Systemic issues also contribute to rates of diagnosis
and their accuracy. GP education about risk factors and
early warning signs as well as screening instruments like
the SCOFF [10] can assist detection and management,
particularly where GPs are expected to coordinate and
manage concurrent medical and psychiatric conditions.
Close and regular liaison with ED specialists may
encourage more regular enquiry about eating difficulties
in those who frequently present with emotional and/or
physical problems. GPs are referral “gatekeepers” (whether
intended or otherwise), and ED clinicians have a role in
supporting and educating their colleagues about frontline
assessment practices and referral thresholds. In the
regions where there are specialist services, GPs are likely
to have greater awareness of eating disorders and in turn
refer to specialist services more frequently [6]. In any
event, presentation to primary care or emergency services
should always be used as an opportunity to introduce, or
re-engage with an ED clinician or ED service if one is
available.