Avoidant Restrictive Food Intake Disorder pathway

Avoidant Restrictive Food Intake Disorder pathway

A trailblazing national initiative which could help young people with an eating disorder is being developed with help from Oxford Health NHS Foundation Trust.

This week Oxford Health NHS Foundation Trust is supporting the national Eating Disorder Awareness Week run by BEAT – seven days devoted to highlighting an issue that affects many people.

The Trust works hard all year round to support people experiencing an eating disorder and also to develop new ways to help. And now its contribution to efforts to support people with a condition known as ARFID are starting to make a difference.

What is ARFID?

Avoidant Restrictive Food Intake Disorder (ARFID) is a condition where someone does not eat enough food or avoids certain types of food, like food with certain colours. There are a number of health risks associated with ARFID including weight loss, nutritional deficiencies and faltering growth.

In child and adolescent eating disorder services it is thought that approximately one in three service users meet criteria for ARFID.

Oxford Health CAMHS (Children and Adolescent Mental Health Service) team – based in Bath and North East Somerset, Swindon and Wiltshire (BSW) – was chosen to represent one of the seven NHS England regions in a national ARFID pilot project.

The hope is that the pilot project will help to inform and develop a more effective “pathway” – or route to effective treatment – for anyone suffering from ARFID.

James Fortune, Head of Service, said: “We are really excited to be trailblazing how we improve service provision for children and young people with ARFID in Wiltshire.

“This is a great opportunity for us to work closely across the health system to provide the right help at the right time, ensuring that the treatment we provide is results focused and evidence based.

“It has been recognised that there is a gap in service provision for children and young people with the disorder and so the project gathered information on the prevalence of ARFID across different services, looked at current services available and collected data to improve care.”

The national project was lead by Dr Rachel Bryant-Waugh from South London and Maudsley (SLAM) NHS Trust.

The work involved the team tracking past and present cases, following up with clinicians to gather greater insight into what a successful pathway would look like, and speaking to families and children about their experience of ARFID. The information has now been collated and sent to NHS England.

Pilot project work will continue to benefit people

As a result of the work on the pilot the Oxford Health CAMHS BSW team has continued to strengthen awareness of ARFID within the team and to outside services.

A digital ARFID Appreciative Inquiry day and a multi agency virtual event was held last year to enable people to share some unique ideas about what a successful ARFID pathway would look like. The team also ran 30-minute digital ARFID awareness courses to teams across BSW to raise awareness and to guide clinicians as to how to support patients in the most appropriate way.

Useful resources to help continue to support patients with the diagnosis have been created by the team such as an assessment sheet and an ARFID specific food diary.

Although the national pilot project has ended, Oxford Health staff across BSW, Oxfordshire, and Buckinghamshire are continuing to develop local ARFID pathways with NHS commissioners and clinical partners, including paediatricians, dieticians, speech and language therapists and occupational therapists, to ensure that young people with the condition will have access to treatment.

Published: 2 March 2021