https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/psychological-and-mental-health-services-pamhs/national-feeding-and-eating-disorders-service/refer-patient-feeding-and-eating-disorders-service/

Refer a Patient to the Feeding and Eating Disorders Service

The Feeding and Eating Disorders Service (FEDS) is a national specialist Child and Adolescent Mental Health Service. As a mental health team our focus is on psychological and interactional aspects of feeding and eating, rather than on medical and structural ones. We therefore work in in partnership with local teams, who manage medical and risk factors.

As a national tertiary service, we work with children from all over the country where local primary and secondary services have been trialled and difficulties persist. Children that we work with will have a severely restricted food intake driven by a range of factors including sensory sensitivity, fear of weight gain, concerns about body image, weight, and shape, specific fears (for example, vomiting, choking) or a lack of interest in food and eating.

Referral criteria

We accept referrals for children who are:

  • Aged under 16 years.
  • Experiencing difficulties with eating which are having a significant impact nutritionally and socially or emotionally. The nutritional impact of the diet could be evidenced by a low weight for height or by nutritional deficiencies as seen on nutritional blood tests.
  • Medically stable and overseen by local services. Any physical or medical symptoms should have been investigated and investigations concluded before referral to our service. The referrer should be a point of contact who oversees the child and is responsible for coordinating contact between services involved, for example community paediatrician, psychologist, CAMHS clinician.
  • Who have already received a local feeding-based intervention before referral to our service. This should be trialled for a reasonable period of time (at least several weeks) prior to referral. Local interventions could include support from professional such as OT, SLT, CAMHS clinician or dietitian. These should be feeding based and focused on behavioural aspects of feeding. For example, advice and intervention around food exposure, mealtime routines and adaptations, sensory desensitisation strategies or anxiety work. Unfortunately, a lack of local service provision will not be considered sufficient reason to discount this requirement. Please include reports detailing local services received when making a referral.

How to make a referral

Referrals can be made by Paediatricians and CAMHS clinicians. Unfortunately, we do not accept referrals from dietitians, GPs, private services or other healthcare professionals. We also do not accept self- or parent-referrals.

Referrals should be made using our referral form.

This form should be completed fully and returned along with reports detailing previous secondary care feeding input. Please note that referrals considered incomplete or without sufficient supporting information will not be accepted.

Completed forms and reports should be emailed.

Email: gos-tr.pamhs@nhs.net

What happens next?

Incomplete referrals and those not made by a Paediatrician or CAMHS clinician will be rejected on receipt. Other referrals will be discussed within the team to determine whether they meet our referral criteria. For those that are accepted, some families will be invited to attend for an assessment, and for others the local team will be invited for a consultation.

Following assessment or consultation, we will provide a report outlining our observations and recommendations. For some families further input may be offered. The types of support that we may provide include liaison to support local services, schools training, a parent intervention group, family-based therapy, individual behavioural therapy, parent-delivered therapy, individual and group sensory desensitisation and dietary support.

Please note that all children who are accepted into our service must remain open to local services, such as a Paediatrician or CAMHS team. Dietetic monitoring is expected to be continued locally, either by a dietitian or GP. As a mental health team, we are unable to provide acute or urgent monitoring and cannot offer medical interventions such as blood tests.

Reference: 1225WAD0028