Humber and North Yorkshire Integrated Care Board

4. Mr R complains about the local care commissioned by the ICB. Specifically, he raises concerns about the lack of NHS-commissioned services for ARFID, to support his son. Mr R states that no local services are available, despite ARFID being clinically recognised as an eating disorder.

5. Mr R explains that earlier intervention could have helped his son manage a broader range of foods. He reports that his son currently eats only a limited selection of unhealthy foods and becomes agitated when presented with anything outside his preferred range.

6. As a result, Mr R says his son has become severely overweight, experiences pain when walking and now requires a wheelchair to leave the house. He also suffers from poor sleep, chronic constipation, and is at high risk of long-term health complications.

7. Mr R would like the ICB to establish a local ARFID support service or allow his son to access services out of area. He hopes his son can benefit from care pathways similar to those already in place in other regions. If this cannot be provided through the NHS, Mr R seeks a financial remedy to help fund private treatment.

8. Mr R told us his son received a private diagnosis of ARFID in 2022 and has been living with this condition for several years. He explained that his son’s extremely restricted diet has significantly impacted his physical health, including the development of obesity.

9. Mr R has tried to access local services to support his son. His son’s paediatrician referred him to a specialist service in Leeds, but this was declined due to catchment-area boundaries. We understand how disappointing that must have been, especially given the urgency of the support needed.

12. Our legislation, the Health Service Commissioners Act 1993, says we can only consider a complaint about failings in a service provided by a health service body, a failure of a health service body to provide a service which it was a function of the body to provide, or failings connected with any other action taken by or on behalf of a health service body. This means we cannot consider commissioning arrangements, in the absence of guidance to say a service should be provided.

13. Mr R’s complaint relates to the actions of the ICB, which does not commission services for ARFID. ICBs are responsible for planning and commissioning NHS services in their local areas. This means they decide which services should be available to meet the needs of the local population and allocate funding accordingly.

14. The ICB does not commission the local Child and Adolescent Mental Health Service (CAMHS) to treat ARFID directly, although support may be available for co-occurring conditions such as anxiety. We also understand that while private services do offer specialist therapy, these fall outside NHS-funded provision.

15. We need to consider if the ICB should have commissioned an NHS service for ARFID, in line with national guidance and the ICB’s responsibilities.

16. ARFID is not currently recognised as a standalone eating disorder within the NICE guideline NG69 (2020), which covers eating disorders in children and young people. In its response dated 10 March 2025, the Trust said NHS England was expected to publish updated guidance for ARFID in 2023, but this has been delayed indefinitely, and there is currently no confirmed timeline for its release. Given NICE guidance does not outline treatment for ARFID, we have seen nothing to indicate failings in the ICB not commissioning ARFID services.

17. We have considered the outcome Mr R is seeking. Mr R would like the ICB to commission local ARFID services. Sadly, we are not able to make recommendations about what local services should be provided. This is because it is our role to consider whether an organisation has acted in line with the relevant policies and guidance, and we are not able to make recommendations around commissioning, funding and policy.

18. Mr R is seeking a route for his son to be able to access care out of his local area, or to have this funded privately.

19. To seek funding for his son’s care privately, Mr R may wish to make an individual funding request (IFR). Patient’s can make an IFR request for treatment not normally funded. IFR requests are considered on an individual patient basis. It usually needs the support of a clinician, usually the patient’s GP or consultant, to make the case on their behalf. The clinician would submit a completed IFR application to the ICB along with the supporting clinical evidence.

Conclusion

20. We are sorry that we are unable to take further action on this complaint. We hope we have explained the careful consideration given to our decision and clearly outlined the reasons for it.

21. It is clear how committed Mr R is to finding the right support for his son, and we sincerely hope that he can secure the care he needs and deserves.

1. We have carefully considered Mr R’s complaint about Humber and North Yorkshire Integrated Care Board (the ICB). We are sorry to hear of the problems he has experienced supporting his son’s avoidant restrictive food intake disorder (ARFID). We recognise how challenging the situation must be for him and his wider family, particularly his son.

2. We have carefully considered the issues Mr R has raised. Unfortunately, we are not able to achieve the outcomes he is seeking. This is because there is currently no national guidance for ARFID, and we are unable to influence the ICB’s decisions in what services to commission. For these reasons, we will not consider Mr R’s complaint further. We have explained the reasons fully in this statement.

3. We have included some information around the process for requesting individual funding, which can be helpful for care which falls outside of what is locally commissioned. We hope this information is helpful and Mr R is able to find another route to gain appropriate support for his son.