Doctors’ failings on eating disorders ‘are costing lives’

Lack of understanding of eating disorders among doctors is resulting in too many avoidable deaths, with medical staff receiving too little training, a parliamentary select committee has found.

Training on eating disorders in medical schools is limited to “just a few hours”, but junior doctors and GPs need significantly more, according to a report by the Commons public administration and constitutional affairs committee published on Tuesday.

The report also identifies a series of failures by the NHS to act on previous recommendations for improving care for patients.

A 2017 report by the parliamentary and health services ombudsman (PHSO), which examined failures over the 2012 death of Averil Hart, 19, and two other women, called for more training of doctors, improving coordination of services and investigating potential failings in previous serious incidents.

But the committee said not enough action has been taken to implement them fully across the NHS. It called on the General Medical Council to use its influence to ensure medical schools improved training.

Some studies suggest that up to 1.25 million people in the UK may be suffering from eating disorders, which are said to have the highest mortality rate of all mental illnesses. Yet the committee was “shocked” to discover the NHS did not have precise information on the prevalence of eating disorders. It called on NHS England to commission a population-based study.

Many doctors focused only on using body mass index (BMI) to determine whether to offer treatment even though Nice guidelines recommend avoiding using single measures, the report said.

It found few patients had access to an NHS eating disorders specialist. There were difficulties for patients transitioning from child to adult care aged 18. Patients often faced unacceptably long waiting times for adult mental healthcare at a difficult time when they were moving from school to university. The quality of care was often a “postcode lottery”. Some patients were discharged when they reached a certain weight, with no guarantee their mental health had recovered, the report found.

It was essential the NHS learned from previous serious incidents. Nic Hart, the father of Averil Hart, from Newton, Suffolk, who died from anorexia, had been in constant correspondence with more than six organisations before any formal investigation was launched into his daughter’s death, the report stated.

The committee chairman, Sir Bernard Jenkin MP, said: “My committee found serious failings in NHS care for people with eating disorders – doctors only receive a couple of hours of training, patients are left waiting for months for care, and the NHS doesn’t even have accurate data on the number of people suffering from an eating disorder throughout the UK.

“We cannot risk any more avoidable deaths from eating disorders. Eating disorders are complex mental and physical health illnesses and deserve dedicated training, specialist care and a commitment from the NHS to learn from its own mistakes.

“It has been nearly two years since the PHSO reporting on how NHS eating disorder services are failing patients. The government needs to adopt a sense of urgency to stop this problem from spiralling, and my committee is calling for swift action to address deficiencies in care.”

The General Medical Council said it did not have power over medical school curricula. Prof Colin Melville, director of education and standards for the GMC, said it has been doing all it can to influence positive change, including writing to every medical school to ask how and where they include eating disorders in their curricula.

“We are determined to continue working with medical schools, royal colleges, doctors and the wider health system to ensure these complex issues are taught and that patients are identified and supported with appropriate clinical care,” he said.