More than half of England’s integrated care boards (ICBs) plan changes that could result in real-terms spending cuts for eating disorder services, according to an analysis by the Royal College of Psychiatrists (RCPsych).
Cuts by 24 of the 42 ICBs would reduce funding for children and young people’s eating disorder services by more than £835,000 in the 2024-2025 financial year. The reductions range from £3000 by NHS Buckinghamshire, Oxfordshire and Berkshire West ICB to nearly £112,000 by NHS North West London ICB, the college highlighted.
“If these planned cuts come to fruition, it would result in the NHS cutting funding for these vital services in many areas across England,” underlined Dr Ashish Kumar, chair of the RCPsych Eating Disorders Faculty, in a statement.
The planned cuts come amid a 13% rise in referrals to children and young people’s eating disorder services. In the past 12 months, referrals increased from 7008 to 7933. At the end of December 2024, 787 urgent and 5310 routine referrals were still waiting for treatment.
“There is a significant gap between the children and young people in need of care and those who can access treatment,” Kumar warned. “This will only get worse unless we take urgent action to address this crisis.”
More Young People in Crisis
NHS England figures show a sharp rise in the prevalence of eating disorders. Among 11- to 16-year-olds, rates increased from 0.5% in 2017 to 2.6% in 2023. In 17- to 19-year-olds, prevalence jumped from 0.8% to 12.5% over the same period.
RCPsych emphasised that early intervention is crucial for successful treatment. However, high thresholds for accessing services mean many young people wait too long for care, worsening their conditions. Rising demand, staff shortages, and limited resources have forced services to prioritise only the most severe cases.
“As well as major challenges for mental health services, the knock-on effect is being felt within acute trusts,” claimed Saffron Cordery, interim chief executive of NHS Providers. There were “an increasing number of children and young people with eating disorders presenting in emergency departments and being admitted to adult hospital beds,” she noted in a statement.
The RCPsych workforce census 2023 found that eating disorders psychiatry had the highest proportion of vacant consultant posts in England. In March 2023, 21.8% of positions were unfilled, up from 16.1% in 2021. This was adding to the challenge of meeting the NHS England target of 95% of urgent referrals being seen within a week and of routine referrals being seen within 4 weeks. These targets have never been met nationwide. Between October and December 2024, only 81% of urgent cases received care within a week, while 82% of routine cases began treatment within 4 weeks.
Calls for a National Strategy
Cordery said that the latest findings would “ring alarm bells for trust leaders” who had consistently raised concerns about the major mismatch between soaring demand for eating disorder services and their ability to provide them.
In January, the All Party Parliamentary Group (APPG) on eating disorders published a report stating that “eating disorders have one of the largest treatment gaps in modern healthcare”.
The APPG recommended a national strategy for eating disorders, additional funding for services, and increased investment in research. RSPsych supported these calls, stressing the need for adequate funding to improve care and address workforce challenges.
“Eating disorders, in particular anorexia nervosa, have high rates of mortality, yet are treatable conditions and with the right care and support in a timely manner most patients can make a full recovery,” Kumar said.
He urged the government to prioritise recruitment and retention of mental health professionals. “This must be backed by adequate funding so that services have the resources they need to deliver the care our children and young people deserve.”
Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written three books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.
More than half of England’s integrated care boards plan real-terms funding cuts for eating disorder services, despite rising demand and staff shortages, the Royal College of Psychiatrists has warned.
