Care options

Care option Description Code Unit
Inpatient
Assessment A half-day assessment, including a medical assessment, where an inpatient stay may be arranged and a report provided. 33160 Per assessment
Treatment, anorexia or bulimia Treatment for severe and intractable eating disorders managing the acute symptoms of the illness in an intensive care setting together with stabilisation of feeding, impulsive behaviours, family work, NG feeding, risk assessments and MHA management.

NHSE commissioned for people who fulfil the NHS England specified criteria.
39870 OBD
Treatment, one-to-one nursing As per the standard treatment option, but with one-to-one nursing due to concern for the person’s well-being. This option is only used in exceptional circumstances and reviewed on a shift-by-shift basis.

NHSE commissioned for people who fulfil the NHS England specified criteria.
91420 OBD
Step-up to recovery This option is mostly suitable for people who have severe and intractable eating disorders. They usually
have complex long standing problems with food, health, vocational function and cognitive and
emotional difficulties. This specialist treatment programme is based on the social recovery model of care
with particular focus on developing life skills, and is tailored to the stage of an individual’s journey of
recovery using a mix of groups, peer support and key-working. This option can be used as a transitional
service from day care or outpatients and/or inpatients. This programme is available from 8am to 8pm
seven days a week and can include all meals depending on a service users individual care plan. A gradual reduction in number of days attended is anticipated as new community activities are ntroduced.

NHSE commissioned for people who fulfil the NHS England specified criteria.
92632 Per day
Care option Description Code Unit
Outpatient
Assessment, anorexia, bulimia, binge eating disorder not otherwise specified A comprehensive assessment with a psychiatrist or senior clinician which includes an eating disorders diagnostic interview, general psychiatric evaluation and physical observation to assess for comorbidities, with both the patient and the carer. Recommendations are provided in a report to the patient, family and referrer and include a history, summary of current difficulties, diagnosis, psychological report and care plan. 39901 Per assessment
Assessment, transition A comprehensive assessment with a psychiatrist or senior clinician of up to two hours incuding liaision with child and adolescent team, meeting with carer and service user. 92986 Per assessment
Treatment, anorexia, bulimia, binge eating disorder Treatment involves an average of 30 one hour sessions of guided self-help treatment, individual or group psychological therapy, family therapy/carers skills, or a combination of all four depending on need, as well as specialist dietetic appointments and medical reviews as part of this package. Physical monitoring including any necessary physical investigations and/or medication are risk assessed and tailored to each person’s treatment. 39902 Per session
Treatment, supported self-care, bulimia This care option includes eight sessions of online cognitive behavioural and motivational enhancement therapy, and 20 minutes of support each week from staff, either online of via phone once each week, for up to 10 weeks. This package is suitable for people who are bingeing daily but not several times a day, where there is not significant co-morbidity or social risk. The therapist will also liaise with the person’s GP and other care providers regarding other physical monitoring needs. Following completion of the package, the therapist will see the person for a 60 minute review to assess whether additional treatment is required. 92839 Per package
Day care, assessment A joint mini assessment will be completed with the service user's current eating disorders care team and if indicated, day care treatment may be recommended. This mini assessment is offered at no cost. 91803 Per assessment
Day care, treatment A review with the service user is held on initiation of day care treatment to discuss and agree a treatment plan. The option is a six to nine month programme, running five days a week between 10am and 4pm. Service users begin to reduce their daily attendance gradually from five days a week to two days a week as they advance closer to discharge. Service users are engaged with the outpatient treatment programme (which is charged at the outpatient treatment sessional rate) alongside the day care programme which continues for six months following discharge from day care.

Service user care and engagement is reviewed weekly by our consultant psychiatrist and MDT. Monthly care review meetings are held involving the service user, carer’s, GP and CMHT’s, to discuss treatment and progress to date. The day care programme is an extensive programme of group therapies, individual key working, nutritional rehabilitation and occupational therapy. All service users who come to day care are expected to work towards a healthy BMI and adhere to the eating disorder symptoms reduction programme. The aim of day care is to support service users in rebuilding their lives outside of an eating disorder and becoming fully integrated members of society.
50144 Per day