Averil Hart
A similar concern from this report was raised again 1 time later. See the linked reports.
The coroner's concerns
1. lack of training on eating disorders
“Inadequate training of doctors and other medical professionals re eating disorders”
2. absence of formal monitoring agreements
“Lack of formally commissioned service level agreement for the provision of robust and effective monitoring of moderate to high risk AN patients by primary or secondary care providers”
3. insufficient prevalence data
“Lack of robust and reliable data regarding the prevalence of eating disorders”
Linked reports
This report
“Evidence from a wide range of clinicians who had engaged with [the deceased] in 2012 echoed the evidence of clinicians attending the four inquests of the women referred to above.”
Later report
“Of those, only one had knowledge of MARSIPAN and his understanding of MARSIPAN was extremely limited.”
Responses
2021-0058-Academy-of-Medical-Royal-Colleges-Redacted.pdf ↗· Academy of Medical Medical Royal Colleges and Health Education England
2021-0058-Response-from-Department-of-Health-Social-Care-Redacted.pdf ↗· Department of Health and Social Care
Stated action
“We accept the recommendations from this report and will take them into account when planning improvements to adult eating disorder services.”
2021-0058-Response-from-General-Medical-Council-Redacted.pdf ↗· General Medical Council
2021-0058-Response-from-Health-Education-England-Redacted.pdf ↗· Academy of Medical Medical Royal Colleges and Health Education England
2021-0058-Response-from-NHS-England-and-NHS-Improvement-Redacted.pdf ↗· NHS England
Stated action · August 2019
“NHSEI issued national guidance in August 2019 which sets out a clear expectation that CED services develop integrated pathways with primary care and where responsibility for medical monitoring sits. The guidance outlines that”