Member Article

Priory invests £1 million in new residential eating disorder service at Wimbledon Park

• Arthur House opens its doors, offering psychological expertise as well as nutritional, dietary support from experts • MP for Wimbledon and Health Minister, Stephen Hammond, opens new service
• Rising demand for help with eating disorders treatment, as admissions at NHS services reach highest level in a decade • Service aims to prevent ‘revolving door’ treatment

The Priory Group, specialists in mental healthcare, has invested £1 million in a specialist residential treatment centre for eating disorders.

The service, which is fully CQC-registered, provides a treatment programme helping those over the age of 18 ‘step back’ into daily life following more intensive hospital treatment.

But it can also help those looking to reverse their worsening relationship with food, thereby avoiding hospital inpatient treatment altogether, and individuals who may not meet the NHS criteria for hospital treatment.

Opening the new service, Stephen Hammond, MP for Wimbledon and Minister for Health, said: “It’s important to take the opportunity to highlight the work that is being done to help improve support for those with eating disorders, so I welcome the opening of Arthur House for those stepping down from an intensive hospital stay, or looking to address eating disorders at an early stage.

“A common issue among individuals is relapse, and services like Arthur House have an important role to play both in ensuring recovery is sustained, and helping avoid repeated hospital stays. It was very interesting to meet the team, discuss the therapies and treatment on offer, and to understand how the service aims to support individuals, helping them make links with the local community and turning their hopes for a healthy future into reality.”

Trevor Torrington, Priory Group CEO, said: “We are delighted to be opening Arthur House which builds on Priory’s strong record of delivering high-quality eating disorder services with a high rate of successful outcomes. The consultant-led team of staff at Arthur House has extensive expertise. We were delighted to welcome the minister and show him how Arthur House offers an innovative alternative to hospital and can help prevent the cycle of relapse - which can be a common feature among sufferers of eating disorders – enabling clients to sustain a lasting recovery.”

Services available at Arthur House, near Wimbledon, south-west London, include nutritional and dietary support, and psychological therapies from a team of experts led by consultant psychiatrist Dr Peter Webster, a specialist in eating disorders.

The number of NHS admissions of patients with potentially life-threatening eating disorders has almost doubled over six years.

Those with a primary or secondary diagnosis of an eating disorder reached 13,885 in the year to April 2017, up from 7,260 six years earlier in 2010-11, according to the Guardian. The data, obtained from NHS Digital, showed NHS admissions at their highest in a decade.

Relapse is common, resulting in a “revolving-door” treatment for patients, who keep re-entering services.

Arthur House, initially for privately-funded clients but with a view to being able to accept those who are NHS-funded, via Clinical Commissioning Groups (CCGs), in future, where appropriate, consists of residential treatment for anorexia nervosa, bulimia nervosa, binge eating disorder (BED), or mixed eating disorder symptoms – with the aim of preventing relapse.

It is expected that most people will stay for a minimum of two months.

Director of the Arthur House service, Steve Clarke, says; “The vast majority of people who are admitted as a hospital inpatient for treatment relating to an eating disorder will experience around 6 weeks of initial, intensive therapy. In many cases, this can set them well on the road to recovery, but it’s a long road and I feel strongly that individuals – some of whom will still be feeling fragile and vulnerable – need additional rehabilitation support.

“What The Priory can offer is a complete treatment programme, including hospital treatment, followed by intensive therapy once the individual is mentally well enough to understand the underlying causes of the eating disorder, usually taking 28 days.

“After this, Arthur House can offer a reduced therapeutic and more experiential programme preparing for everyday life by recreating challenges in a safe environment, and this is a vital missing link within current UK treatment.”

Steve, who manages the successful eating disorders programme at Priory’s Life Works Hospital in Old Woking, Surrey adds; “There is increasing evidence from international clinics and specialist services that this ‘bridging’ approach plays a huge role in helping those with eating disorders manage their recovery in the long-term by preparing them for situations they may encounter.”

As well as therapy programmes, including CBT (Cognitive Behavioural Therapy), DBT (Dialectical Behaviour Therapy) and CRT (Cognitive Remediation Therapy), which focus on the way the brain processes information, individuals at Arthur House will also benefit from practical exposure interventions, where they are gradually exposed to food-related activities and behaviours to reduce the anxiety often experienced during these situations. These may include:

• Shopping for food, based on the ‘enjoyable’ nutritional values of food rather than fear of fat/calorie content • Building a nutritionally balanced recipe from scratch • Ordering food in a restaurant, allowing ‘forbidden’ foods to be normalised • Trying on clothes in a public changing room to challenge dysmorphic body image

Recent research1 has shown that relapse among recovered anorexia nervosa patients is common. Studies with an average follow-up of 18 months found relapse rates of between 35% and 41%. Other studies2 have suggested that “exposure and response prevention (ERP)” plays an important role in the ongoing recovery from an eating disorder and in the avoidance of relapse – but until now, access to such programmes in the UK, especially residential, has been extremely limited.

Steve says; “There are many daycare facilities in the UK, and, whilst they do offer important services, it is important to remember a vital aspect of eating disorders is the destructive behaviours of the sufferer that often take place outside of daycare, such as purging. At Arthur House, individuals will be kept safe during the day, and importantly, at night.”

Steve adds; “Working closely with our clients during this time of extended care, and assisting them during the transition home and hopefully back to work and everyday life, is incredibly satisfying for our team. It is something we all feel very proud of and I have every confidence that this new service at Arthur House will provide us with the tools to deliver these outcomes even more effectively than before.”

References: 1 Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study, BMC Psychiatry. 2016; 16(1): 316. Tamara Berends et al 2 Rationale for the application of exposure and response prevention to the treatment of anorexia nervosa, International Journal of Eating Disorders, Joanna E. Steinglass MD et al, 2011

This was posted in Bdaily's Members' News section by Niamh Donnelly .