Urgent action is needed to prevent people from dying from eating disorders, warned England’s parliamentary and health service ombudsman, saying those affected were being “repeatedly disapproved”.
The NHS needs a “complete cultural shift” in how it tackles the condition, while ministers must make it a “key priority”, according to Rob Behrens.
Little progress has been made since his office published a devastating report in 2017 that highlighted “severe shortcomings” in eating disorder services, he said.
Lives continue to be lost due to “lack of parity between services for children and adults” and “poor coordination” between NHS staff involved in treating patients. There are still problems with training medical professionals, added Behrens.
“Six years ago we raised concerns by ignoring the alarm report, so it is extremely disappointing to see the same issues still occurring,” he said. “Small steps for improvement have been made, but progress has been slow and we need to see a much bigger change in the way eating disorder services are delivered.
“Eating disorders are extremely complex, and those on the front lines treating people have a tremendously difficult job to do. This isn’t helped by the lack of a sense of urgency to address the scale of the problem. Doctors need better support to do their job of protecting patients.”
Some progress has been made, he acknowledged, such as scaling up early intervention services to support children and youth and the work of the General Medical Council to identify and address gaps around eating disorders in medical training.
But there are still “unacceptable” gaps in services that result in inadequate care and preventable deaths, Behrens added. Since 2019-2020, his office has received 234 complaints related to eating disorder services.
It recently held a case over the death of a 35-year-old teacher who believed her food was being tampered with and refused to eat. She was sectioned and taken care of by the NHS before she died. However, the ombudsman’s investigation found a number of “significant flaws” and concluded that if things had been done differently, it could have survived.
Her food and drink intake was not properly monitored and the staff did not act quickly enough when she needed to be transferred to a specialist hospital.
Other serious failings included staff failing to respond to abnormal kidney and liver function tests and low blood sugar results quickly enough, and failing to take appropriate action when a blood test suggested a possible acetaminophen overdose, the ombudsman found. .
His father, who was not named by the ombudsman, described his death in a statement as “absolutely devastating”, adding that it “destroyed the family”.
“We feel completely disappointed. We could see what was going on, we could see that she was starving, but no one was listening to us. It felt like there was a lack of urgency and a lot of complacency.
“When they finally fed her through a tube, she could no longer push herself up on her elbows or hold her head up on her own,” he said. “It was 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 change of culture within the NHS, where there is a willingness to learn from mistakes.
“The government also needs to deliver on its promise to treat eating disorders as a key priority so that we can see significant changes in this area and ensure that patients receive the quality of care they deserve.”
Tom Quinn, director of external relations for Beat, an eating disorders charity, said it was “appalling” that vulnerable patients weren’t getting the treatment they desperately needed.
“Alarms have been ringing for years but NHS staff are still not being adequately resourced,” he said. “We need a fully funded long-term plan to invest in eating disorder services, ensuring services can recruit and retain staff.”
A spokesperson for the Department of Health and Social Care said: “Improving eating disorders and mental health services is a priority and this is why we are investing nearly £1 billion in community mental health care for adults with serious mental illness. , including eating disorders, by 2024.
“We are also providing an additional £54 million a year in eating disorder community services for children and young people to build the capacity of community eating disorder teams across the country.”