Open access. To examine how often referring community mental health teams (CMHTs) utilised treatment recommendations made by the national highly specialised service for patients with severe obsessive–compulsive disorder (OCD) and body dysmorphic disorder (BDD). We analysed all patient notes for admissions to the unit (August 2012–August 2014) and recorded how many treatment recommendations were implemented by CMHTs prior to admission and at 6 months post-discharge.