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The majority of children and young people with an eating disorder will be treated in the community by local child and adolescent mental health services (CAMHS) or through referral to specialist in-patient services.

In patient services, for adolescents are provided by three regional units in Scotland. These are the South of Scotland based at Royal Edinburgh Hospital with 12 beds serving Lothian, Fife & Borders; West of Scotland based at Stobhill Hospital Glasgow with 24 beds serving Greater Glasgow & Clyde, Forth Valley, Lanarkshire, Dumfries & Galloway and Ayrshire & Arran and the North of Scotland based in Dundee with six beds, serving Tayside, Grampian, Highland, Shetland, Orkney and Western Isles.

To meet demand the North of Scotland planning group are currently developing an outline business case for rebuilding of the Dundee unit to include the addition of further six beds.

The Mental Health of Children and Young People: A Framework for Promotion, Prevention and care by 2015 includes a specific section on school years that requires all health boards to work in partnership with local authorities, the voluntary sector and schools. As part of this role NHS boards should make available a named link person to every school (or alternatively have a clearly articulated link system) to ensure that the mental health needs of pupils which includes eating disorders are identified at the earliest opportunity and that good links are in place with local CAMHS services.

By delivering closer working relationships between specialist mental health clinicians, such as psychiatrists and schools, children and their parents or carers should benefit from an increased confidence of teachers identifying where specialist help is needed.

Education authorities are responsible for ensuring that their staff have the necessary skills, knowledge and competences to recognise and support the learning needs of the children in their classroom to enable them to learn effectively.

Hands on Scotland: http://www.handsonscotland.co.uk/

provides a toolkit for teachers, carers and anyone working with children giving practical information on eating disorders, anxiety, phobias, bullying and many others.

If parents are refusing treatment for their child against the advice of the clinicians in charge of their care, the child may be subject to the supervision of the local authority, under the child protection regime contained in the Children (Scotland) Act 1995 Part 2. A children’s hearing operating under this part of the act can be asked to attach a condition of treatment to a supervision requirement.

If it is believed that the child is severely ill and they or their family refuse treatment considered to be essential, it may be possible for the lead clinician involved in their care to overrule their decision. If the situation is thought to be very serious, then it is possible for the child to be treated without either the child’s or their parents consent under the Mental Health (Care & Treatment) (Scotland) Act 2003.

The involvement of family members in the child or young persons treatment is seen as important. Where appropriate to do so the child or young person and their family will be offered family meetings and/or family therapy. The child or young person will also have meetings with the health care professionals. Normally the family will also be kept informed of progress in treatment.

NHS Quality Improvement Scotland now known as Health Improvement Scotland produced a Patients guide to Eating Disorders in Scotland:

http://www.healthcareimprovementscotland.org/default.aspx?page=12455,

which gives recommendations for identification, management and treatment of eating disorders inn adults, young people and children. The document also contains details of useful internet sites which contain content for patients, their families and carers.

This information is not held centrally

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. The provision of care for people with mental health problems is the responsibility of GPs, NHS boards and local authorities working with partners in the private and third sectors.

NHS Quality Improvement Scotland now known as Health Improvement Scotland produced a Patients Guide to Eating Disorders in Scotland.

which gives recommendations for identification, management and treatment of eating disorders in adults, young people and children. The document also contains details of useful internet sites which contain content for patients, their families and carers.

http://www.healthcareimprovementscotland.org/default.aspx?page=12455

This information is not held centrally.

The majority of children and young people with an eating disorder will be treated in the community by local Child and Adolescent Mental Health Services (CAMHS). A small number will be referred to specialist in-patient services. A wide range of treatment and therapeutic interventions will be available to respond to the assessed needs of individuals in line with national guidelines.

The involvement of family members in the child or young persons treatment is seen as important. Where appropriate to do so the child or young person and their family will be offered family meetings and/or family therapy. The child or young person will also have meetings with the health care professionals. Normally the family will also be kept informed of progress in treatment.

Policy officials are not aware of any representations that have been made by the Scottish Government to the European Parliament or UK Treasury in relation to a reserved matter of VAT on sun creams.

The total number of people treated for eating disorders in Scotland is not available centrally.

Information available from the Practice Team Information (PTI) scheme, which can provide national estimates of the number of people consulting either a GP or practice-employed nurse where an eating disorder was noted as one of the reasons for consulting, is shown in the following tables.

Information available on patients seen in hospital is also shown in the tables below, but this will only relate to a small proportion of people treated for an eating disorder, given the majority of people will be treated in the community and other settings such as hospital outpatients, counselling services etc, for which information is not available.

PTI records indicate reasons for consultation but this does not specify whether treatment was provided. The PTI sample covers approximately 6% of general practices in Scotland and their population is regarded to be broadly representative of Scotland as a whole in terms of their age, gender and deprivation profile. PTI data are available from 1 April 2003. They cannot be used to estimate figures by individual NHS board area.

Table 1 shows the estimated numbers of patients who consulted either a GP or practice-employed nurse in Scotland for different types of eating disorders, categorised as anorexia, bulimia, other eating disorders and unspecified eating disorders, during the financial years 2003-04 to 2009-10. Table 2 shows estimates of numbers of patients consulting for any eating disorder, split into four age groups (14 and under, 15 to 24, 25 to 44 and 45 and over).

Some patients may have consulted for more than one type of eating disorder during the year and therefore the total number of patients seen for any eating disorder is slightly lower than the sum of patients seen for each individual eating disorder. Overlap is most likely where patients had a consultation for which only a general eating disorder code was recorded as well as a consultation for which a specific eating disorder was recorded.

These are estimates based on a sample of practices that may vary between years. The 95% confidence intervals give an indication of the uncertainty around the estimates. For relatively rare conditions the confidence intervals will be fairly large.

Information on number of patients treated for eating disorders at acute and psychiatric hospitals during financial years 1999-2000 to 2009-2010 is shown in tables 3 and 4.

Table 1. Estimated number of patients in Scotland consulting a GP or practice-employed nurse for an eating disorder at least once in the year, by type of disorder.

Estimated numbers¹, with 95% confidence intervals²

Table 2. Estimated number of patients in Scotland consulting a GP or practice-employed nurse for an eating disorder at least once in the year, by age group.

Estimated numbers¹, with 95% confidence intervals²

Notes:

1. Based on data from 59, 53, 51, 49, 48, 58 and 60 PTI practices that submitted complete GP and practice nurse data for the years ending 31 March 2004, 2005, 2006, 2007, 2008, 2009 and 2010 respectively.

2. As the estimates are based on data from a sample of practices, 95% confidence intervals are included to indicate the relative degree of certainty of these estimates.

3. The total number of patients seen for any type of eating disorder is lower than the sum over individual conditions, because some patients will have consulted for more than one type of eating disorder and hence will be counted in more than one category.

Table 3. Number of patients treated at acute hospitals (SMR01) in Scotland for eating disorders, by type of disorder, age and NHS board of residence, Financial Years 1999-2000 to 2009-2010

Table 4. Number of patients treated at psychiatric hospitals (SMR04) in Scotland for eating disorders, by type of disorder, age and NHS board of residence, Financial Years 1999-2000 to 2009-2010

Note:

*Indicates values that have been suppressed due to the potential risk of disclosure and to help maintain patient confidentiality.

-Indicates zero values.

All Scottish Government funding to support the grassroots development of community football is routed through sportscotland who operate a number of funding streams that are available for clubs and groups to access. I have asked the chief executive of sportscotland to write to the member outlining the detail of these funding streams.

In 2009-10, football received record funding of £6.478 million invested into the grassroots and development of youth football and support for Scottish football organisations and clubs for a number of other initiatives in supported employment and football supporter initiatives.