‘Fun-loving’ teenager with anorexia ‘referred into NHS team with severe staffing crisis’, inquest told
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Anorexic teenager Averil Hart, who died just weeks into her first term at university, was referred into an eating disorder team experiencing a “severe staffing crisis”, an inquest heard.
Dr Jane Shapleske, giving evidence to Tuesday’s hearing in Peterborough, said it was “absolutely recognised” that the Norfolk Community Eating Disorder Service (NCEDS), which the 19-year-old was referred into after 10 months as an inpatient, had significant staffing issues.
She said the teenager, from Newton, near Sudbury, had refused a referral to the Suffolk eating disorder team on discharge from the ward at Addenbrooke’s Hospital, Cambridge, in August 2012.
Between February and May, she had been gaining around a kilo a week and had set herself an “ambitious goal” to take up her creative writing course at the University of East Anglia that September.
The former Colchester Royal Grammar School pupil died just 10 weeks into her first term in December 2012.
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She had rapidly lost weight and collapsed in her room on December 7.
Rushed to the Norfolk and Norwich University Hospital (NNUH), she died on December 15, after slipping into a hypoglycaemic coma.
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Dr Shapleske, now retired, worked as a consultant psychiatrist in the Cambridge Adult Eating Disorder Service while Averil was on the ward.
She said that because she chose not to engage with the Suffolk team, “technically” Averil did not have a care coordinator between her discharge in August and arrival at university on September 23.
However, a doctor Averil had a “really good relationship with” was asked to bridge the gap. Without this, she would have been left solely in the care of her GP.
Dr Shapleske added: “We hoped there would be someone (a care coordinator) then, but there was a severe staffing crisis.
“This (affected) anyone being referred into a service, including Averil.”
The 19-year-old had her first appointment with an assigned care co-ordinator in Norwich in mid-October.
Dr Shapleske said Averil was deemed to be at high risk of relapse but had spoken of her wish to go to UEA, where she had an unconditional offer.
“There was no pressure for her that she needed to go at the beginning of August,” she added.
Dr Shapleske said going to university was a “massive motivation for her”, adding: “We were in a very difficult position because she decided on a course of events that was risky.”
She told the coroner “it was not unusual” for a patient to lose weight after discharge, and said blood pressure, pulse and temperature would be assessed before intervention.
She said the rate of weight loss considered to be “of concern” in an eating disorder patient would be 0.5kg (1lb) or more per week.
“Sometimes weight can come off fairly rapidly, there was some suggestion that may have happened before she was admitted to NNUH,” Dr Shapleske added.
Mr Horstead is overseeing the separate inquests into the deaths of five women, including Averil, who died from eating disorders while under the care of Cambridgeshire and Peterborough NHS Foundation Trust.
Four of the inquests, into the deaths of Maria Jakes, Emma Brown, Madeleine Wallace and Amanda Bowles, have concluded.
Averil’s inquest, expected to last four weeks, continues.