Intensive outpatient treatment for eating disorders, including day or home-based treatment, could significantly reduce costs to the NHS and still be as effective as inpatient treatment – but has not been made widely available. Despite NICE guidelines stating that residential programmes should be reserved for the most unwell patients, a new report by Beat, the UK’s eating disorder charity, has found that only 30 (33.3%) of NHS trusts offer day or home-based treatment meeting the recommended level of intensity.
South London and Maudsley’s Trust found that including day therapy in an eating disorder treatment programme reduced cost by £87,000 per young person on average. In addition, often fewer days in treatment are needed, with treatment duration decreasing from 196 days in an inpatient unit to 38 when using day and home-based treatment.
Day and home-based treatment programmes allow patients to return home for their evenings and weekends, giving patients the opportunity to immediately put the skills they learn in treatment into practice in their day-to-day lives. This appears likely to make progress more sustainable.
This treatment has also been found to be more acceptable to patients compared to inpatient stays. A patient who received treatment from NHS Lothian’s Anorexia Nervosa Intensive Treatment Team’s home-based programme said, ‘I much preferred it to being in hospital. It helped me more than being in hospital ever did because as soon as I came out [of hospital] I just lost all the weight again.’
Reacting to the report’s findings, Andrew Radford, Chief Executive of Beat said, ‘Eating disorders are very serious mental illnesses, and accessing the best treatment should not be a matter of living in the right place.
‘Appropriate treatment should be considered on a case-by-case basis, and inpatient treatment can be the best way forward for some. However, for others day and home-based treatment can produce the same results as inpatient treatment at a fraction of the cost to the NHS and with less distress. It should surely be an obvious solution to many problems eating disorder services face: offering reduced inpatient admissions, considerable cost savings and increased family empowerment.’