Dr Paul Robinson is Orri’s Director of Research and Development and is a lead Psychiatrist in the treatment of eating disorders. Having been part of the team since day one, he shares his response to our ‘outstanding’ CQC rating.
I have long been convinced that most patients with severe eating disorders do not require admission to inpatient care, and that for those who are admitted, some could have avoided admission with intensive community care and some, perhaps most, could be discharged early, when medically stable, to such care. That was the basis for the service I developed at the Royal Free Hospital in the 90s and I was so pleased when Kerrie (CEO) invited me to be part of the Orri project in 2019.
The idea that one can treat people with severe eating disorders in day care has been supported by our charity partner, Beat, and NICE but unfortunately not taken up universally, for reasons that escape me. Thankfully, Orri has now shown that it can be done effectively and safely.
What are the elements that have contributed to the success of Orri? They are many, and the CQC has recognised them, but I would like to point to a few key areas that I believe to be essential.
The first is effective leadership, and I am referring here not only to our excellent CEO, but also to the whole senior clinical and management team. Their belief in the Orri model and their high professional standards, allow the rest of the staff to participate in what some in the Eating Disorders field regard as a risky enterprise. It is only when the leadership are able to convey a sense of professionalism, adherence to safety and to outcome monitoring, that more junior staff as well as clients, can feel confident enough to get on with the difficult task of client recovery.
The second key area is adherence to effective professional practice, backed by research evidence where that exists, and to professional standards where it does not. The fact that this is universal at Orri means that the quality of care provided is as high as it can be.
The third area that contributes hugely to Orri’s success is the relationships built up between staff and clients. People with eating disorders can experience criticism and rejection when it comes to their beliefs about eating and the body. They can be dismissed as seeming “self-absorbed”. At Orri, a compassionate approach from staff recognises that our clients are in the grip of a compulsion they cannot control and walking alongside the client in this way is an essential part of helping them move on to a healthier way of life.
Could Orri, with 5 stars, do any better? Of course the answer is yes. The model needs to be made available to all NHS patients both using face to face and online therapy, and as well as thinking of expanding existing Orri in a new location, and perhaps establishing Orri 2, we might consider whether other community approaches such as home care might be within our reach.
Whatever the future holds, Orri has, through its successful CQC inspection, become established as a beacon service, to be used and emulated by other services, and for Orri and the Orri model, the future looks very promising.