to us close to their 18th birthday or who require ongoing support, the team will plan for transition to appropriate services to meet the young person’s needs. Discussions about transition to adult services will happen in the months before the person turns 18 and a robust plan will be put in place.
If we receive a referral where the young person is close to their 18th birthday, we may ask our adult eating disorder colleges to assess jointly or instead of us as they will provide the support in the longer term.
