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Doctor warns of ‘national failures’ to protect anorexia patients

PUBLISHED: 15:23 20 October 2020 | UPDATED: 11:27 04 November 2020

Averil Hart with her father Nic Picture: SUPPLIED BY FAMILY

Averil Hart with her father Nic Picture: SUPPLIED BY FAMILY

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A senior GP has described continuing national failures to protect patients with anorexia at the inquest into the death of a university student.

Averil Hart, who died in 2012 after suffering from anorexia nervosa Picture: SUPPLIED BY FAMILYAveril Hart, who died in 2012 after suffering from anorexia nervosa Picture: SUPPLIED BY FAMILY

Dr Katie Bramall-Stainer, who represents GPs nationally and regionally as chief executive of the Cambridgeshire Local Medical Committee, outlined her concerns at the inquest into the death of Suffolk teenager Averil Hart.

The 19-year-old, from Newton near Sudbury, lost weight during her first term at the University of East Anglia and died just 10 weeks later in December 2012.

Dr Bramall-Stainer, giving evidence at Tuesday’s hearing in Huntingdon, described the national picture as “one of a failure to have a sustainable, safe, evidence-based, adequately commissioned position for patients to ensure long term positive outcomes”.

MORE: Gaps in eating disorder support continue eight years on from teenager’s death

Averil Hart inquest: The 19-year-old died from anorexia in 2012 Picture: SUPPLIED BY FAMILYAveril Hart inquest: The 19-year-old died from anorexia in 2012 Picture: SUPPLIED BY FAMILY

She told the coroner: “Where there’s an absence of commissioning around specialist services and monitoring in the community it’s the patient that suffers.

“I fail to understand, as a GP, how a developed nation in 2020 couldn’t be putting the requisite focus and resource and governance around this incredibly vulnerable and fragile cohort of patients who can relapse quickly and relapse seriously, with too often tragic outcomes.”

The GP, who works in Hertfordshire, also criticised a “piecemeal” approach to medical monitoring of people with eating disorders across the east of England region.

Check-ups on weight and blood tests currently fall to GPs in several areas through informal arrangements in what assistant Cambridgeshire coroner Sean Horstead previously described as “old-school” and “ad-hoc”.

Averil Hart inquest: The Suffolk teenager died just weeks into her first term at the University of East Anglia Picture: SUPPLIED BY FAMILYAveril Hart inquest: The Suffolk teenager died just weeks into her first term at the University of East Anglia Picture: SUPPLIED BY FAMILY

Dr Bramall-Stainer welcomed previous evidence confirming a pilot in Peterborough where healthcare assistants trained by specialist services will carry out checks on low to moderate risk patients.

MORE: Anorexic student’s hospital ward had ‘no mental health support’ for entire weekend, inquest told

Monday’s hearing was told of gaps in psychiatric help for eating disorder patients – in Essex, for instance, there is none – with many areas including Suffolk, Bedfordshire and Hertfordshire currently having no formal or funded arrangement for GPs to carry out weigh-ins and blood tests.

Dr Bramall-Stainer described these gaps as “harmful” to both GPs, through increased stress, and to patients themselves.

“It is pro-actively harmful... I believe it is negligent to those patients, who are extremely vulnerable and carry mortality risks greater than cancer patients,” she added.

She said it would be “folly and reckless” to leave the care of eating disorder patients in the community to informal and voluntary arrangements.

MORE: Death of gifted student with anorexia ‘could have been avoided’, mother tells inquest

Also giving evidence on Tuesday, hospital bosses outlined actions taken to improve the safety of eating disorder patients in the eight years since Averil died.

Dr Charlotte Pither, lead consultant in nutrition at the Norfolk and Norwich University Hospital, described a steady year-on-year rise in anorexia patients at the hospital since she joined in 2017.

Around-the-clock mental health support is now available at the hospital for patients, she said - including those with eating disorders and require urgent psychiatric help.

The inquest previously heard there was no support available over an entire weekend when Averil was admitted on a Friday evening.

Both Dr Pither and Dr Ashley Shaw, medical director at Addenbrooke’s Hospital, told the coroner of specialist training for medics on severely ill anorexia patients.

Dr Shaw also outlined improvements to urgent care, including the rollout of a new IT system which flags up a patient’s background and a 24/7 critical care liaison team.

The inquest, expected to conclude next week, continues.


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