Only 1 in 7 NHS areas providing intensive eating disorder treatment in the community, new Beat report finds

Our new report has found that only 1 in 7 NHS areas in the UK are providing the recommended level of intensive community and day treatment for both children and adults with eating disorders.

Just 10 out of 67 (15%) NHS areas provide the recommended level of care for both children and adults, with 6% offering it for children and young people only, and 10% offering it for adults only.

The research shows that intensive community and day treatments are just as effective as inpatient treatment, are far less disruptive to patients and families, and crucially are far cheaper than inpatient care – yet most patients are unable to access these services. In addition, some of the areas which do provide intensive community treatment have extremely limited capacity.

The report found that a typical cost of treating a patient in an inpatient service is more than three times more expensive than in day treatment.

NHS England data indicates that for children and young people in CAMHS (Children and Adolescent Mental Health Services), the average cost of a day in CAMHS day treatment in 2024/25 is £462, whilst the average cost of a CAMHS inpatient admission is £1573 per day.

Inpatient care has also been criticised by those with lived experience for its restrictive nature and the loss of freedom it entails.

• Intensive community and day treatment programmes offer more frequent patient contact than traditional outpatient care, which typically involves weekly sessions, but unlike inpatient care they allow patients to continue living at home.
• These forms of treatment are far less disruptive to those affected, as patients can stay close to their support network and immediately apply the skills they have learnt to real-life situations, such as going out for meals in public.
• Treating patients in the community or in day patient clinics has been found to have equivalent outcomes to an inpatient admission and can reduce the length and total number of inpatient admissions.

‘Inpatient was really traumatic, wasn't therapeutic at all. It was a really competitive environment and anorexia is competitive in its nature. So it's not geared towards recovery. It's almost like we're holding you here so you don't die, but that's it.’ - Person with lived experience

Tom Quinn, Beat’s Director of External Affairs, said:

‘It’s completely illogical that the NHS is spending so much money on expensive and disruptive inpatient services for people who don’t need them. The findings are clear: most people with eating disorders can and should be treated intensively in the community.

‘Every day we hear from people who have been sent away from home where they’ve lost access to their support networks, routines and home comforts. It’s incredibly frustrating to know that all the while they could have stayed in familiar surroundings and had just as successful treatment outcomes – but can’t due to poor management of NHS resources.

‘We know how overstretched and under pressure the NHS is; hospital admissions have increased fourfold over the past decade and it’s clear that this is unsustainable. Decision makers must now undertake a comprehensive restructuring of care so as many people as possible can be treated in the community.’

Beat’s definition of the ‘recommended’ level of intensive community and day treatments is as follows:  

“Patients should be able to access an intensive community treatment programme capable of providing at least four change-focused contacts over at least 3 hours per week, including supervised meal support, and the service should have the ability to adjust the intensity flexibly according to the needs of the patient. Patients should be able to move if needed to a more intensive community or day treatment programme providing at least 20 hours of care, spread over a minimum of four days per week including supervised meal support. These treatment programmes should be provided by a multi-disciplinary team and be offered for at least 6 weeks with the ability to extend thereafter if clinically necessary.”