After a recent inquest held by Cambridgeshire Coroner into the death of a patient, Ms Bowles, who was known to the Eating Disorder service locally. Cambridgeshire LMC were asked to give evidence at this Inquest and in a narrative conclusion the Coroner stated that the patients death may have been influenced by the lack of a robust system of monitoring and this absence “was the direct consequence of the lack of formally commissioned monitoring in either primary or secondary care for eating disorder patients” and this absence “possibly contributed to Ms Bowles death”.
This Inquest is likely to be well-publicised and should act as a spotlight on local arrangements to commission such monitoring arrangements which are not part of primary medica services provided by General Practices. I understand the Coroners Office in Cambridgeshire will be issuing a Prevention of Future Deaths report at the end of a second inquest which is due to be held.
Surrey and Sussex LMC realise that in some areas the LMC Confederation satisfactory arrangements are in place to monitor the health of the vulnerable patient group but in others this is not the case and as an additional point, time from referral to assessment are lengthy.
We suggest these Inquests act as a trigger to review current arrangements.