Freedom of Information Request – Ref: FOI 340-2023
Thank you for your recent Freedom of Information request. Please find our response below.
1. Does the Trust provide any intensive community and/or day patient treatment for eating disorders or
refer patients on to receive such treatment from another NHS or non-NHS provider.? This may include
day patient treatment, home treatment, or another innovative model/s. We are interested in
programmes for children and young people, and/or adults.
Yes – however Day Treatment service is currently paused. Do plan to re-open in the future. As service
we also treat patients using FBT and CBTE/CBTT plus use other methods of treatment through
Intensive Clinical Management.
If you answered “No” to question 1 either of the two options., that is all that is required, thank you for
your response.
If you answered “Yes” to question 1, please answer the remaining questions below. If the Trust provides
more than one model of intensive community or day patient treatment and/or has separate programmes
based on age or any other criteria, please provide separate answers for each treatment programme and
specify which programme is being referred to. If the Trust refers patients on to receive intensive
community or day patient treatment from another NHS or non-NHS provider, please state the name of
this provider, and cover this treatment programme within the answers you give to questions 2-8.
2. What model/s of intensive community or day patient treatment for eating disorders does the Trust
provide or refer patients onto.? Examples include day treatment or home treatment, but we are keen
to hear about any other forms of intensive treatment too aside from inpatient care.. In your answer,
please specify whether these are provided in-person or online/virtually.
As already stated we use FBT, CBTE, CBTT and ICM. In addition, the Day Treatment programme
which is currently paused used the Toronto Model and more recently trialled through a Pilot a
Compassion Focused Therapy approach.
3. What is the intensity of this/these model/s of intensive community or day patient treatment for eating
disorders?
a. Please provide the information requested below. If the Trust provides, or refers patients onto, more
than one intensive community or day patient treatment programme please provide separate answers for
each.:
Number of hours per day if applicable to model. Day Treatment would be 7.5 hours Over 5 days
Number of days per week if applicable to model.
Number of contacts per week and minimum duration of those contacts if applicable to model.
CBTE and FBT for first 8 sessions twice weekly then weekly. CBTT once per week. ICM will vary
in intensity and frequency.
Is supervised meal support provided? If so, for how many meals per day?. Yes but Day
Treatment is paused. Ordinarily would be split to 2 snacks and 1 main meal or 2 meals with 1
snack.
b. Please provide any more information that we should know about regarding the intensity of treatment
provided by this/these programme/s.
4. Are families or other carers engaged with when appropriate. in the treatment provided by this/these
intensive community and/or day patient treatment programme/s for eating disorders? If so, please
describe or attach further information outlining this engagement.
Yes. Families are certainly engaged with Family Based Treatment. ICM will also include family input.
Both CBTEE and CBTT may include family input where appropriate. For Day Treatment families would
be part of the care and management pathway throughout and where appropriate.
5. Is/are the intensive community and/or day patient treatment programme/s for eating disorders time
limited, or is the length of this treatment based on clinical need? If it is time limited, what is the
maximum length of treatment?
Based on clinical need although the recent CFT pilot was a 12-week programme that was subject to
review.
6. What are the referral criteria for patients to access the intensive community and/or day patient
treatment programme/s for eating disorders? In your answer, please detail any exclusion criteria e.g.,
age, type of eating disorder/diagnosis, BMI, comorbidity, or otherwise..
Open access referral into the main Eating Disorders service referral inbox via an online form. A triage is
initially conducted then a full assessment if necessary. A treatment pathway is then determined
following the initial assessment.
7. What is/are the geographic catchment area/s for referrals to the intensive community and/or day
patient treatment programme/s for eating disorders including any such programmes provided outside
the Trust’s usual geographic area, potentially as part of an NHS-led Provider Collaborative.?
Gloucestershire
8. Please state the size of the caseload number of accepted referrals. at the Trust’s intensive
community and/or day patient treatment programme/s for eating disorders on the dates below:
31 March 2023 unknown – unable to split
30 September 2023 unknown – unable to split
If the Trust provides more than one intensive community or day patient treatment programme, please
provide the size of the caseload separately for each and specify whether the programme is for over 18s
or under 18s..
9. Which organisation/s commission the intensive community and/or day patient treatment programme/s
for eating disorders? If this is one or more NHS Integrated Care Board ICB. or NHS Trust as lead
provider for an NHS-led Provider Collaborative., please specify their name/s in your answer to this
question
Gloucestershire ICB.
10. Please tell us what the Trust is proud of about its intensive community and/or day patient treatment
programme/s for eating disorders and outline the challenges and opportunities the Trust has
experienced in providing this/these programme/s.
Good outcomes
Good feedback
Innovative CFT pilot with positive outcomes.
FOI Request
I am writing to you under the Freedom of Information Act 2000 to request information regarding intensive community and day patient treatment programmes for patients with eating disorders. Please provide a reference number for this request in your acknowledgement email. [If this request is forwarded internally, please do not cut out the introductory wording before the questions].
A note for clinicians/services involved in responding to this request
We are conducting this survey to help us understand how widely available these forms of treatment are across the UK. The top-level findings will be published in a report, in which individual services/providers will not be named. Instead, we will report the findings in terms of the proportion of providers or areas that offer intensive community and/or day patient treatment programmes for people with eating disorders.
We recognise that eating disorder services are under extreme pressure and are facing major challenges in recruiting and retaining the staff they need. This request will form part of a wider Beat project that will aim to understand and help overcome the barriers that the NHS faces in expanding access to these innovative service models. This will include challenging policy makers and commissioners to provide the required resources.
Background
Intensive community and day patient treatment programmes offer increased contact hours for the patient compared to traditional outpatient treatment. The patient returns home at night and therefore is not an inpatient. Such treatment programmes can help minimise inpatient admissions and reduce length of stay when admission is necessary.
Day patient treatment programmes sometimes called ‘day care’. tend to be run as a group programme, with patients attending the service during the day and returning home for evenings and weekends. Such programmes could potentially be delivered partially or wholly online/virtually. Some intensive community treatment programmes include home treatment, whereby a clinician visits the patient’s home to support meals and snacks and offer psychosocial intervention. There are other models of intensive community treatment aside from home treatment and we are very interested in hearing about these approaches too.
Questions
1. Does the Trust provide any intensive community and/or day patient treatment for eating disorders or refer patients on to receive such treatment from another NHS or non-NHS provider.? This may include day patient treatment, home treatment, or other innovative model/s. We are interested in programmes for children and young people, and/or adults.
£ Yes
£ No, and the Trust has never provided such a service
£ No, but the Trust did provide such a service in the past [Please provide more information below, including what led to the closure of this service/s]
If you answered “No” to question 1 either of the two options., that is all that is required, thank you for your response.
If you answered “Yes” to question 1, please answer the remaining questions below. If the Trust provides more than one model of intensive community or day patient treatment and/or has separate programmes based on age or any other criteria, please provide separate answers for each treatment programme and specify which programme is being referred to. If the Trust refers patients on to receive intensive community or day patient treatment from another NHS or non-NHS provider, please state the name of this provider, and cover this treatment programme within the answers you give to questions 2-8.
2. What model/s of intensive community or day patient treatment for eating disorders does the Trust provide or refer patients onto.? Examples include day treatment or home treatment, but we are keen to hear about any other forms of intensive treatment too aside from inpatient care.. In your answer, please specify whether these are provided in-person or online/virtually.
3. What is the intensity of this/these model/s of intensive community or day patient treatment for eating disorders?
a. Please provide the information requested below. If the Trust provides, or refers patients onto, more than one intensive community or day patient treatment programme please provide separate answers for each.:
Number of hours per day if applicable to model.
Number of days per week if applicable to model.
Number of contacts per week and minimum duration of those contacts if applicable to model.
Is supervised meal support provided? If so, for how many meals per day?.
b. Please provide any more information that we should know about regarding the intensity of treatment provided by this/these programme/s.
4. Are families or other carers engaged with when appropriate. in the treatment provided by this/these intensive community and/or day patient treatment programme/s for eating disorders? If so, please describe or attach further information outlining this engagement.
5. Is/are the intensive community and/or day patient treatment programme/s for eating disorders time limited, or is the length of this treatment based on clinical need? If it is time limited, what is the maximum length of treatment?
6. What are the referral criteria for patients to access the intensive community and/or day patient treatment programme/s for eating disorders? In your answer, please detail any exclusion criteria e.g., age, type of eating disorder/diagnosis, BMI, comorbidity, or otherwise..
7. What is/are the geographic catchment area/s for referrals to the intensive community and/or day patient treatment programme/s for eating disorders including any such programmes provided outside the Trust’s usual geographic area, potentially as part of an NHS-led Provider Collaborative.?
8. Please state the size of the caseload number of accepted referrals. at the Trust’s intensive community and/or day patient treatment programme/s for eating disorders on the dates below:
31 March 2023
30 September 2023
If the Trust provides more than one intensive community or day patient treatment programme, please provide the size of the caseload separately for each and specify whether the programme is for over 18s or under 18s..
9. Which organisation/s commission the intensive community and/or day patient treatment programme/s for eating disorders? If this is one or more NHS Integrated Care Board ICB. or NHS Trust as lead provider for an NHS-led Provider Collaborative., please specify their name/s in your answer to this question.
10. Please tell us what the Trust is proud of about its intensive community and/or day patient treatment programme/s for eating disorders and outline the challenges and opportunities the Trust has experienced in providing this/these programme/s.