Ignoring the alarms: How NHS eating disorder services are failing patients

Parliamentary and Health Service Ombudsman, December 2017

Reports on the Parliamentary and Health Service Ombudsman’s investigation that found that Averil Hart’s death from anorexia would have been avoided if the NHS had cared for her appropriately. It highlights five areas of focus to improve eating disorder services.

  1. General Medical Council (GMC) should conduct a review of training for all junior doctors on eating disorders to improve understanding of these complex mental health conditions.
  2. Health Education England (HEE) should review how its current education and training can address the gaps in provision of eating disorder specialists. If necessary HEE should consider how the existing workforce can be further trained and used more innovatively to improve capacity. It should also look at how future workforce planning might support the increased provision of specialists in this field.
  3. The Department of Health and NHS and availability of adult eating disorder services to achieve parity with child and adolescent services.
  4. The National Institute for Clinical Excellence should consider including coordination in its new Quality Standard for eating disorders to help bring about urgent improvements in this area.
  5. Both NHS Improvement and NHS England have a leadership role to play in supporting local NHS providers and commissioners to conduct and learn from serious incident investigations. NHSE and NHSI should use the forthcoming Serious Incident Framework review to clarify their respective oversight roles in relation to serious incident investigations. They should also set out what their role would be in circumstances where local NHS organisations are failing to work together to establish what has happened and why, so that lessons can be learnt.

Click here to read the full report.

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