More support needed for GPs to treat eating disorders

As reported by BBC News, two leading medical organisations have told the BBC that GPs are not getting the right support to treat eating disorders

The Royal College of General Practitioners (RCGP) and the British Medical Association (BMA) say doctors need more time with patients and more specialist units. It comes after a survey was conducted on GP experiences by the charity Beat. Over 92% asked thought their GP needed more training with eating disorders.

Beat Eating Disorders asked nearly 1,700 people about their experience of trying to get a diagnosis from their GP. Out of those questioned, 69% also said they felt their GP didn’t know how to help them. The survey has been released to coincide with Eating Disorder Awareness Week.

Jess Griffiths had an eating disorder between the ages of 11 and 21 and, now in full recovery, she works as a consultant to NHS England and with her local eating disorder service in Dorset. She tells the BBC that when she first went to her GP to try to get help, she wasn’t entirely transparent about what she was struggling with.

“I was presenting at a low weight and not having periods, so the GP put me on the pill, but I went there hoping he would ask me the questions [about a potential eating disorder]” she says.

“But it’s really hard for people with eating disorders to – in a really pressurised situation with a doctor – say how they really feel.”

As part of a three-year training plan to become a GP, doctors have to complete training in mental health, which includes eating disorders. This is on top of what’s taught at medical school and the two years of post-graduate foundation training.

Dr Richard Van Mellaerts is part of the BMA’s GP committee and has told the BBC the results of the survey are “deeply saddening”.

“People with eating disorders should never feel that GPs are a barrier to accessing care, so it is vital that medical education and training supports doctors to identify eating disorders and support their treatment,” he says.

But he adds that there is “poor provision of specialist care”, which has left GPs “frustrated up and down the country”.

The Royal College of GPs’ vice-chairman Dr Gary Howsam says that what doctors need is longer appointments in order to provide the best possible care.

“Eating disorders, indeed all mental health conditions, are complex – they may also not be the primary reason a patient has made an appointment to see their GP,” he says.

“The standard 10-minute appointment is inadequate for GPs to have the necessary conversations with patients, but offering longer appointments means offering fewer, and patients already report having to wait too long to access GP care.”

Jess Griffiths agrees: “I think GPs do an incredibly difficult job – they have to know a lot about illnesses, mental health conditions, and they are strapped for time.

“The workforce issue means we do struggle to provide that level of care needed in specialist services currently – so I can totally empathise,” she says.

Jess provides support to the charity Beat. Using her personal and professional experience, she has helped develop a training programme, which she thinks could be helpful for GPs who need more eating disorder support.

“We’re providing resources to ensure that with the limited time GPs have, they can make an effective assessment and gain all the information they need to then know how to support a person.”

She says it should be made easier for GPs to book eating disorder patients in for double or triple appointments, so they can get enough time together.

“The difficulty with eating disorder patients is they don’t often present in a crisis, and they are generally not underweight, so it’s not often visible what is going on. You need to get to the thought processes behind the mental illness and that definitely takes longer than 10 minutes,” she says.

In response to these comments, a Department of Health and Social Care spokesperson said: “Eating disorders can be devastating for people living with them, and we want to ensure that everyone has access to the right support.

“We are working with partners – including Health Education England – to improve training for GPs, and with the General Medical Council to ensure newly qualified clinicians understand and know how to respond to eating disorders.

“We have invested £58m this financial year to expand adult community mental health services, including those for eating disorders. This is on top of the additional £1bn we are investing in community mental health care for adults with severe mental illness as part of the NHS Long Term Plan.”