The BDA Paediatric Specialist Group, ARFID Specialist Sub-Group and Autism Specialist Sub-Group have jointly written to NHS England’s Chief Executive and other senior leaders, calling for a national review of how nutritional risk associated with ARFID and severe selective eating is identified and managed across England.
This letter follows three Prevention of Future Deaths reports issued by HM Coroners in the last five years relating to deaths associated with undiagnosed or inadequately managed ARFID and malnutrition. While each case had unique circumstances, the recurrence of these reports raises important questions about current systems of care, access to specialist support, and how nutritional risk is recognised and escalated.
Our members and colleagues continue to report rapidly rising referrals, increasingly complex presentations, fragmented pathways, and significant variation in service provision across the UK. Many dietitians are managing high-risk cases without consistent access to multidisciplinary support, supervision, training or national guidance.
The letter calls for NHS England to commission a national review into nutritional risk associated with severe selective eating across children and adults. We believe this would help establish a clearer understanding of:
- current service provision and workforce pressures
- variation in pathways and access to care
- gaps in national guidance and training
- opportunities to strengthen patient safety and early identification
Alongside this, we are also sharing the letter with counterparts across Scotland, Wales and Northern Ireland, recognising that while services are organised differently across the home nations, many of these challenges are unlikely to be unique to England.
We recognise that serious complications associated with ARFID and selective eating remain uncommon. However, the increasing number of reports describing severe malnutrition and micronutrient deficiency suggests this is an area requiring greater national attention and coordinated learning.
Members are encouraged to:
- share the letter within their professional networks
- raise concerns and examples of service gaps within their own organisations
- engage local parliamentary representatives (MPs, MSPs, MSs and MLAs) to support awareness of the issue nationally
NHS England also encourages members of the public and professionals to report patient safety incidents, including near misses and concerns relating to gaps in care, through the Learning from Patient Safety Events (LFPSE) service.
For further information or to raise any views, please email [email protected]