Inpatient eating disorders treatment

Inpatient treatment is provided for eating disorder patients at high medical or psychiatric risk and those who are motivated to make changes but have been unable to do so after an effective period of outpatient treatment.

The service has 14 bedrooms for local and national patients with severe eating disorders. Of these, 12 are reserved for women and two for men.

If admission is required, patients and their carers are offered the opportunity to visit the unit and to meet with inpatient staff for an introduction and preparation for admission. On admission a keyworker from the nursing team is allocated to each patient, and this keyworker will remain the same until discharge. They will meet weekly with the patient and coordinate their care. An initial Care Programme Approach meeting is organised soon after admission, to begin the process of discharge planning and liaison with relevant after care services.

Care plans and length of stay at the unit is guided by individual need and not by fixed programmes of treatment. The inpatient treatment packages combine meals and nutritional support with more intensive medical, psychological and social care than can be provided by outpatient attendance. Care is delivered through a combination of group work, individual sessions, specialist psychotherapies and occupational therapy interventions within a framework of motivational enhancement.

Ongoing day patient and outpatient treatment is recommended for at least one year following discharge from inpatient treatment. For the majority of patients this will be offered at Vincent Square, although for some patients it is sometimes more appropriate to transfer care to a local eating disorder service.

Many of the components of the day treatment programme are accessible to both inpatients and day patients, in order to facilitate flexible and graduated movement between these two levels of care. Transitions between services (or components within a service), are associated with high risk of disengagement and relapse. Continuity of relationships with staff and peer group, structure of the programme and familiarity of the environment help to reduce the risk of disengagement or relapse at the time of transition from inpatient to day patient care.

Transitions are graded, with periods of increasing home leave in preparation for discharge to day patient care. Timing of transition is determined by progress with weight gain during periods of home leave and not by fixed length of stay or body mass index (BMI) criteria. Thus, if a patient is able to continue to make progress with weight gain on leave, they will be able to continue care as a day patient, even if BMI remains low. Where geography precludes the use of day patient care, inpatient care is extended until there is evidence from periods of extended leave that progress is likely to continue with local outpatient care.

Contact details:

Address: Vincent Square Eating Disorder Service, 1 Nightingale Place, London SW10 9NG
Phone: 020 3315 2104

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