Anorexia: Women's deaths prompt fears over specialist care

Concerns about a shortage of eating disorder specialists have been raised by a health minister following the deaths of five women with anorexia.

Coroner Sean Horstead warned NHS trusts were "finding it difficult to fill" eating disorder vacancies, after the women's inquests in Cambridgeshire.

Conservative MP Nadine Dorries said she shared concerns over the shortages.

She said more accurate data was needed about the number of people with eating disorders.

Mr Horstead had said that while eating disorders have the highest mortality rate of mental illnesses, he was "concerned that there may also be a significant under-reporting of the extent to which eating disorders have caused or contributed to deaths".

The assistant coroner for Cambridgeshire and Peterborough oversaw the inquests into the deaths of Averil Hart, 19, of Newton, Suffolk; Amanda Bowles, 45, from Cambridge; Madeline Wallace, 19, from Peterborough; Emma Brown, 27, from Cambourne, near Cambridge; and Maria Jakes, 24, from Peterborough.

The prevention of future deaths report covered all the inquests. The women died between 2012 and 2018.

It was written following the conclusion of the inquest into the death of Miss Hart, which found systemic failures and neglect.

A report published in 2017 found Miss Hart was failed by "every NHS organisation that should have cared for her".

Her father, Nic, said: "Whilst I welcome Nadine's comments I find it strange that we're nearly four years since the [2017 report] that came to the same conclusions and nearly nine years since Averil died, I wonder why it's taken so long for the government to realise they don't have the specialisms and expertise in this area."

In her response to Mr Horstead, Ms Dorries, minister for patient safety, suicide prevention and mental health, said: "I share your concerns on the shortage of eating disorder specialists across the country."

Mr Horstead said there was "inadequate training of doctors and other medical professionals" regarding eating disorders.

The General Medical Council, also responding to the coroner, said: "The provision of education and training on eating disorders is evidentially inconsistent and sometimes insufficient to prepare all doctors to recognise and manage or refer patients."

It said it was working with schools to address "gaps and bring consistency to undergraduate education on eating disorders".

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Ms Dorries said the Covid pandemic had seen an increase in demand for eating disorder services, with 7,555 children and young people starting treatment in the first nine months of 2020-21, compared to 5,831 in the same period the previous year.

"Given the high risk presented by Covid-19 in this group, all areas have been advised to continue prioritisation of service delivery, and to take steps to mitigate the potential impact of COVID-19 on this vulnerable group," Ms Dorries added.

She said the 2007 Adult Psychiatric Morbidity Survey found 6.4% of adults displayed signs of an eating disorder but the latest survey, in 2016, did not collect information on eating disorders.

However, she added the 2019 Health Survey England showed 16% of people aged 16 and over "screened positive for a possible eating disorder".

Mr Horstead also raised concerns about monitoring of eating disorder patients.

In its response, NHS England and NHS Improvement said its guidance was that "medical monitoring needs to be based on local... agreements".

It added that it was working with Health Education England to improve staff training on eating disorders, and had begun offering new courses.

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