Dr. Brendan Doody:

I will just speak for the Linn Dara service. We have eight eating disorder beds. Obviously, that is a finite resource in respect of the number of young people we can admit. Due to the fact the beds are specialist eating disorder beds and that we also offer the option of nasogastric, NG, feeding, we are able to admit young people who are much more unwell from paediatric ward settings. We can treat them in a service where they are getting more than just the nutritional treatment, but also all of the other therapeutic interventions and the comprehensive therapeutic care package. The team assesses all children with eating disorders who are referred to the service. We make an assessment and prioritise the young people who we feel require and would benefit from inpatient care. Given that we now have a specialist eating disorder community service, there may some cases where the needs of the young person can be met by that service. We talked about the number of referrals earlier. Looking at the figures from the community eating disorder team, the number of children that the community eating disorder team is referring on for inpatient admission is usually less than five per year. The national clinical programme is about the need to provide specialist services in the community to enable parents to access specialist treatment in the community such that their child does not require to be admitted to hospital or an inpatient CAMHS setting. On the one had, thinking back, when A Vision for Change was launched all those years ago there was a view that nationally, all we would require would be four inpatient beds for eating disorders. Looking at what has happened over the last few years, we recognised the increased demand for the services, but we did not anticipate the degree to which the demand would explode. We are obviously, in a sense, trying to catch up with something that is increasing. It is important that we take a whole-system approach, particularly given the fact that the majority of young people with eating disorders can be treated successfully in the community. Those specialist services need to be there. The fact we have that specialist community service in Linn Dara is really positive. It enables the young people and families to access specialist treatment at a community level, without having to wait for it. That reduces the likelihood of negative outcomes. We know that the longer an eating disorder persists, the more likely it is to become chronic. The young people who are more likely to require inpatient treatment are those who have a disorder that persists. In other words, the key is being able to access the specialist treatment in a timely fashion in the community.