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South West London and St George's

Mental Health NHS Trust

Eating Disorders Service

Springfield University Hospital

A Referrer's Guide

1 Who we are

South West London and St George's Eating Disorders Service is one of the largest and oldest established Eating Disorders Services in the world. The Service offers treatment to people with severe eating disorders both nationally and locally, and has an international reputation.

Who the service is for

Anyone from the age of 11 years (no upper age limit) requiring assessment, care and treatment. Treatment is offered on an outpatient, daycare or inpatient basis dependent upon the severity and the individual needs of the patient. The Service accepts patients detained under the Mental Health Act. The Service also provides specialist opinions.

2 National Inpatient Unit: Avalon Ward

Avalon Ward is a 25 bedded inpatient unit for treatment of severe eating disorders, mainly anorexia nervosa. The unit takes local patients from the five London Boroughs of Kingston, Richmond, Merton, Sutton and Wandsworth, as well as patients from all over the country including Northern Ireland. The members of the multidisciplinary team (MDT)have at least a hundred years of experience between them in working with eating disorders, and areas of expertise include occupational therapy (OT), psychotherapy, social work, dietetics, psychology, family therapy, psychodrama, exercise therapy as well as the more obvious input from nursing and medicine. The unit offers refeeding including naso-gastric feeding and medical monitoring of people with severe anorexia nervosa in crisis. We also take male patients. A five bedded medical bay for nasogastric feeding and medical monitoring of people in crisis is opening shortly and will include two beds for child and adolescent patients. There is also a full programme of groups and individual psychological therapies. Outcome measures and audit include patient experience, quality of life, and change in eating behaviours. Results show that the majority of patients leave having increased their BMI, reduced use of behaviours, and learned new skills.

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Avalon Ward is a teaching and training environment for the whole MDT, and has medical students, student nurses, undergraduates in psychology, therapy trainees, and OT students, all contributing to the ethos of positive change. Referrals are by telephone or fax, and are accepted subject to funding from Primary Care Trusts.

6 Eating Disorders Local Outpatient Service

The Eating Disorders Local Outpatient Service covers the five London Boroughs of Kingston, Richmond, Merton, Sutton and Wandsworth, (population approximately 1 million). The service assesses, liaises with primary and secondary care, and treats severe eating disorders. The multidisciplinary team offers a wide range of evidence based therapies including Cognitive Behavioural Therapy for Eating Disorders, Cognitive Analytical Therapy, Mentalisation Based Therapy, Dialectic Behavioural Therapy, OT, psychodynamic behavioural psychotherapy, psycho-education, psychotherapy groups, and non-specific supportive clinical management or person centred treatment, the nurse led intervention, based on the approach of the award winning ANNEX nursing development unit originally set up here 20 years ago. The team are highly skilled, with many years of experience between them and are successful in keeping the number of admissions to hospital low by managing people at high risk with severe and enduring anorexia nervosa in the community. Patients are seen at locality sites within their home borough, or at an alternative site if they prefer. Outcome measures based on questionnaires given to people before and after treatment show significant improvement in quality of life and reduction in the use of eating behaviours. There are close links with Avalon Ward and the Day Hospital. Referrals are accepted from General Practitioners and Community Mental Health Teams in the five Boroughs.

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8 Eating Disorders Local Day Hospital

The Eating Disorders Day Hospital was set up in 2005, and offers intensive treatment to local people from the five London Boroughs with severe eating disorders, who need more than outpatient treatment, but are able to manage at home in the evenings and at weekends. The Day Hospital is staffed by a skilled multidisciplinary team led by an occupational therapist, and has a comprehensive programme of groups and individual psychotherapy, and includes two meals and two snacks a day, running from 0800 until 1600. The outcome studies from the Day Hospital are showing significant improvement in BMI, quality of life and reduction in the use of behaviours, such that it is now attracting international recognition for it's innovative approach based on attachment theory. Research shows that outcome measures are as good as inpatient outcomes but at a much reduced cost. There are close links with Avalon Ward and the Outpatient Service. Referrals are accepted via the Outpatient Service.

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10 Inpatient Unit for Children and Adolescents: Wisteria Ward

Wisteria Ward is a ten bedded national inpatient unit for young people between the ages of 11 and 18 with severe eating disorders and weight loss related to mental health problems. The multidisciplinary team are a highly experienced team in this specialist field and offer assessment and consultation to other teams,and multi-family group programmes in addition to the inpatient service. Refeeding (including naso-gastric feeding) is provided under close medical monitoring. Psychological therapies include individual cognitive and psychodynamic therapies and group therapies. Family involvement in the treatment is emphasised. As family therapy has been shown to be the most effective therapy in treating young people with eating disorders, a range of family interventions are offered ­ family therapy (in accordance with NICE guidelines), multi-family group treatment, information sessions, dietetic advice, supported family meals and parents' support groups. A family suite means families from some distance away can spend time with their children when they are too unwell to go home. Education is an important component. Ofsted has rated the tuition unit on Wisteria Ward as "outstanding" overall and in every category.

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The outcome measures for the young people treated on Wisteria show significant improvement in BMI, reduction in use of behaviours, the learning of new skills and improvement in quality of life and low re-admission rates. Referrals are accepted, subject to funding from CAMHS via telephone or fax.

12 Contact details

Adult Eating Disorders Service Tel: 020 3513 6747 Fax: 020 3513 6724 Child and Adolescent Eating Disorders Service Tel: 020 3513 6683 Fax: 020 3513 6724 Springfield University Hospital Glenburnie Road London SW17 7DJ Switchboard tel: 020 3513 5000 Specialist Services Directorate tel: 020 3513 6305 Email: [email protected]

The nearest tube station to Springfield Hospital is Tooting Bec (Northern Line), a 12-15 minute walk. Bus G1 serves Springfield Hospital itself. On nearby Trinity Road there are buses 219 and 319. On Upper Tooting Road there are buses 57, 155, 219 and 355. On Tooting Bec Road there are buses 249 and 319.

Design from The Drawing Room www.drawingroom.uk.com

How to find us

Photography by Paul Lapsley

Revise Feb 2012

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