Setting

This audit would be relevant in eating disorders services, particularly in outpatient settings. It was originally conducted for an eating disorders service within a child and adolescent mental health service (CAMHS), but it would also be appropriate in adult services.

Background

Eating disorders comprise a range of syndromes with physical, psychological and social features. The provision of psychiatric treatment by high-quality, age-appropriate, specialist eating disorder services has a clear effect on patient outcomes. The purpose of this audit was to ensure that the local service provision was in line with national standards.

Standards

According to the 2004 guideline on eating disorders produced by the National Institute for Health and Clinical Excellence (NICE):

ᐅ most patients with anorexia and bulimia nervosa should be managed on an out-patient basis

ᐅ psychological therapies should be offered to all patients who are diagnosed with an eating disorder

ᐅ psychological therapy for anorexia nervosa should last at least 6 months.

The target is that these standards are met for all patients diagnosed with specific eating disorders.

Method

Data collection

Data were collected, using a specific data tool, from all the referrals to an eating disorder service over 1 year. The data tool allowed information to be collected on the following areas:

ᐅ diagnosis at first assessment

ᐅ treatment offered (psychological, parent psycho-education, medication) and whether it was delivered on an out-patient or in-patient basis

ᐅ types of psychological therapy offered (e.g. family therapy, individual psychodynamic therapy, interpersonal therapy, cognitive–behavioural therapy or a combination)

ᐅ duration of therapy.

Data analysis

The percentage of the sample with documentation of a diagnosis in line with the ICD–10 classification was recorded. In addition, for patients who required treatment, the percentages with documentation of the following were calculated:

ᐅ type of treatment offered (psychological, others, combined)

ᐅ type of psychological therapy offered

ᐅ duration of therapy (recorded as less than or more than 6 months).

Resources required

People

The audit should be undertaken by at least two people, owing to the amount of information collected.

Time

For a service receiving 100 referrals per year it is estimated that the data collection would take around 15 hours.