Feeding Under Restraint National Audit - Quality Improvement Taskforce

There are approximately 300 beds across England commissioned by NHS England for the inpatient treatment of Adults with severe Anorexia Nervosa. There are also a number of CAMHS EDUs although there is a drive to treat younger people with Anorexia in generic CAMHS wards rather than specialist EDUs - where they will have a specific individualised care plan. As there are around 15,000 acute mental health beds and 1000 Forensic beds in England - inpatient eating disorder beds are very much in the minority. Anorexia Nervosa remains a rare disorder although inpatient admissions for the treatment of very severe presentations are increasing. However, it has been noted that there are more blanket restrictions in EDUs than in any other area of mental health care. It is therefore timely to examine some of these known practices, what is the rationale for using them and to develop some guidelines around regular review and reflection regarding their use. A national audit has been agreed for which will gather evidence around the frequency, circumstances, clinical and systemic factors contributing to nasogastric tube (NGT) feeding under restraint as a basis for development of evidence-based consensus guidelines to support NGT feeding practice and avoidance of iatrogenic harms.