Box 3: PHSO Recommendation Three
The National Institute for Health and Care Excellence (NICE) should consider including coordination as an element of their new Quality Standard for Eating Disorders.
58.The PHSO’s report notes that NICE guidance on eating disorders “identifies that particular care should be taken to ensure services are well coordinated when more than one service is involved” but found that there were wide variations in how eating disorder care was coordinated and that poor coordination of services was a “starkly common issue”. In written evidence to us the PHSO further explained:
A detailed care plan that all providers involved in a patient’s care pathway understand, and that comprehensively assesses an individual’s needs and considers risks is an essential part of ensuring care is properly managed. Without this, and in the absence of frequent and clear communication between providers and the engagement of appropriate multidisciplinary expertise, there can be tragic consequences.
59.NICE has included coordination of services in its quality standard on eating disorders and we welcome the timely implementation of this recommendation; however, it is important to ensure that organisations embed such standards. Dr Nicholls said in oral evidence:
What I am not clear about is what the impetus or leverage is to enforce those quality standards and what expectation there is for services to adhere to those quality standards. It is the standard but as to whether there has been an audit against that standard as yet, I have not seen any evidence of that.
60.Rethink Mental Illness, while welcoming the NICE quality standard, argued that transitions must not only improve between NHS services but also between NHS services and educational institutions, noting that students’ transitions from home to university pose issues for many students.
61.To help support the implementation of the quality standard, the Government’s evidence described work NICE is undertaking with national partners
Care Quality Commission: NICE has developed a checklist in line with the quality standard, for inspectors to use when assessing services for people with an eating disorder;
Beat (the eating disorders charity), Royal College of General Practitioners, and Royal College of Paediatrics and Child Health have agreed to be supporting organisations for the quality standard and to promote the standard within their networks.
62.We welcome the inclusion of coordination in the new NICE quality standard on eating disorders but further work is necessary to embed those standards. We recommend that the PHSO Delivery Group, as part of its work, commission an audit of the extent of implementation of the NICE guidelines. This could be completed over the next few months (before we report again on this topic - see paragraph 84 below).
66 , Parliamentary and Health Service Ombudsman, December 2017, p 16
67 Parliamentary and Health Service Ombudsman,
68 , NICE, September 2018
70 Rethink Mental Illness,
71 Department of Health and Social Care, Health Education England and the National Institute for Care Excellence,
Published: 18 June 2019