Referrals to the Thames Valley Specialised Adult Eating Disorder Provider Collaborative can only be made by a patient’s Adult Community Eating Disorder Service (ACEDS).
Referrers and local community eating disorder (ED) services retain clinical responsibility for managing patients in their local area until the patient is admitted to an inpatient specialised eating disorder unit (SEDU) and engage actively throughout the care pathway. This follows the principles of NHS England’s (NHSE) Commissioning Guidelines.
Making a referral
For all referrals, please fully complete the HOPE SPA NHSE referral form. This should be supported by the most recent Risk Assessment and Medical Assessment documents.
Completed forms are to be sent securely to the Single Point of Access (SPA): hopespa@oxfordhealth.nhs.uk
When sending patient information via email or as an attachment, please ensure compliance with your organisation’s data protection guidance.
Referrals received by 16.00 on Monday will be reviewed in that week’s Clinical Activity Panel (CAP), with prioritisation based on clinical need in discussion with partners.
Forms containing insufficient information may cause delay whilst we seek clarification.
For all telephone enquiries, the SPA can be contacted on 07827 357 357.
Our response
The HOPE SPA team will respond and acknowledge receipt of referrals within 2 working days.
Standard email responses to acknowledge receipt of the referral will be used.
Available by phone during weeks days, the SPA team can provide updates on potential bed availability in the network.
All referrals are scheduled for discussion at the weekly CAP meeting, including updates on individual patients, by SPA.
Types of referrals and their eligibility criteria
Referrals into HOPE SPA are for intensive treatment of severe eating disorders.
Note: BMI is not the sole risk indicator. It may be appropriate to admit a patient suffering from severe and medically unstable bulimia nervosa for symptom interruption of inappropriate compensatory behaviours, or patients with Type 1 diabetes and disordered eating (T1DE), pregnancy, or not responding to intensive community treatment, and presenting with other urgent eating disorder related risk.
Suicide risk and behavioural disturbance as independent risk factors should not be prioritised for SEDU admission, these patients should be managed on acute psychiatric wards with consultation from ACEDS. Complex presentations may necessitate careful multi-agency coordination.
The criteria used to define emergency, urgent and routine referrals into the service are as follows:
When acute physical or mental health (e.g., suicide risk) emergencies pose an imminent threat to life and necessitate admission within 24 hours, a referral is considered an emergency.
Medical Emergencies in Eating Disorders guidelines (MEED) advise that emergency referrals should be made to an acute hospital in the first instance. In case of uncertainty, please consult a medical specialist regarding the urgency of medical intervention.
Medical emergencies require admissions to acute medical settings before SEDU can be considered. HOPE SPA needs to be informed of such admissions, and a SPA referral should be made. The patient should be prioritised as an urgent referral to ensure timely transfer to SEDU.
The ACEDS team should email the SPA a copy of the NHSE referral form to facilitate a prompt transfer from acute hospital once the initial refeeding risk has subsided. Refeeding usually takes 2-3 weeks.
Patients requiring an urgent referral must meet one or more of the following criteria:
- Patients who are deteriorating in the community despite adequate community treatment.
- Patients who have been admitted to acute hospitals for emergency care.
- Multiple factors, such as deteriorating physical health, evidence of extreme compensatory behaviours, a severely restricted diet (1000kcal per day), unstable physical parameters, or social factors, which may necessitate urgent SEDU treatment.
- Patients with high risk and treatment refusal needing Mental Health Act (MHA) assessments or recalls from Community Treatment Orders (CTOs) who cannot wait to be allocated by the Clinical Activity Panel (CAP).
- Patients meeting urgent admission criteria who require alcohol detoxification or stabilisation of co-existing medical problems that cannot be managed in an inpatient SEDU (e.g., acute respiratory infection; uncontrolled diabetes; uncontrolled COPD; heart failure) should be referred for an initial period of refeeding in an acute medical setting.
For routine/planned referrals, the patient meets one or more of the following criteria:
- Outpatient psychological treatment has not been sufficient to effect a change or improvement, including patients who meets the criteria for a diagnosis of anorexia nervosa and continue to lose weight.
- Those who are chronically underweight (usually due to lengthy illness) and are unable to manage in daily life and require intensive support with partial weight restoration. According to the HOPE Provider Collaborative outcome evaluation study, a planned 6-8-week admission with 1-1.5kg/week weight restoration produces the same outcomes as treatment as usual.