Call 01726 873 408 or email the High Risk Avoidant Restrictive Food Intake Disorder Service.
Open Monday to Friday, 9am to 5pm, except for bank holidays.
The address below is for correspondence only. We do not hold clinics at these premises. Check your appointment letter for clinic location.
Write to: First Floor Offices, Building A, Green Court, Truro Business Park, Threemilestone, Truro, TR4 9LF.
The service is a countywide specialist community eating disorder team for children referred by healthcare professionals.
The team offer community-based assessment and intervention for children and young people under the age of 18 years, with suspected or diagnosed avoidant restrictive food intake disorder, sometimes referred to as ARFID.
We do not offer treatment for anorexia nervosa, bulimia nervosa or binge eating disorder. If you feel that you or your child are suffering from these conditions, refer to the links further down this page.
Avoidant restrictive food intake disorder is a relatively newly recognised condition that describes feeding difficulties such as:
To be given a diagnosis, the feeding difficulties must be severe enough to impact the child or young person’s ability to meet their:
This would typically be associated with:
Our team comprises a:
We also work alongside our colleagues from community paediatrics and child psychiatry.
There will be an interim change to the referral pathway for our service. This will be for a 3-month period from August 2025. This is due to demand and capacity challenges which have been found to pose clinical and operational risks requiring review and evaluation.
NHS Cornwall and Isles of Scilly commissioned the service which became operational in April 2024. The service is jointly delivered by Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust.
The service has been piloting 2 operational pathways:
The services' pathways have been pilot-based in delivery to allow for evaluation of local need, the clinical interventions, and demand required, to ensure that pathways configured meet the most at need cohort in our local population.
Demand, clinical presentations and system expectation of the service have superseded its capacity, and delivery infrastructure.
The service is undertaking a full-service evaluation over the next 3 months, the data intelligence and full review will inform recommendations for the future service operational modelling.
It is necessary to make an interim change to support referral management to place safeguards within the service for those at most need of this provision and to allow capacity for a comprehensive evaluation to take place.
The service will only be triaging and accepting referrals received directly from paediatrics and the Children's Eating Disorder Service. This applies to all new referrals during this period.
Children and young people already on the service caseload will continue to receive care as per their existing care plan.
If concerns arise around children who are deemed to be failing to thrive, then local pathways as part of the paediatric offer should be sought, which covers inadequate calorie intake or nutritional intake, and or weight gain.
A further communication will be shared with the local system, following the full service evaluation and revised local pathways moving forward.
Using our eligibility criteria and the i-Thrive model, the clinicians will identify which pathway will best meet the child or young person’s needs.
Our team provides a range of i-Thrive support and interventions across the domains of getting advice, getting help, getting more help and getting risk support.
Our multi-disciplinary team consultations usually run on a Tuesday. They enable services who already have professional relationships with the child or young person and family to seek specialist clinical advice and guidance. The consultation will be held with the referring professional not with the child or young person or family.
To help us understand the impact of the feeding difficulties on the child or young person and family we will send out several forms and questionnaires for the referrer to complete with the family prior to the consultation. There will be a combination of clinicians at these meetings, usually including a medic and allied health professionals.
The consultations will be held either in person or online via Microsoft Teams with the referring professional or team to discuss their referral, current concerns and expectations for the child and young person.
As a team, we will develop a formulation report based on our discussions at the consultation. The referring professional will then arrange to meet with the family to share the formulation report.
The service do not offer direct interventions as part of a consultation but seek to support other services to implement a range of options.
The child or young person and family will be offered an initial in person (face-to-face) assessment in either the medic led clinic or allied health professional led clinic (such as psychologist, dietician, or occupational therapist).
These clinics usually run on a Tuesday. The assessments generally last up to 2 hours.
There will usually be between 2 and 5 clinicians including a combination of medic, psychologist, occupational therapist, and dietician. This can seem like a lot of people, but it helps us to make a more complete assessment of your child or young person’s current difficulties and aims to avoid multiple assessment with different professionals.
The team may need to do some physical monitoring (such as weight, height, blood pressure) and potentially a blood test. However, this will be highlighted in your appointment letter and support will be provided if needed.
To help us understand the impact of the feeding difficulties on the child or young person and family we will send out several forms and questionnaires for the family to complete prior to the assessment.
Parents and carers need to attend the assessments with their child. It is really important to get the perspectives of everyone involved. We offer time for parents to speak with the clinicians without the child or young person present and where appropriate for the child/ young person to speak with the clinicians individually.
We value hearing the child or young person’s voice and understanding the difficulties the avoidant and restrictive eating has on the whole family.
The initial assessment aims to develop a shared understanding between the child or young person, family and professional of the feeding difficulty. This determines whether the service is the right service for them.
If it is not the most appropriate service, the assessment provides alternative recommendations for that individual. This could include getting advice with some suggested strategies or escalation to getting risk support. A copy of this outcome report will be sent to the individual or family, GP, referrer and other teams who support the family. This could include redirection to another service for example Eating Disorder Service or CAMHS.
If this is the most appropriate service, the child or young person may be offered further sessions.
At this point the child or young person will be assigned a link allied health professional from the service.
Depending on whether you attend a medic led or allied health professional led clinic, the assessment is most likely to take place in mid-Cornwall, for example in Truro.
Avoidant restrictive food intake disorder is most typically a chronic condition, with food restriction being long standing and so the child or young person may not present as acutely physically unwell.
Any of the red flags below indicate a clinical emergency and referrers must follow the guidance given.
Any 1 or more of the following:
For any red flags, the referrer must contact the child or young person’s GP on the day for advice and onward referral to the local paediatric team (for all young people up to the age of 18).
Should your child or young person’s mental health, physical health or risk worsen, contact their current health professional to share this information.
If following assessment your child or young person is accepted for further sessions, they will be placed on a waiting list. Waiting times for this can vary depending on the clinical demand for the service.
Although your child or young person may be allocated a link professional to assist with your communication with the team, we provide a team approach to support your child or young person’s journey through our service.
Due to demand for our services, we encourage you to inform of us of any appointments you may need to cancel or rearrange. We follow a ‘was not brought’ policy. This policy means we have a limit of missed appointments we can accept before considering discharge from the service. This is to ensure all children and young people waiting are safeguarded and allows other people waiting for support to access help in a timely way.
We are not a crisis service. Professionals can provide a maximum number of appointments at any given time due to supporting many children and young people. This means that if your child or young person is open to the team and requires more intensive support due to an increased risk to themselves or others, a support request can be made to our Multi-Agency Rapid Response Service for enhanced risk support if clinically appropriate.
We understand that coming to meet unfamiliar people and sharing personal information with us can feel an overwhelming or a worrying experience.
Your first experience of meeting our team will be at your initial assessment. This assessment hopes to explore a range of topics so that we can better understand you.
We will ask you questions about:
We encourage you to think about some of these topics, your strengths, and challenges ahead of the appointment and you are welcome to write notes down and bring this with you. This might be helpful in making sure you share as much information with us as you can to help your assessment outcome.
We offer you time to be seen alone in the assessment if that would be helpful for you.
We are here to learn what your needs are. This might mean that other services might be more helpful for you based on what you would like support with.
Attending appointments is not something you have to do. It is your choice to work with us as your care will be led by you.
If you do not feel ready to work with us, or if you decide you would like to stop attending once you have started, we will respect your decision and will provide safety planning for you.
If we feel that you are at high risk of harm and not feeling able to work with us, we may discuss alternative options with you and your parent or carers.
All information you share with us in your appointments will be kept confidential between yourself and the team. If you share any information with a professional that suggests you may have been or are currently at risk of harm from others or to others, we have a duty of care to share this with the relevant services. If we need to do this, we will be open with you as to why we are doing this and who we are sharing this information with.
If you require reasonable adjustments to be made prior to your appointment, let us know as soon as possible.
Welcome to our guide to avoidant restrictive food intake disorder resources. We hope you find them helpful. We cannot be responsible for the content of external sites, although we are working hard to keep this page up to date.
