Birch Ward
The Northern Centre for Eating Disorders
West Park Hospital
Edward Pease Way, Darlington, County Durham
DL2 2TS

Phone: 01325 552053

Email: [email protected]

About Birch Ward

Birch Ward, based at West Park Hospital in Darlington treats adults with eating disorders, specifically anorexia nervosa. Birch Ward provides individual care for adults with eating disorders in a specially designed environment.

From admission there will be several people involved in your or your loved one’s care:

Responsible Clinicians, Nursing Team, Healthcare Assistant, Allied Health Professionals, Activity Coordinators, Pharmacists, Chefs, Housekeeping. Patients admitted to the ward will also have access to Speech and Language Therapist, Physiotherapist, Tissue Viability and Physical Health Practitioners

A typical day on Birch

Being weighed

The frequency will be agreed at the point of admission. However, this can change – weigh days are decided by the patient on admission we do not stick to set days within Birch ward –we do appreciate that these can be particularly difficult days for any patient.

Meal guidance

Meal and snack times are a central part of treatment. However we recognise that for some, this can be one of the most difficult times of the day. Our aim is to support as much as possible through a structured food-focused approach so nutritional health and mental wellbeing can be restored. This guidance has been produced in collaboration with service users to ensure that meal and snack times are as supportive and successful as possible.  These mutual expectations of one and other help maintain a supportive atmosphere reducing triggers and help aid recovery.

Supported dining (with staff support)

Staff support is available to everyone. This is determined in collaboration with each patient – be this 1:1 or floating support. 

Unsupervised dining

Movement to the unsupervised dining in based on progress and through discussion.

Post meal support

After each main meal (lunch or dinner) on leaving the dining room all patients come together and have a 30-minute period of support with staff- sometimes this is extended to 60 minutes for extended post meal support.  This is to promote rest and digestion.  To support all patients to with sit with difficult emotions and thoughts.

A post meal Activities co-ordinator is allocated each day and several approaches for this will be used including diversional, mindful/relaxation techniques as well as and psychologically based groups.  1:1 work will be available for patients who have engaged in specific food challenge work or requested this.

This support provides an opportunity to seek and give help and advice and to discuss any difficulties which have emerged.

Following breakfast and snacks, activities will be programmed within the ward.  The level of post meal observation by staff will depend upon need on an individual basis.

Eating and Daily Living Skills (EDLS)

This is performed in conjunction with the Occupational Therapy team and will be discussed with all patients in further detail when appropriate. The objective of EDLS is to equip patients with skills that can be used once discharged home.  Please see later for more information.

Supported snacks and meals

Once assessed by our OT team patients can begin having time off the ward to have snacks and meals out.

Individual therapy

The aim of individual therapy is to help the person develop an understanding of and address the key psychological aspects of their eating disorder.  This may also include looking at additional difficulties such as depression or trauma symptoms. This will be agreed between the patient and individual psychologist.  In allocating a psychological therapist we will strive to take account of any therapy preferences the patient might have and your history of any previous treatment, in line with our therapist’s availability.

Eating and Dietary Living Skills (EDLS) programme

This runs alongside the main ward programme and addresses the core areas of eating and dietary skills affected by eating disorders within an individualised patient approach. All patients are given a copy.   The aim of the EDLS programme is to address the core areas of eating and dietary skills affected by eating disorders within an individualised patient approach.

When felt appropriate by the MDT, an EDLS assessment completed by the OT/ nursing / dietetic staff and Individualised plan created.  The progress through the agreed stages will be monitored by the MDT (nursing, dietician, OT, OT Assistant, Psychiatrist) with use of observational assessment sheets and an associated workbook held by the patient and completed together. 

A care plan will contain a personalised and agreed mixture of the following components dependant on what we recommend and what the patient wishes to engage with.   This care plan will be incorporated within the ward programme and a specific timetable.

Each patient timetable will generally include, as a minimum:

• Physical review and investigations as per plan
• Daily 1:1 with contact nurse for the day
• Specialist 1:1 or group psychological therapy interventions as required and agreed.
• Weekly named nurse support & planning sessions
• Eating & Dietary Living Skills which is led by the Occupational Therapist
• Occupational therapy activities & groups
• Ward based group sessions.

Group programme

We have aimed our group programme to be broadly suitable for all patients on the ward, and so that people can join at any time; these are referred to as ‘Open’ groups. Open groups are groups when anyone can join at any time during the duration of the group. There are a small number of groups where it may not be possible to attend at a certain point in time. These are referred to as ‘closed’ groups. Closed groups will have a set number of participants and will only work with those individuals during the duration of the group.

All group sessions can be offered on a 1:1 basis if patient struggle with the group settings.

Time off the ward and leave

At present we risk assess each individual patent with regards to time off the ward and leave. This is done in collaboration with patients, carers and the full MDT.

Visiting times

We do encourage visits with family, carers, friends and professionals to take place outside of mealtimes and post meal times- this is to benefit our patients with their full engagement in a key part of their treatment on the ward. Our mealtimes on the ward are below:

• Breakfast: 8.30am to 8.50am
• AM Snack: 10.30am to 10.45am
• Lunch: 12.30pm to 13.00pm
• PM Snack: 14.30pm to 14.45pm
• Evening Meal: 17.00pm to 17.30pm
• Supper: 21.00pm to 21.20pm

There is a period of rest during post meal support for all patients highly encouraged, these are 20 minutes following breakfast and snack, 15 minutes following AM snack and PM snack and 30 minutes following lunch and evening meal. If it has been discussed and agreed in collaboration with the patient and the MDT based on certain support required, post meal may be doubled to best support the patient.