Implementation of an all-age eating disorders service in the National health service in England: The Dorset experience

Abstract

This article provides a commentary on the development of an integrated all-age eating disorders service in the Eating disorders service within the NHS in Dorset. Previously separate services existed for those under the age of 18 and those age 18 and over. The change from traditional age based services to the all age service was prompted by the observed problems with transitions for patients, their families and the service such as discontinuities in care, and distress to patients and families. In addition the literature on transitions although limited in eating disorders showed that patient and carer perspectives were mostly negative about transitions. The aim was to create an all-age service working with patients of different ages, through developing the competencies of the team to appropriately meet the needs of the all age population. This paper describes the context and rationale for this change, its implementation using the organisational change policy approach to service transformation, including addressing the concerns of the stakeholders (patients, carers, staff, and mental health service commissioners), as well as observed changes in the service and its development. Since the all-age service started in 2016, new research has become available on both the improvement of the transition experience and the potential advantages of all-age services and relevant aspects are discussed.