Eating Disorders Awareness Week

Andrew Stephenson Excerpts

Thursday 29th February 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Hollobone. I start by paying tribute to the hon. Member for Bath (Wera Hobhouse) for securing an important debate on an important topic. I know that both as an MP and as the chair of the all-party parliamentary group she has long been a champion for those living with eating disorders. She has worked with the hon. Member for Sheffield, Hallam (Olivia Blake) and others on the APPG to ensure that eating disorders are kept high on the political agenda.

I share the passion for this issue expressed by all the hon. and right hon. Members who have spoken in this debate. As the right hon. Member for Hayes and Harlington (John McDonnell) said, one thing that unites everybody in the Chamber today is that we have all tried to help a constituent, or the family of a constituent, who is suffering from an eating disorder. I have certainly done so in my 13 years as the MP for Pendle, and those cases that I have dealt with are some of the most difficult and emotional to have come across my desk in my surgery.

Improving eating disorder services is a key priority for the Government and a vital part of our work to improve mental health services. As we have heard, this week is national Eating Disorders Awareness Week, and raising awareness is essential to making progress on this important issue. I am grateful for the work of Beat and other charities across the whole sector; they have shone a light on eating disorders and they support people who are struggling.

We know that having an eating disorder can so often be utterly devastating for those with the condition, as well as for those around them. As I think has been said by pretty much every hon. Member who spoke today, we know that eating disorders can affect people of any age, gender, ethnicity or background. However, we do know that recovery is possible, and that access to the right treatment and support can be life changing. Early intervention is vital, and we want to ensure that children and young people with eating disorders get swift access to support.

Since 2016, investment in children and young people’s eating disorder community services has risen every year; £53 million was invested per year in 2021-22, and that figure rose to £54 million in 2023-24. As part of the £500 million covid-19 mental health recovery action plan, we invested an extra £79 million to significantly expand young people’s mental health services—enabling 2,000 more children and young people to access eating disorder services. We have also introduced a waiting time standard for children and young people with eating disorders. Our aim is for 95% of children to receive treatment within one week for urgent cases, and within four weeks for routine cases.

[Abena Oppong-Asare]

On the Minister’s point about getting waiting time targets down to one week, those targets were implemented in 2015, and they are yet to be met. Could the Minister explain what work is being done to address that, because he just mentioned those same targets again?

[Andrew Stephenson]

I completely recognise the shadow Minister’s challenge on that point and the concern that she has—I will set out what we are doing to address it. She also mentioned the Royal College of Psychiatrists, which published a report on this today. It is worth putting on record that we very much welcome that and that we look forward to working with it and other stakeholders. Waits are not as short as we would like, and the Government are determined to meet our waiting-time standards for children and young people with eating disorders. Extra investment is going into the services to meet increased demands and reduce waits, so hopefully we will start to see progress made towards meeting those targets. However, we acknowledge that, while there has been record investment and progress in improving access to eating disorder services and improving quality, there has also been a significant increase in demand for those services over the past few years. That was especially true during the pandemic, with increased demand outstripping the planned growth in capacity.

Children and young people’s eating disorder services are treating 47% more children and young people than before the pandemic, with almost 12,000 children and young people starting routine or urgent treatment in 2022-23, compared with just over 8,000 in 2019-20. That surge in demand has made meeting our waiting-time targets more challenging, and waits are not as short as we would like them to be. However, I am proud that our services and clinicians, backed by new funding, are supporting more children and young people than ever before. Those services are changing and saving lives.

We also know that even earlier intervention is critical to prevent eating disorders from developing. Community-based early mental health and wellbeing support hubs for children and young people aged 11 to 25 can play a key role in providing that support. In October 2023, we announced that £4.92 million from the Treasury’s shared outcomes fund would be available to support hubs, and an evaluation to build the evidence base underpinning those services.

[Wera Hobhouse]

Can the Minister perhaps comment on what I said about intensive out-patient units, in that we really do not have any information on how widely spread they are and where they are being provided? They are a very good alternative way of treatment, and we really need more information about where they are available.

[Andrew Stephenson]

We do need more information on that, and I will come to that point. The next point that I wanted to make was on an announcement that I know the hon. Lady will already be aware of, but other hon. Members may not be. Following the evaluation of some excellent commercial tenders from hubs across the country, the Government announced just this week that we are now providing an additional £3 million, which means that total of 24 hubs will receive a share of almost £8 million in 2024-25. That is more than double our original target of funding 10 hubs, and organisations across England—from Gateshead to Truro—will now benefit.

I appreciate that there is still a bit of a postcode lottery around the country, but we are looking to strengthen services, working with different partners across England, to ensure that we are improving services—enhancing existing services—or developing new services where they have not been provided in the past.

[Abena Oppong-Asare]

I just want to add to the point made by the hon. Member for Bath (Wera Hobhouse) about hubs. What work will be done to ensure that the data is captured to see how the growing problem of eating disorders can be addressed and what effective treatments could slow the increase?

[Andrew Stephenson]

We are working very closely with NHS England and partners to ensure that that data is captured. We are also working with the charities involved in this sector and with others.

I know that the Minister with responsibility for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), has been doing a lot of work on this and has met with various stakeholders. I perhaps should have said at the start of the debate that the reason my hon. Friend is not here and hon. Members have me instead is, of course, that the International Women’s Day debate in the Chamber was still going when this debate started —so, unfortunately, there was an unavoidable clash.

However, I know that this is a topic very close to my hon. Friend’s heart, and getting the data right is really important for us to ensure that the gaps that currently exist in services are being addressed. I will certainly ensure that the shadow Minister’s issue is raised with my hon. Friend; if I may, I will ask her to write to the hon. Lady on that.

We know that eating disorders can have devastating effects on adults too. Under the NHS long term plan, by 2023-24 we are investing almost £1 billion extra in community mental health care for adults with severe mental illness, including eating disorders. That extra funding will help to enhance the capacity of new or improved community eating disorder teams covering the whole of the country. As part of funding provided in 2021-22 in response to pressures created by the pandemic, we also provided £58 million to support the expansion of community mental health services for adults, including those relating to eating disorders.

Many hon. Members in their contributions raised avoidant/restrictive food intake disorder, or ARFID. I share their ambition to improve support for people living with this under-recognised condition. In 2019-20, NHS England funded seven community eating disorder teams for children and young people, one in each region of England, in a pilot programme to improve access, assessment and treatment for children presenting with ARFID. The pilots ran from September 2019 to March 2020 and included training to support the adaption of each service’s existing care pathways, assessments and treatment interventions for children and young people with ARFID. The training from those pilots is now available for local areas to commission for their community children and young people’s eating disorders services. In 2021, NHS England also commissioned ARFID training for staff delivering treatment in inpatient children and young people’s mental health services.

We recognise that more needs to be done. We know that the earlier treatment is provided, the greater the chance of recovery. NHS England continues to work with eating disorders services and local commissioners to improve access to treatment for all children and young people with a suspected eating disorder, including those presenting with ARFID.

Several hon. and right hon. Members raised the issue of BMI and the Dump the Scales campaign. NHS England continues to emphasise to systems and services that BMI should not be used as a single measure to determine access to treatment within either adult or children and young people’s eating disorders services. That is in line with NICE recommendations and is included in the national published guidance, as well as in the recent community mental health framework. NHS England is also in the process of updating the children and young person’s guidance, which will also state that BMI should not be used as a single measure.

The hon. Member for Bath asked whether we would consider appointing an eating disorder champion who could help to galvanise action and support for people living with those conditions. As she may know, the Government do not currently have plans to appoint a specific champion role, but I can assure her that the Department of Health and Social Care and NHS England already work closely with stakeholders advocating for better care, such as Beat. We are also very grateful for the work of Dr Alex George in his role as the Government’s ambassador for children and young people’s mental health, which includes championing the needs of those with eating disorders.

The right hon. Member for Hayes and Harlington raised the issue of palliative care pathways. I want to assure him and other hon. Members that people with eating disorders should not be routinely placed on palliative care pathways, including those with severe, complex or enduring eating disorders. The NHS is clear that all those with severe, complex or enduring eating disorders should have access to evidence-based treatments focused on helping people recover, including hospital-based care if appropriate. Staff involved in the care of people with complex and severe eating disorders must adhere to the legal frameworks that safeguard their best interests, and NHS England will work with patient groups and stakeholders to develop further guidance on that.

The hon. Members for Bath and for North Ayrshire and Arran (Patricia Gibson) raised the issue of suicide. It is critical that we all do all we can for those affected by eating disorders before they reach that point. That is why the Government published a suicide prevention strategy in September of last year, which aims to reduce suicide over the next five years. I want to reassure right hon. and hon. Members that people in contact with mental health services, including those with eating disorders, are a priority group for the strategy.

In closing, I extend my thanks once again to the hon. Member for Bath for securing the debate, and to all the hon. and right hon. Members here today for their thoughtful contributions and questions.