Community Eating Disorders Service

Assessment

We offer an in-depth multi-disciplinary assessment with the whole family/carers. This includes:

• Questionnaires completed by the young person and carer(s)
• Physical health information
• An in-depth interview

The assessment takes around three hours (we would advise you bring a snack for when we have a break).

We will take physical observations and request blood tests and an ECG from your GP before assessment which are reviewed by the team.

The in-depth interview involves talking to the young person and their family/carers all together and separately. We ask about developmental and medical history, family history and other mood problems. We also ask in-depth questions about eating behaviour.

After the in-depth interview, a consultation happens with the wider team considering all the information, including the questionnaires. This is then fed back to the young person and their family/carers, and if the young person meets the criteria for a diagnosis of an eating disorder then it is also given.

Care plans and treatment plans are discussed during this feedback session. You will be allocated a care co-ordinator following assessment who will arrange your next steps with us and be your first point of contact.

If you do not receive a diagnosis we will offer some advice during the feedback session and appropriate signposting to more suitable services.

We offer NICE (National Institute for Health and Care Excellence) concordant treatments, which vary depending on your diagnosis.

There is a range of treatments, which can include:

• Family-Based Treatment: This is a therapy which has the best evidence base for treating young people with eating disorders. This requires the whole family (including siblings) to attend weekly sessions where the family are supported and empowered to help the young person recover from their eating disorder.
• Specialist Supported Clinical Management: This is mainly medical management where physical observations are made regularly and short ‘check ins’ are offered. They assess, identify and review key problems with the aim of weight restoration. Psychoeducation and nutritional advice is also given.
• Dietitian: Our Dietitians support people to trust that eating a balanced diet is the right thing and can ensure nutritional adequacy for individualised diets. This can be offered alongside other treatments.
• Family Therapy: Our family therapists help families make sense of the impact that an eating disorder can have on their relationships. They work collaboratively with your family using your own strengths and resources to reach your goals.
• Cognitive Behavioural Therapy (CBT): Our team offers CBT, which helps explore thoughts, feelings and behaviours that the individual wants to change. Our psychologists may also offer other types of individualised therapy if appropriate.
• Art Psychotherapy: This is offered by art psychotherapists who give individual sessions based on psychodynamic principles. Sessions are usually weekly for 3 to 12 months.
• Child and Adolescent Psychotherapy: This is offered by child and adolescent psychotherapists who provide consultation, individual sessions for young people, and parent support, based on psychodynamic principles. Sessions are usually weekly for 3-12 months.
• Group Therapies: Coping skills group: we offer a rolling group for all young people in our service, the group is facilitated by a therapist and an assistant psychologist. This group helps to manage your anxiety and distress through treatment and life stresses. Body Image group we offer an 8 session body image group when young people are a healthy weight and need some extra support and skills to manage body image concerns.

Parents/Carers Group

We run a 6-week rolling psycho-education group for parents and carers who are completing Family Based Treatment. This group gives essential information about eating disorders, understanding treatment and also to hear other’s experiences.

It runs every Tuesday 09.30-11am online. Following assessment you will be sent information regarding the group and the MS TEAMS link. We encourage all parents/carers who have any role in helping the young person attend. 

What parents/carers have said about the group

“The group was informative and helpful. It supported us through a difficult period.”

“The knowledge to educate us regarding the eating disorder was perfect. The parents group was an excellent opportunity to see how others are affected.”

We also offer a monthly drop in support group for all parents/carers that have young people in the service. This is online on the last Tuesday of the month and anyone is welcome to attend once they have had their first 6 week review.

The service treats young people who have an eating disorder and supports their parents and families, who are important in the young person’s recovery.

Eating disorders can be extremely distressing and can affect the whole family. It is crucial that specialist intervention is both prompt and robust in order to make life saving decisions about the young person in need.

Helping young people to restore lost weight and develop healthier eating behaviours is key for our service, as well as encouraging people to talk about their feelings and learn healthier ways of coping with things as they start to recover.

We welcome people from all backgrounds, cultures, nationalities and religions. Please share with us any information about things we can do to make your experience with us more helpful.

Nurses

We have a number of clinical nurse specialists who complete assessments, and co-ordinate and deliver treatments, such as family-based treatment and specialist supported clinical management.

Doctors

We have psychiatrists who may be involved in your assessments and treatments, including prescribing and monitoring of medication and reviews. A psychiatrist may oversee your care and review your treatments. We have specialist GP’s who support us with physical monitoring and interpreting blood tests and ECG’s as well as offering physical monitoring when required. We have a Paediatrician who you may see for physical examinations and consultations as and when necessary.

Dietitians

Our dietitians offer assessments and treatments. They use the current public health and scientific research on food, health and disease, which they translate into practical advice to help people make appropriate lifestyle and food choices. Our dietitians are also trained in NICE guideline treatments and may co-ordinate and deliver treatment alongside the nurses.

Therapists

We have different types of therapist within our therapies team including:

• Child and Adolescent Psychologists work with individuals and parents/carers offering consultation, parent support and individual psychoanalytic psychotherapy. 
• Family therapists offer assessments and the treatment they offer ( systemic family therapy) involves working with families to nurture change and development
• Art psychotherapists mainly offer treatments of one-to-one art psychotherapy.
• CBT therapists who work with individuals and families to deliver 1:1 treatment

We offer self referrals from parents/carers or young people themselves please contact us directly to make a self referral (please note that a parent/carer needs permission to self refer for anyone over 16years old). Please call us on 01372 216 633. We will need an up to date weight and height to be able to triage a self referral.

We accept requests for support from GPs, schools and other health professionals for children and young people who have or are suspected of having an eating disorder. To contact us or make a request for support:

• Visit the electronic referral system - GPs only
• Visit the secure Riviam web portal - GPs, schools and other professionals
  Please make your request for support on Google Chrome 
• Call Access and Advice on 0300 222 5755
  We are open Monday to Friday, 9am to 6pm. The service is not open on weekends and bank holidays.

If you work for Surrey and Borders Partnership NHS Foundation Trust please follow the consultant-to-consultant request for support procedure.

We require a weight and height for referral.

There is no minimum weight restrictions to access our service, and it is no longer recommended for GPs to "watch and wait" but to refer for early intervention.

Once we receive the request for support you will be offered an assessment.

Areas covered

We are a Surrey-wide service covering Elmbridge, Epsom and Ewell, Guildford, Hart, Mole Valley, Reigate and Banstead, Runnymede, Rushmoor, Spelthorne, Surrey Heath, Tandridge, Waverley and Woking.

Request for support criteria

Children and young people who have, or are suspected of having, an eating disorder. We are commissioned to see children and young people who experience Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, other Specified Feeding or Eating Disorders and high risk ARFID.

At assessment, we establish if the young person meets the criteria for an eating disorder. If they are diagnosed with an eating disorder we will then provide treatment.

Waiting Times

We see urgent requests for support within five days and routine requests for support within 15 days. We aim to offer evidence based treatments within 28 days of contact. If you are concerned please consult with your GP or school nurse who can request support if needed.

“We were, from day one, left in no doubt as to the seriousness of Anorexia. We feel fully educated on the illness. Our daughter was listened to sympathetically and genuinely helped by all involved.” 

“We were grateful for the support and understanding, and being taught how to help our daughter when we had no idea what to do.”

“Everyone I came into contact with was so helpful in my daughter’s recovery.”

“My keyworker made me feel safe and comfortable at a time when I felt alone, attacked and angry. She let me open up without feeling judged and brought such positive energy which made me realise I actually wanted to recover.” 

“The service helped me stay out of hospital and turn my eating disorder around.”

“All the support I have received has been extremely helpful. I feel they really listened to me, they cared and helped me get better, healthy and happy again. The care I received was appropriate.”

Books

• Help Your Teenager Beat an Eating Disorder by James Lock and Daniel Le Grange
• Skills-based learning for caring for a loved one with an eating disorder: The New Maudsley Method by Janet Treasure and Grainne Smith
• Eating Disorders: A Parent's Guide (2nd Edition) by Rachel Bryant-Waugh
• Anorexia and other eating disorders: How to help your child eat well & be well by Eva Musby
• Decoding Anorexia : Carrie Arnold

Websites

• Beat eating disorders 
• Anorexia Family
• Anorexia and Bulimia care
• Tabitha Farrar
• Samaritans
• Anxiety Canada
• NHS
• British Dietetic Association
• Health & Care Professions Council: Dieticians
• F.E.A.S.T's Around The Dinner Table forum (feast-ed.org)

Videos

• Explaining Family Based Treatment and its Evidence – Parents to Parents
• Family Based Treatment Phase 1 – What To Do and Why You need To Do It – Parents to Parents
• Anorexia – Parents to Parents: What We Wish We Had Understood
• Help your child eat with trust, not logic: the bungee jump (Anorexia & other Eating Disorders) – Eva Musby
• Stuck and not eating – Eva Musby

ARFID resources

Websites

• ARFID Awareness UK
• ARFID - Beat (beateatingdisorders.org.uk)

Support groups

• ARFID awareness UK run a parent and carer support group on facebook
• BEAT Eating Disorders Charity run online support groups through their website for young people and parents and carers. Online support groups - Beat (beateatingdisorders.org.uk)
• Family Voice Surrey Restrictive Food Intake Group
  This is a monthly online support group for those whose children suffer with restrictive food intake for whatever reason, ARFID, ASD, allergies, poor swallow etc. Held on Zoom. Home - Family Voice Surrey. 

Contact Details

The Child & Young People’s Eating Disorder Service
The Meadows Day Hospital
The Meadows
Horton Lane
Epsom
Surrey KT19 8PB

Please note: we are not a Day Hospital- we have inherited the building and the address. 

Parking

Free parking is available in front of The Meadows Day Hospital, subject to availability. 

Free parking is also available at Surrey and Borders Partnership Trust (SABP)’s Ramsay House, subject to availability. Take the first left after you enter West Park into Richmond Crescent and follow the road around, you will see the SABP car park on the left almost immediately. 

Free parking is also available in the SABP car parks next to the Training Centre/ Burnham Suite (on your left) and outside of Farmside/ HOPE Services (on your right) once you have driven past the front of The Meadows, subject to availability.

When parking at any of those locations, please do not park in the disabled spaces unless you qualify and have a blue badge.
 

Telephone

01372 216633

Opening times

Monday to Friday, 9am to 5pm

Contact name

Service Manager: Suzanne Cole

Out of hours contact

Surrey and Borders Partnership NHS Foundation Trust switchboard: 0300 5555 222

Areas covered

• Elmbridge
• Epsom and Ewell
• Guildford
• Mole Valley
• Reigate and Banstead
• Runnymede
• Spelthorne
• Surrey Heath
• Tandridge
• Waverley
• Woking