Eating disorder patients ‘repeatedly failed’, says England watchdog

Little progress made within NHS since devastating 2017 report raised concerns, says health ombudsman

Urgent action is needed to prevent people dying from eating disorders, the parliamentary and health service ombudsman for England has warned, as he said those affected are being “repeatedly failed”.

The NHS needs a “complete culture change” in how it approaches the condition, while ministers must make it a “key priority”, according to Rob Behrens.

Little progress has been made since the publication of a devastating report by his office in 2017, which highlighted “serious failings” in eating disorder services, he said.

Lives continue to be lost because of “the lack of parity between child and adult services”, and “poor coordination” between NHS staff involved in treating patients. There remain issues with the training of medical professionals, Behrens added.

“We raised concerns six years ago in our ignoring the alarms report, so it’s extremely disappointing to see the same issues still occurring,” he said. “Small steps in improvements have been taken, but progress has been slow, and we need to see a much bigger shift in the way eating disorder services are delivered.

“Eating disorders are enormously complex, and those on the frontline treating people have a tremendously difficult job to do. This [is] not helped by a lack of a sense of urgency to address the scale of the problem. Clinicians need better support to do their job of protecting patients.”

Some progress had been made, he acknowledged, such as scaling up early intervention services to support children and young people, and work by the General Medical Council to identify and address gaps around eating disorders in medical training.

But there remain “unacceptable” gaps in services that result in poor care and avoidable deaths, Behrens added. Since 2019-20, his office has received 234 complaints relating to eating disorder services.

It recently upheld a case about the death of a 35-year-old teacher who believed her food was being tampered with and refused to eat. She was sectioned and under the care of the NHS before she died. However, the ombudsman’s investigation found a series of “significant failings”, and concluded that had things been done differently, she may have survived.

Her food and drink intake was not adequately monitored, and staff did not act quickly enough when she needed to be transferred to a specialist hospital.

Other serious failings included staff not responding to abnormal kidney and liver function tests and low blood sugar results quickly enough, and not taking appropriate action when a blood test suggested a possible paracetamol overdose, the ombudsman found.

Her father, who was not identified by the ombudsman, described her death in a statement as “absolutely devastating”, adding that it had “ripped the family apart”.

“We feel completely let down. We could see what was happening, we could see she was starving, but no one would listen to us. It felt like there was no urgency and too much complacency.

“When they finally did feed her via a tube, she could no longer lift herself up on her elbows or hold her head up on her own,” he said. “It was already too late.”

Behrens said the woman’s death was “incredibly sad”.

“It is heartbreaking to see repeated mistakes and tragedies like this happening again and again. We need to see a complete culture change within the NHS, where there is a willingness to learn from mistakes.

“The government also needs to fulfil its promise to treat eating disorders as a key priority so that we can see meaningful change in this area and make sure patients receive the quality of care they deserve.”

Tom Quinn, the director of external affairs at Beat, an eating disorders charity, said it was “appalling” that vulnerable patients were not getting the treatment that they desperately need.

“The alarms have been sounding for years but NHS staff are still not being given appropriate resources,” he said. “We need a fully funded long-term plan to invest in eating disorder services, ensuring that services can recruit and retain staff.”

A Department of Health and Social Care spokesperson said: “Improving eating disorder and mental health services is a priority and that’s why we are investing almost £1bn in community mental health care for adults with severe mental illness, including eating disorders, by 2024.

“We’re also providing an additional £54m per year in children and young people’s community eating disorder services to increase capacity of community eating disorder teams across the country.”


Andrew Gregory Health editor

The GuardianTramp

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