Clinical Assessment

Non-urgent referrals are assessed within 8 weeks and urgent assessments within 2 weeks. Assessments are conducted by a trained member of the multidisciplinary team (MDT) and reviewed at a weekly MDT assessment meeting. The assessment procedure includes:

• Biopsychosocial assessment
• Diagnostic and aetiological formulation
• Assessment of motivation and readiness for change
• Psychiatric and medical risk assessment
• Assessment of carers’ concerns and needs (where appropriate)
• Formulation of an appropriate care plan, utilising and liaising with primary and secondary services as appropriate.

A written assessment report is sent to the patient and copied with a short covering letter to the referrer and/or GP within 2 weeks. The assessment letter and care plan are reviewed with the patient at a follow-up appointment 2-3 weeks after assessment. Those with sub-clinical eating disorders are offered an assessment letter, advise and self help book, and where appropriate, treatment recommendations for primary or secondary care.

Patients offered treatment at Vincent Square Clinic are placed on the waiting list for out-patient, day patient or in-patient treatment as appropriate. The GP/referrer is asked to maintain responsibility for their patient’s psychiatric and medical care until start of treatment at Vincent Square. Advise, a self help book, and where appropriate, treatment recommendations for primary or secondary care are offered whilst the patient is waiting for treatment.

Liaison Nurse Service

The liaison nurse service is available to referrers for consultation and advises about initial assessment and management, appropriateness of referral and management of risk. Joint assessments and shared care arrangements are facilitated as required. The service provides regular training events for (primary and) secondary care professionals in the assessment and management of eating disorders.

The liaison nurse therapy service provides out-patient care for difficult to engage high risk patients. The model of care combines elements of assertive outreach, supportive therapy, motivational enhancement and cognitive analytic therapy to provide a structured approach to harm minimisation, engagement and therapeutic change.

The service is highly flexible and responsive, with capacity to provide urgent interventions, with greater intensity than once weekly appointments. The style and frequency of sessions is determined by clinical need. For all patients, the goal of this work is to facilitate engagement in a process of active change and not simply to support patients remaining unwell.

Whilst for some patients a complete episode of care may be conducted within the liaison nurse therapy service, others will progress to utilise other elements of the service.