FREED in Yorkshire

Experiences of FREED in the Leeds and York Partnership NHS Foundation Trust (LYPFT).

LYPFT are one of the founding FREED sites. FREED-UP started in Leeds in 2016, as part of the FREED-UP scaling-up project funded by the Health Foundation. In 2018, with the introduction of CONNECT (West Yorkshire and Harrogate Adult Eating Disorder Service (WYHEDS), LYPFT led the expansion of FREED across Yorkshire. FREED is now available to patients in the whole of West Yorkshire, Harrogate and the surrounding rural areas.

Before FREED was introduced, adult eating disorder services in Leeds and it’s surrounds were limited to patients with moderate to severe Anorexia Nervosa and severe Bulimia Nervosa. However, FREED made it possible for young people with a recent onset eating disorder to receive evidence-based treatment rapidly, largely irrespective of their severity.

LYPFT brought expertise in group-based treatments to the FREED Network. They were the first to adapt the Maudsley Model Anorexia Nervosa Treatment for Adults (MANTRA) so it could be used in a group format. LYPFT clinicians have found FREED to foster creative, engaging ways of working.



"Early intervention is something we should have started many years ago, it is the future… FREED has provided the evidence base that was needed to start early intervention in eating disorders."

Dr Rhys Jones, Clinical Lead and Consultant Psychiatrist, LYPFT CONNECT

Mary Franklin-Smith, LYPFT FREED Champion reflected “before we started FREED, we worried that there may be a flood of referrals and that we wouldn’t be able to keep up with demand. Yes, the service got busier but it was manageable and there wasn’t the ‘flood’ we worried about. Group treatment has been an important part of ensuring we can see everyone within the FREED suggested timeframe.”

Dr Monique Schelhase, LYPFT CONNECT, FREED-UP Site Lead, feels that that the implementation of FREED has been significantly beneficial for the entire service, staff and patients alike. She encourages other sites to consider implementing FREED and reflects on the value it can bring to a team and service:

“Innovative research coupled with creativity that is clinically driven and places the patient at the heart of all the processes, should inspire all health professionals and services. That is exactly what FREED-UP has achieved. In Leeds we needed to alter our established ways of working to engage in the study but it was undoubtedly beneficial to our patients and indeed for the entire service to do so. It was most pleasing to witness first-hand the success of the study and the national expansion of this potentially life-altering approach to eating disorders. It was a privilege to have been chosen as a partner site for the FREED-UP study. The benefits are undeniable, so much so that we remain committed to maintaining an early intervention pathway for our patients. The FREED train has left the station and it’s not stopping….so I would encourage everyone to hop on board! You have nothing to lose and everything to gain by doing so”.

At LYPFT the team are clear that the introduction of FREED allowed them to streamline and revise their pathways and ways of working “Early intervention is wonderful and it’s something we should have started many years ago. Early intervention is the future and it is where services are heading…FREED has provided the evidence base that was needed to start early intervention in eating disorders.” Dr Rhys Jones, Clinical Lead and Consultant Psychiatrist, LYPFT CONNECT.

The FREED Champion role has been central to the success of FREED in Leeds and the associated expansion across West Yorkshire. Mary Franklin-Smith has found her role to be about championing FREED, delivering training, creating and overseeing clinical pathways.

There is no denying that implementing FREED meant a great deal of change for the team at LYPFT and change can be rather challenging! Mary talks about the wonderful hope that FREED offers to its service users and their families, and reflects on the role of the FREED Champion. “It is my role to enthuse, inspire and motivate the team, reminding them that they are all part of helping us to provide a service that really does change lives. When you approach it with that perspective it can make the many changes to routines, daily duties and administration feel less daunting. It’s been crucial for me to spend time with each member of the multi-disciplinary team and to help problem solve any issues they are facing during the short term, initial adjustments that need to occur whilst the service shifts to accommodate FREED. It’s important to consistently remind staff that their dedication is greatly appreciated and will pay off in the long run. It’s necessary to hold the bigger picture in mind”

The team feel that the introduction of FREED has helped them be more age appropriate in the way they offer treatment to the emerging adults in their care. Karen Williams, deputy FREED champion and Specialist Clinical Nurse said “FREED has given me the freedom to think more creatively about how I do things. I try to speak in a way that is relevant to young people and I am more flexible with incorporating technologies like WhatsApp and Facetime. The FREED principles have enabled us to see the bigger picture and connect with young people. We have developed a more comprehensive understanding of the role social media can play in an individual’s recovery. I am far more likely to explore the role social media has within their life, alongside sending an email to a patient or texting them their appointment time, we all need to get with the times!”

The many FREED resources helped the team think about the format for delivering psycho education around brain malleability and sharing accessible resources across all arms of the service to help patients really understand what is happening to their bodies and most importantly their brains.

The expansion of FREED in West Yorkshire speaks to the success of the approach in the region. Clinicians, patients and carers have all benefited from FREED. Mary said “at a personal level, being part of FREED has been life changing for me and woken me up to what is possible. It allows me to work in a way that I’ve always wanted to work. FREED is what one would want for themselves and their loved ones.”

"At a personal level, being part of FREED has been life changing for me and woken me up to what is possible. It allows me to work in a way that I’ve always wanted to work. FREED is what one would want for themselves and their loved ones."

Mary Franklin-Smith, LYPFT FREED Champion

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