Yorkshire Centre for Eating Disorders

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Yorkshire Centre for Eating Disorders

Yorkshire Centre for Eating Disorders Newsam Centre, Seacroft Hospital Leeds, LS14 6WB E: [email protected] T. 0113 855 6400 F. 0113 855 6401

Yorkshire Centre for Eating Disorders

Referral Form

SECTION A: INFORMATION FOR REFERRERS

Services Provided and Referral Criteria

The Yorkshire Centre for Eating Disorders (YCED) in Leeds is a specialist service which provides treatment for individuals with eating disorders. We provide community, outpatient and inpatient treatments utilising a range of therapies alongside medical risk management in line with NICE and MARSIPAN (Royal College of Psychiatrists) guidelines. We accept referrals for individuals who:

 Are 18 years of age or above, however, we can also accept referrals for individuals who are 17 if they are not in full time education.

 Have moderate to severe Anorexia Nervosa, i.e. core psychopathology and BMI<17kg/m²

 Have severe Bulimia Nervosa, i.e. core psychopathology and daily bingeing AND daily purging

 Have ‘Eating Disorder Not Otherwise Specified’ (EDNOS) if they are pregnant or have type 1 Diabetes Mellitus

All referrals are discussed at our weekly MDT meeting and please be aware that referrals received after 1pm on a Tuesday may not be reviewed until the following week. YCED can offer consultation and second opinion assessments in complex cases where an eating disorder is part of a comorbid condition however we are not commissioned to offer treatment if individuals do not meet the above referral criteria. We do not accept self-referrals. We also do not accept referrals for individuals who have a current substance misuse disorder and we require a period of 6 months abstinence before we can offer any clinical input. YCED can also offer packages of training and consultancy for other UK clinicians.

Note that all individuals are welcome to attend our weekly YCED support group even if they do not meet our referral criteria. Likewise all family and carers of individuals affected by eating disorders are welcome to attend our monthly Family and Carers Support Group. For further information regarding these support groups please contact our administration team.

Care Pathways

For individuals registered with a Leeds GP:

 Individuals with a BMI<15kg/m² can be referred directly to YCED from primary care.

 All other individuals should be referred via the Single Point of Access (0300 300 1485) for screening by secondary mental health services and a holistic and FACE risk assessment must be provided before YCED can accept the referral.

For individuals registered with a GP outside of the Leeds catchment area:

1  All individuals require a named care coordinator from their local community mental health team to ensure that coordinated care between YCED and local services is optimised in keeping with the Care Programme Approach.

 All referrals for patients outside the Yorkshire region should be made via NHS England.

For individuals currently under the care of Leeds Teachings Hospitals NHS Trust (LTHT):

 All LTHT inpatient referrals should be made via LTHT Liaison Psychiatry services who can then refer to YCED if needed.

 All LTHT outpatient referrals should be made as per the standard care pathway outlined above.

B: YCED REFERRAL FORM

Please complete all sections electronically. YCED cannot accept referrals unless all the relevant information is provided below. Once completed please email to: [email protected].

Please also send copies of:

 any recent clinical assessment letters  a recent risk assessment  most recent blood results  most recent ECG

DATE OF REFERRAL

AREA (Leeds/National)

REFERRER DETAILS

Name

Profession

Work address

Contact telephone number

Email address

Fax number

CARE COORDINATOR DETAILS (if applicable, see section A)

Note: YCED cannot accept referrals for national patients without a named care coordinator

Yes No Care coordinator applicable

If applicable, is the care coordinator also the

2 referrer? If no, then please complete the box below.

CARE COORDINATOR DETAILS:

Name

Profession

Work address

Contact telephone number

Email address

Fax number

REASON FOR REFERRAL

Yes No Assessment and community/outpatient treatment

Inpatient treatment

Second opinion assessment

Other (please specify)

PATIENT DETAILS

Name

Gender

DOB

Home address

NHS number

Contact telephone number

Next of kin

Ethnicity

Interpreter required

Patients opinion of referral to YCED (please delete Aware and consents to referral as appropriate) Aware but does not consent to referral Not aware of referral Other (please specify)

3 GP DETAILS

Name

Work address

Contact telephone number

Email address

Fax number

CLINICAL DETAILS

Summary of current difficulties

Background history including previous ED treatment

MHA status

BMI

Weight (kg)

Height (m)

BMI (wt/ht2)

Behaviours

Yes No Type Frequency Bingeing …times/day …times/week

Self-induced …times/day vomiting ….times/week

Laxative misuse …tablets/day …tablets/week

4 Diuretic misuse …tablets/day …tablets/week

Excessive exercise …hours/day …hours/week

Alcohol misuse …units/week

Illicit drug use …/day …/week

…/day …/week

Other disordered …/day eating behaviours …/week (please specify)

Risk summary

History Current Details Ideas of self-harm

Ideas of harming others Deliberate self-harm (without suicidal intent)

Suicide attempts

Plans/preparations to commit suicide Physical harm to others

Threats/intimidation (including verbal abuse)

Child protection issues

Safeguarding issues

Absconding

Compulsory admission

Physical comorbidities (please list)

5 Psychiatric comorbidities (please list)

Current medication (please list and include dosages)

Allergies (please list and give details)

Food intolerances (please list and give details if medically confirmed)

Dietary requirements

Yes No Details None

Vegan

Vegetarian

Other (please specify)

Date and summary of most recent blood investigations (please attach or send formal results with this referral form)

Date Summary

Date and summary of most recent ECG (please attach or send ECG with this referral form)

Date Summary

Additional information

6 7

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