London Assembly Health Committee: Eating Disorders in London (February 2024)

Summary

In June 2023, the London Assembly Health Committee launched an investigation into eating disorders in London, following reports that referrals for eating disorder services have increased in recent years and performance against waiting time standards dropped during the COVID-19 pandemic.

The aim of this investigation was to understand what is driving the increase in referrals, how services are responding to this additional demand and to explore people’s access to, experiences of, and outcomes from treatment services. The Committee held two formal meetings with expert guests, including clinicians, people with experience of living with an eating disorder, and representatives from the Greater London Authority and NHS England. It also held a private session with people with lived experience of being affected by an eating disorder and received 112 responses to its survey from those with experience of an eating disorder, supporting a family member or friend with an eating disorder or those working with those experiencing an eating disorder. 

Content

This report highlights several concerns around the increasing prevalence of eating disorders in London and the pressures faced by services to respond to this demand. Too many people and their families are not able to get the care and treatment they desperately need. This report identifies major issues related to barriers to securing referrals, waiting times for services, quality of care, management of discharges and the paucity of support in the community. The key findings made in this report include:

• The demand for eating disorder services in London has increased in recent years and was accelerated by COVID-19. However, some GPs could benefit from updated training on eating disorders and many people struggle to access referrals to specialist services.
• Whilst NHS funding for eating disorder services is at its highest ever level, services in London have struggled to cope with the demand. Performance on waiting times has worsened, with people stuck on long waiting lists, often with their symptoms getting worse and with little interim support.
• Some services are left to prioritise only the most severely ill people and are reportedly going against clinical guidance by using body mass index (BMI) as a threshold for determining who should and shouldn’t have access to services.
• Excellent care is available in parts of London, but work is needed to provide consistent access to the best care possible for all Londoners. 
• Resources of community groups and voluntary sector organisations are not currently being harnessed effectively to support those with mild to moderate symptoms.
• The absence of positive support networks for young people leads some to engage in ‘pro-eating disorder communities’ online, which may encourage and accentuate existing eating disorders.
• Eating disorders have a devastating impact on families and yet there is little support provided to families and carers of people with eating disorders.  

The report makes 12 recommendations for change.