Gaps in eating disorder support continue eight years on from teenager’s death
PUBLISHED: 17:05 19 October 2020 | UPDATED: 12:56 20 October 2020
Eating disorder patients are still facing gaps in support in the east, nearly eight years on from the death of a teenager with anorexia nervosa, an inquest heard.
Averil Hart, from Newton near Sudbury, rapidly lost weight in her first term at the University of East Anglia (UEA) and died just 10 weeks later in December 2012.
Dr Jaco Serfontein, who now oversees eating disorder treatment in the wider eastern region, told Monday’s hearing in Huntingdon that the medical monitoring of eating disorder patients considered at low to moderate risk – which includes regular check-ups on weight and blood tests – currently falls to GPs in several areas.
MORE: Inquest to probe tragic death of Suffolk teenager with anorexia
Shortages of specialist staff in eating disorders often exacerbates the problem and the success of the service can depend on whether GP surgeries cooperate, the inquest heard.
If a patient does not receive medical monitoring from their GP they will then be escalated to a specialist service, Dr Serfontein said, but in some areas, such as Essex, there is no dedicated psychiatric input for patients with eating disorders.
When asked by assistant Cambridgeshire coroner Sean Horstead if he feels there is an increased risk of future deaths without formally commissioned monitoring, Dr Serfontein said: “Yes, absolutely”.
MORE: ‘Fun-loving’ teenager with anorexia ‘referred into NHS team with severe staffing crisis’, inquest told
The Norfolk Community Eating Disorder Service, assigned to help Averil in 2012, faced similar problems in the form of a “staffing crisis” in the weeks before she died, the inquest previously heard.
The recruitment issues meant patients needing urgent attention were prioritised over those considered at lower or moderate risk, with waiting lists extended.
Dr Serfontein said this impacted the quality of care and added: “We prioritised the safety of urgent patients, which was to the detriment of less urgent ones.”
He said recruitment problems facing eating disorder services are even greater in 2020.
Recognising that “(for patients) to be safe, there needs to be medical expertise,” Dr Serfontein said a pilot system - where healthcare assistants trained by eating disorder specialists support GP surgeries - will be rolled out in the Peterborough area by April 2021.
It is hoped this will then roll out across the region.
MORE: Anorexic student’s hospital ward had ‘no mental health support’ for entire weekend, inquest told
The coroner raised concern at what will happen in the meantime, and described the current situation of arranging weight and blood test checks with GPs as “old-school” - similar to how they were in 2012 - and “ad-hoc”.
He described a “lacuna” across the east in terms of formal support offered.
In contrast to the situation in Essex, a ‘locally enhanced service’ in Norfolk saw more than 100 GPs trained through workshops and as of 2019, three districts (North Norfolk, South Norfolk and Norwich) were the only areas to have formal specialist monitoring of eating disorder patients in the east, Dr Serfontein added.
Professor Tim Kendall, of NHS England, described a national push towards more formalised community support for eating disorder patients with a renewed focus on earlier intervention.
Mr Horstead said that while overseeing Averil’s inquest and those of four others with eating disorders, he had been “struck” by a “shared level of ignorance” among GPs and hospital doctors on aspects of anorexia nervosa.
Professor Kendall recognised a shortfall in understanding of eating disorders among those not working directly in specialist services and said efforts are continuing to roll out training.
But he said implementing such a programme will take time and hoped for improvements by 2023.
The inquest, set to conclude next week, continues.
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