Eating disorders: NHS reform needed to break silo working and aid vulnerable patients
NHS dentists have been left hamstrung in aiding vulnerable patients with eating disorders, as authorities fail to set out guidance, treatment pathways or fix target focused system, say the British Dental Association as new research highlights the ‘key role’ dentists could be playing in the detection of health conditions including anorexia nervosa, bulimia and Gastro-Oesophageal Reflux Disease (GORD).
New data from researchers at Kings College London, published in the British Dental Journal, found that many of the medical conditions that result in the erosion of tooth enamel, can have serious and even possibly fatal consequences if left undiagnosed or untreated.
Eating disorders affect an estimated 725,000 people in the UK, at a cost of around £15 bil per annum. Patients who are reluctant to seek medical help may instead visit a dentist for treatment of conditions such as tooth wear associated with frequent vomiting.
The BDA has called on The National Institute for Health and Care Excellence (NICE) to act on requests to provide clarity on onward referral by dentists when they suspect that a patient might have an eating disorder, and include dentists in multi-disciplinary teams treating in-patients with eating disorders. It has also called on government to offer a decisive break from the widely discredited NHS contract.
Since it was imposed in 2006 the target driven NHS contract has forced practitioners to prioritise targets for curative treatment, with 85 per cent of practitioners reporting it is restricting the time they can spend with patients.
Dentist’s leaders have said progress on these steps, as part of a coherent oral health strategy, is essential to unlock the unrealised potential of the profession.
The BDA says progress on priority areas, including reducing antibiotic prescribing and delivering advice on diet, nutrition and lifestyle has been stymied by the ‘targets and tick-boxes’ culture. It has accused government of consistently failing to offer joined-up approaches to related challenges such as tooth decay and obesity.
The BDA's chair of General Dental Practice Henrik Overgaard-Nielsen said, “Dentists are uniquely placed to provide an early warning for eating disorders, so it’s tragic that they have been left out of the equation. Left without the time, training or appropriate pathways to refer patients, we cannot unlock this potential.
“The NHS desperately needs to deliver a joined-up approach to healthcare. When it comes to anorexia and bulimia our patients cannot afford silo working or policymaking.
“Ultimately a contract system that puts government targets before patient care remains a major barrier. Unless the NHS is prepared to value the life-changing interventions dentists can make we cannot make progress. "