Braemar ambulance cover criticised after womans death

A Braemar family is calling for better ambulance cover for the Aberdeenshire town following the death of a 74-year-woman.

Pam Anderson died of a heart attack in September while being transported by ambulance to Aberdeen Royal Infirmary.

It was called after another single-crewed ambulance responded to her case but was unable to take her to hospital.

The Scottish Ambulance Service has agreed to meet her family to discuss the case.

A single-crewed ambulance, or paramedic response unit, can be allocated to incidents where they can initiate treatment.

However, in most cases, a double crew is needed to allow a crew member to be with the patient when heading to hospital.

Braemar’s own ambulance was withdrawn in 2007.

Her family said the first ambulance – from Ballater 17 miles away – did not have adequate crew to take her to hospital. She instead had to wait for another one to come from Tomintoul, 31 miles away.

Mrs Anderson’s husband Douglas said he did not blame the ambulance crews, who he described as professional, and said they tried everything to save his wife.

“We have no complaints with them, but there have been a few near-misses in the village over the years”, he said.

“This is perhaps a sign that we need a better service for Braemar for the future.”

Mrs Anderson’s daughter, Sarah Christie, said: “My mum was well-liked in the village and would do anything for anybody.

“Her death has brought home to us what a precarious situation we are in in this outlying community.

“We don’t know if it could have changed the outcome for mum, but maybe if we get the right resources it could for someone else.”

Braemar Community Council is writing to the Scottish Ambulance Service seeking answers.

The Scottish Ambulance Service expressed its “deepest sympathies and condolences” to the family following Mrs Anderson’s death.

In a statement it said: “We are limited in what we can say about individual cases due to patient confidentiality but we have been in close contact with the family and have arranged a meeting with them to discuss the case in detail.

“The Braemar area is served by ambulance stations in Ballater, Tomintoul, Alford and Banchory. While these are the stations which are geographically the closest, the ambulance service will always dispatch the closest, most appropriate response.

“The service have a wide range of resources which can be deployed depending on the nature of the incident and the condition of the patient, such as ambulances, paramedic response units, air ambulances, advanced practitioners and community first-responders.”

Christmas shopping done with weeks to spare

When the November lockdown was announced a “mini-rush” of shoppers headed for the High Street, determined to squeeze in a bit of the normal festive experience before the shutters came down and the closed signs went up.

But for Rochelle MacKenzie-McQueen there was no need to scramble into action.

She started weeks ago and now has her Christmas gifts in the bag, for around 10 friends and family members.

“Normally I would have waited until early December,” she says. “But because of Covid I thought, I’ll just get them now.”

The 29-year-old has a medical condition that means she has to be particularly careful to avoid the virus, so she shopped online. But she could see another lockdown was looming and knew others would be doing the same.

“I thought better to get it done early, because as soon as Black Friday hits everyone is going to be trying to order,” she says.

Now she’s relieved the pressure is off.

Even in a normal year there is a divide between those of us feeling a bit smug that by Guy Fawkes Night we’ve done everything, down to the labels and ribbons, and those of us planning an adrenaline-fuelled dash around the stores on Christmas Eve.

But in 2020 it is harder to work out how to tackle it. The face masks, hand sanitiser and queues have made the shopping experience an uncomfortable balance of risk and reward. We don’t even know exactly where we’ll be able to shop and when, whether deliveries will come on time. It is even less clear whether there will be bargains to be found or if some things will be hard to get.

Recent surveys for American Express and John Lewis suggested that, as a result, more of us planned to get ready for Christmas early this year. The department store found that less than 2% of us were going to leave it until the last minute, while 60% of us hoped to have all the presents, prosecco, pyjamas and panettone sorted by the end of November.

Laura Pemblington has not only bought all of her Christmas presents – for her parents, her husband, her two young boys and a few other friends and family – but she has wrapped and carefully stashed them out of sight.

“I just sat here one night and said, ‘I need to cheer myself up.’ I made myself a hot chocolate, put on Elf – that’s my favourite Christmas film – and wrapped.”

That was about three weeks ago now. As for shopping, she started that during the first lockdown in the spring.

“There were some good deals,” she says. “Because I was sat at home I thought, ‘I’ll buy that.’ Before I knew it, I was done. I was shocked myself.”

She thinks she saved money too as long as she can be disciplined about not adding to the pile.

Shopping early doesn’t work for everyone though, says Kate Hardcastle, consumer expert at Insight with Passion. A lot of people look forward to the experience of Christmas shopping itself as a ritual, a marker at the end of the year when they can let go and treat themselves.

“There is something about the ambience – the lights, the smell of chestnuts in the street, we’re wrapped up and glowing, maybe we’re bumping into people we know, and we’ve got longer to stop and chat – that enhances the shopping experience,” she says.

It might make us spend more, but it also makes us feel good, she says. You won’t get that same experience shopping in August or online, but she points out, you may not get it this year at all, even if you wait until December.

“If the stores do reopen after this four-week period, there’s going to be a different type of shopping. It’s going to be very frustrated, pressurised shopping. It’s going to be very anxious shopping,” she says. “No time for frivolousness, no time for browsing.

“Nothing says Christmas less than wearing a bright blue medical face mask, does it?”

And in the end that may just mean we end up buying less than we might have. There are a lot of people, says Ms Hardcastle, who prefer to shop in person, looking for inspiration, using cash. In particular, grandparents are eager to treat grandchildren who they haven’t been able to spend as much time with this year. There are things they would pick up in stores that they wouldn’t necessarily come across online.

But if shopping is curtailed, you can always get started on other seasonal activities instead.

Laura has followed up Elf by watching Miracle on 34th Street, It’s a Wonderful Life, The Grinch (cartoon version once, Jim Carrey version twice) and The Nightmare Before Christmas (too many times to count).

“I think it’s because this year has been so rubbish,” she says. “With everything that’s gone off I’m trying to make it extra festive.”

Others are taking the same approach. Members of Mumsnet admit their Christmas trees have been “twinkling away” since the half-term break, and plan to put on the Christmas songs playlist and decorate their homes by mid-November.

But we won’t all be rushing to get on with it.

Rochelle is pretty sure her brother will be sticking to his usual timetable.

“He’ll literally buy Amazon vouchers on Christmas Eve and have them emailed to us,” she says.

“I tell him to put some thought into it. He just says, ‘Everyone’s happy with vouchers.'”

Codemasters: UK games firm to sell to Take-Two

Veteran British video game company Codemasters has confirmed it plans to sell to US giant Take-Two.

Codemasters is best known for its racing games, including the Dirt Rally series and Formula 1 licences.

The studio was founded in the UK, and currently has its headquarters in Southam, Warwickshire.

Take-Two has offered a deal that values Codemasters at £739m ($973m), and Codemasters says it intends to recommend it to its shareholders.

The announcement comes on the same day the firm released its latest title, Dirt 5.

Despite its current focus on racing games, Codemasters has dabbled in several other notable franchises over the years.

The firm created the Dizzy series of platforming games in the Spectrum and Commodore era, as well as several sports games.

An alternative take on its racing games arrived in the form of the successful Micro Machines franchise in the 1990s, and it also published – though did not develop – well-known British-made sports games Brian Lara Cricket and Jonah Lomu Rugby.

The buyout deal is worth £1.20 in cash and £3.65 in Take-Two shares for every Codemasters share.

It is not, however, fully finalised, with a “firm offer” yet to be officially made. The two companies confirmed the existence of the current deal after media reports of a possible sale emerged.

“Take-Two believes that the combination of Take-Two and Codemasters would bring together two world-class interactive entertainment portfolios, with a highly complementary fit between 2K and Codemasters in the racing genre,” Take-Two said, referencing the Take-Two video game publisher 2K, which counts many sports titles among its catalogue.

Star Wars toys dumped in Stourbridge garage fetch £250k

A collection of vintage Star Wars toys found in bin bags in a garage has fetched more than £250,000 at auction.

They and other toys were left to an elderly couple, from Stourbridge, in their neighbour’s will.

The couple were unaware of the value of the items, which sold in total for £410,000, and had arranged for skips to throw many of them away.

They were sold by Aston’s Auctioneers in Dudley, West Midlands, in its last sale before closing permanently.

Auctioneer Chris Aston said he did not expect the items to fetch so much.

“The best piece was the vinyl cape Jawa, the guys from the desert in the original Star Wars film,” he said.

“Not many of these vinyl cape ones made it on to the market, so to find one sealed on the card like the one in this collection, we think there is only eight of them in the world.”

That item alone fetched £22,000.

The unnamed couple had invited Mr Aston to look at the large number of toys and comics in the man’s house, but had arranged for skips because they had no idea of how valuable some of the items were, Mr Aston said.

“The first day I was there I found a rare Batman figure,” he said.

“As soon as I found that, I thought, well if that is in there, there could be loads of gems, so I instructed them to cancel the skips.

“It was our best sale ever in 15 years and also our last ever auction as we are now closing the business permanently having been badly affected by the lockdown earlier in the year.”

Man jailed for setting fire to policeman in Newquay

A man told police “I will set you on fire” before throwing a cider bottle filled with petrol at them, causing flames to “explode” over an officer.

PC Darral Mares suffered serious burns to his hand and body when he was doused with the accelerant in Newquay, Cornwall, on 11 September.

Blagovest Hadjigueorguiev previously admitted attempting to, and inflicting, grievous bodily harm (GBH) with intent.

Judge Robert Linford told Truro Crown Court it was a “wicked” act.

PC Mares and PC Alan Lenton were sent to remove the Bulgarian and his belongings from Duchy of Cornwall land, where he had been camping.

Footage from the officer’s bodycams captured the 30-year-old holding a bottle and telling the officers: “I will set you on fire. This is my stuff, I’m not disturbing anyone. Go away.”

The court heard the defendant threw the cider bottle containing petrol at the officers then threw petrol on his camp fire, causing flames to “explode” over PC Mares, 51.

PC Lenton rolled his colleague on to his back to extinguish the flames and was issued a commendation by Judge Robert Linford.

The judge told Hadjigueorguiev: “It was a wicked, deliberate and extremely violent act, directed at a man who had previously tried to help you.”

The defendant was jailed for 10 years and six months for causing GBH with intent on PC Mares, and six years for attempted GBH with intent on PC Lenton. The sentences will run concurrently.

Det Insp Daniel Massey, from Devon and Cornwall Police, said PC Mares was “on the road to recovery”.

“This incident reflects the dangers and challenges the police face on a daily basis, despite this force area being one of the safest places to live,” he said.

Sunny payday loan customers may get nothing in payouts

Half a million borrowers mis-sold payday loans by collapsed lender Sunny are likely to receive no more than 1% of their compensation entitlement.

Administrators KPMG are emailing all those who have a right to a payout, inviting them to make a claim.

But they are warning that the funds available mean they may not receive a penny, or 1% at most.

However, victims of mis-selling will automatically have negative entries on their credit records cleared.

This will be done automatically by the end of November, with any notes of defaults on their first five Sunny loans cleared, and notices of any subsequent loans deleted entirely.

That should help those struggling to access credit, as a result of their history with Sunny, having more success in the future.

Sunny was one of a series of high-profile payday lenders to have collapsed, mostly in response to a wave of complaints over the mis-selling of short-term, high-cost loans.

Many of these loans were found to have been unaffordable to repay, and should never have been granted.

Wonga was the most high-profile collapse in August 2018, followed by other big names in the sector such as WageDay Advance and QuickQuid.

Sunny, the brand name of Elevate Credit International Limited, fell into administration in June. In October, some of the existing loan book was sold to Perch Capital, and others were written off.

Administrators then assessed how many of Sunny’s 700,000 customers had been mis-sold loans, and concluded that 500,000 had been affected and could make a claim. It is emailing all of them in the coming weeks.

Others whose cases have already been dealt with by the Financial Ombudsman, but have not received any payout, can also put in a claim for compensation.

All claims must be submitted by the end of January.

“Whilst the dividend will depend on the volume of claims and queries received, we estimate that any dividend payable could be less that 1p in the pound and that any payment would likely be made in spring 2021,” the administrators said.

Debt adviser Sara Williams, who runs the Debt Camel blog, said: “Since Wonga went under, the figures have been emerging about the massive scale of payday loan mis-selling.

“These show how ineffective regulation was at preventing so many people being trapped in unaffordable debt for so long.”

Popular app T&Cs longer than Harry Potter

The combined terms and conditions of 13 top apps including TikTok, WhatsApp and Zoom would take 17 hours and five minutes to read, a firm has estimated.

The documents contain a joint total of 128,415 words – longer than any one of the first three Harry Potter novels.

The longest was Microsoft Teams at 18,282 words – or two-and-a-half hours of reading time for many people.

In 2018, a BBC study found that several website policies required university education levels of reading ability.

It is not possible to use the services without agreeing to the terms.

Other long documents discovered by thinkmoney included Candy Crush (14,189 words), Twitter (11,022) and Facebook (8,588). The word count included both terms and conditions and privacy policies.

The shortest on the list was Google Meet with 4,717 words.

Privacy researcher Stephanie Hare said that both the length and language used in such statements made them difficult for adults and children to be able to make informed consent about what they were agreeing to – and the only alternative was to not use the app at all.

“Consent implies choice, but choice is not what’s on offer. It is difficult, if not impossible, for most of us to work and live today without using a smartphone, computer and other devices that allow us to transact online,” she said.

The EU data regulation GDPR states that communications to individuals about their data must be “concise, transparent, intelligible and [in an] easily accessible form, using clear and plain language, in particular for any information addressed specifically to a child”.

Microsoft Teams does include a sentence in its terms asking children not to create an account if they do not understand the service agreement – but it is more than 1,500 words into the document.

Microsoft declined to comment.

Kate Bevan, editor of Which? Computing magazine, pointed out that both Android and Apple devices now signpost more clearly what permissions an app is seeking – such as access to a device’s microphone, camera or location.

“When you install an app, take a couple of minutes to think about what it’s asking to do, and if you’re not comfortable allowing an app access to your contacts, for example, then think twice about whether you want to install the app,” she said.”It is important for businesses to communicate in a way that users understand.”

At an event last year, Simon McDougall, a senior executive at the UK Information Commissioner’s Office, described the “I agree” button at the end of terms and conditions documents as “one of the biggest lies on the internet”.

“How many people are actually reading these things, how many are actually clicking, because it is quite scary how the muscle memory is building up as these hands are just clicking their way through,” he said, as reported by the website IT Pro.

Anorexia: How the eating disorder took the lives of five women

A mother, an Olympic hopeful, a medical student, a waitress and a writer. What do the lives and deaths of five women tell us about how anorexia is managed and treated?

“A lucky dip”. That is coroner Sean Horstead’s frank assessment of the system by which many patients with eating disorders are cared for.

He has just heard the last of a series of back-to-back inquests into the deaths of five women: Averil Hart, Emma Brown, Maria Jakes, Amanda Bowles and Madeline Wallace.

All died between 2012 and 2018, and the Cambridgeshire and Peterborough assistant coroner unearthed issues including patient monitoring, inadequate record-keeping and missed opportunities in care.

He said the successful treatment of eating disorders was often “reliant on the goodwill of GPs”.

Mr Horstead has written a Prevention of Future Deaths report in respect of all five women. He states his concerns about the monitoring of people with eating disorders and calls for greater clinical training in the area, for staff ranging from “consultants to health care assistants”.

Cambridgeshire and Peterborough Foundation Trust (CPFT), which runs the eating disorders service all five women used, said it was “committed to supporting further developments regionally and nationally”.

Madeline Wallace, known as Maddy, was a bright, motivated 19-year-old who hoped to become a doctor.

Diagnosed with anorexia nervosa in October 2016, Miss Wallace, from Peterborough, “rapidly lost weight” during her first term at Edinburgh University in 2017.

Peterborough GP Dr Rebecca Coates saw her repeatedly during her illness.

Giving evidence, Dr Coates told how at first she had little knowledge of eating disorders, turning to GP colleagues and then Google to research treatment.

Using “best clinical judgement” was incredibly difficult due to the nature of anorexia, said Dr Coates.

Another issue was the “gap” in provision when Miss Wallace went to Edinburgh.

Despite being a “high-risk” patient, Miss Wallace became increasingly concerned about her weight loss there.

Mr Horstead said she only had one dietician meeting in three months, despite raising anxieties surrounding meal preparation and planning.

Ahead of her move to Edinburgh, Dr Penny Hazel, a clinical psychologist at CPFT, tried to get her an appointment at the city’s specialist Cullen Centre in April 2017. She was told to call back in August, the inquest heard.

The centre could only accept her as a patient after she had registered with a GP in Edinburgh. An appointment could take a further six weeks.

At the end of 2017 Miss Wallace returned home to focus on getting better.

But on 4 January 2018 she was taken to Peterborough Hospital with chest pains. Feeling “agitated” and worried, she discharged herself.

The next day, during a regular anorexia check-up, she told another GP about her symptoms but was told she had pulled a muscle or broken a rib, her mother Christine Reid said.

On 7 January her mother phoned 111. A nurse from Herts Urgent Care referred her to an out-of-hours GP who made an urgent referral for hospital treatment.

The GP’s request was denied and she was sent home with antibiotics.

The urgent care nurse admitted she knew little about anorexia and had not considered sepsis or an urgent hospital admission herself.

On 8 January, Miss Wallace was again taken to hospital and diagnosed with pneumonia which had developed into sepsis.

The following day, doctors attempted a procedure to save her life but she died in theatre.

It is thought her temperature spiked in her final week, but that this was dismissed by a GP as within the normal range for a healthy person.

Her parents believe that because she had a lower-than-normal body temperature, the supposedly normal reading might in fact have been a sign of infection.

In evidence, Dr Coates said assigning eating disorder patients a single doctor might save lives in the future.

Had she seen Miss Wallace in the week before her death, she believes she may have noticed “red flags” – such as her raised temperature.

“I would have noticed a change in Maddy from the previous weeks and looked into it further,” she said.

Following the inquest, Mr Horstead said GPs’ knowledge of anorexia was “woeful and inadequate”.

Emma Brown, 27, was found dead in her flat in Cambourne, near Cambridge, on 22 August 2018.

An accomplished runner with Olympic ambitions, she was first diagnosed with anorexia at 13.

Her mother, Jay Edmunds-Grezio, described how Ms Brown would run 15 miles (24km) a day to maintain her low weight.

She trained with Bedford Harriers under the guidance of Paula Radcliffe’s former coach, Alex Stanton, in an effort to boost her self-esteem.

“In her mind she was heading for the Olympics but she couldn’t control the amount she was running,” said her mother.

Simon Brown told the inquest his daughter’s illness was a “descent into hell”.

He said: “This is an illness where the patient feared weight gain, she feared recovery, so fought against the help that was being offered.”

A post-mortem examination gave Ms Brown’s cause of death as lung and heart disease, with anorexia and bulimia nervosa as contributory factors.

Mr Horstead heard how GPs had sent dozens of letters to CPFT outlining concerns, including the lack of time, money and specialist knowledge they had to adequately monitor eating disorder patients.

The coroner voiced concern at the “paucity” of Cambridgeshire and Peterborough Clinical Commissioning Group’s investigation into Ms Brown’s death.

He noted there were no interviews with her parents or “key clinical figures”.

Averil Hart, 19, of Newton, near Sudbury, Suffolk, loved sports and outdoor activities.

She was, said her mother Miranda Campbell, a “beautiful, intelligent, incredibly witty, fun-loving girl”.

First diagnosed with anorexia in 2008, she was voluntarily admitted to the eating disorders unit at Addenbrooke’s Hospital, Cambridge, in 2011.

Discharged in August 2012, she moved to Norwich the following month to study creative writing at the University of East Anglia (UEA).

She was admitted to hospital in Norwich on 7 December 2012 after collapsing in her university room, and died at Addenbrooke’s on 15 December 2012.

The coroner heard how she had written in her diary about falsifying her weight and restricting her food intake.

On November 13 2012, she wrote: “I can’t believe I’m still going, what I’m even running on any more. I just look thin and in pain.

“It makes me so sad.”

Locum GP Dr Wendy Clarke admitted she “knew practically nothing” about anorexia prior to treating her, and had to look up guidance for medical monitoring during her first appointment.

The inquest also heard doctors had misunderstood who was responsible for her monitoring, and had not followed up to check necessary tests had been done.

There were delays in her treatment and, over a weekend at the Norfolk and Norwich University Hospital, no specialist dietetic or psychiatric help was sought.

She therefore received no nasogastric-gastric (a tube from the nose to the stomach) feeding, which an expert witness said could have increased her chance of survival.

Mr Horstead found Miss Hart’s death “was contributed to by neglect”, citing among the factors a “lack of formally commissioned service for medical monitoring of anorexic, high-risk of relapse, patients”.

He also said there was a “failure” to speak to Miss Hart’s father after he raised concerns about her serious deterioration.

Dr Katie Bramall-Stainer, chief executive of Cambridgeshire Local Medical Committee, told the inquest there was a national failure in treatment and support for “this incredibly vulnerable and fragile cohort of patients who can relapse quickly and relapse seriously, with too often tragic outcomes”.

Maria Jakes, 24, from Peterborough, died of multiple organ failure in September 2018.

Mr Horstead cited insufficient record-keeping and a failure to notify eating disorder specialists in her final weeks as possible contributory factors.

Ms Jakes, a waitress, had battled anorexia nervosa since the age of 12 and also had a personality disorder.

Because she was sensitive to perceived interference by health professionals – a common trait of people with eating disorders – she was allowed to report her own weight to doctors, despite being known to inflate it.

The inquest heard she was discharged from an eating disorders ward at Addenbrooke’s in January 2018, but there was “insufficient monitoring” of her weight before her admission to Peterborough City Hospital in July.

The coroner concluded that multiple agencies had “missed opportunities” to properly monitor her illness.

Amanda Bowles, however, was keen to have regular check-ups, repeatedly asking for medical monitoring from her GP.

Her requests, the inquest heard, went ignored for six months after she was discharged from the CPFT’s Adult Eating Disorder Service (AEDS) in December 2016, despite her “critically low” body-mass index (BMI).

Her condition went unmonitored until May 2017 when a doctor noted Ms Bowles “hadn’t been reviewed for some time, seems to have fallen through the net”.

Aged 45, the mother-of-one was found dead at her Cambridge home in September 2017.

Mr Horstead concluded a lack of monitoring likely contributed to her death. 

After the inquest, her sister Rachel Waller said “the most important thing to [her sister] was her son”.

She said: “She really battled this illness and even though it wasn’t her, it was a massive part of her life, but she battled that to enable him to have a relatively normal life.”

The demand for CPFT’s eating disorders service is high.

In 2018-2019, the service received 32 urgent and 533 non-urgent referrals.

The East of England has just 14 inpatient NHS beds specifically for eating disorders. A further 22 private beds can be commissioned. 

During the inquests, Dr Jaco Serfontein, clinical director at the trust, said beds were always full.

While not officially linking the deaths, saying “each woman was a different person and each had different factors”, the coroner found common themes, in particular the “continuing absence” of a formally commissioned provision for monitoring.

This absence, said Mr Horstead, had led to a “miscommunication” between those treating patients with anorexia.

Miss Hart’s father Nic, who attended some of the other inquests as well as his daughter’s, said the hearings had shown there was “very little monitoring of young people with eating disorders in the community”.

“We desperately need better monitoring by the GPs and the eating disorder specialists to make sure there’s early intervention,” he said.

“We then need the NHS to roll out safe care for people with eating disorders throughout the UK.

“At the moment it’s a huge postcode lottery and I think depending on where you live depends on the type of care you will receive.”

A lack of beds was raised by Chris Reid, Madeline Wallace’s mother.

“Conversations were had about going to a specialist ED (eating disorders) hospital, but she stayed home as there were no spaces locally,” she said.

“Her health went downhill rapidly and she spent two days in critical care, and she was then found an emergency bed in the local eating disorder hospital in February 2017.”

She also talked of the problems of caring for a loved one with an eating disorder.

“I was very concerned, as was she, but didn’t know much about the illness and, as parents, we appeared to have little impact on encouraging Maddy to eat. Excuses were made and she became evasive,” she said.

“Typical issues encountered included not appreciating anorexia is a serious/life-threatening mental illness; not knowing about the distorting effect it can have on physical test results and the significance of this for care.”

The families of some of the women voiced concern at the lack of funding and education for eating disorders.

Simon Brown, Emma Brown’s father, bears no grudge and has nothing but admiration for the clinicians involved in his daughter’s care, even inviting some to her funeral.

“I don’t know where they find the drive, the skill, to keep going back,” he said.

“You’re not that well supported, you’re under-staffed, under-budgeted, the patients hate you, the parents blame you, there’s not enough money and actually we don’t yet really know how to treat these people anyway.

“Why would anybody do that? Who am I to find blame in the people that have devoted their professional lives to trying to help people like Emma?”

Rachel Waller, sister of Mandy Bowles, fears the stigma associated with anorexia makes it difficult for patients to be treated seriously beyond those who specialise in it.

“This disease has the highest death rate of any mental health condition, and yet it’s treated as some sort of adolescent teenage frippery disease where they’re simply choosing not to eat because they want to look slimmer,” she said.

Maria Jakes’ grandmother Kath Wakerly said GPs focused too much on patients’ weight as an indicator of illness.

“It seemed… they had to get to a low weight before they were actually admitted to hospital,” she said.

“We just need a whole rethink, training across the board: the nurses, doctors, GPs, dieticians.

“I think something good needs to come out of what’s happened to these lovely young people. I wouldn’t wish that illness on anyone.”

A CPFT board meeting in September was told there remained a “gap in provision” for medical monitoring of eating disorders patients, including some who were high risk.

The trust are, alongside local GPs and the CCG, developing a commissioned medical monitoring model, which will be piloted in Peterborough, managing patients according to the severity of their illness.

Those deemed medium to high risk would receive monitoring delivered by CPFT specialists, whereas those in the low to medium group would be monitored by health care assistants, supported by CPFT specialists, in primary care settings, such as GP surgeries.

On the final day of Miss Hart’s inquest, NHS England announced it would roll out an “early intervention service” across 18 regions, targeted at young people living with an eating disorder for fewer than three years, in a bid to prevent its escalation.

An NHS spokesman said: “The important and deeply concerning findings and learning set out by the coroner must be acted on by all those services involved.

“The NHS will continue to expand and improve access to eating disorder services, including in Cambridgeshire and Peterborough, to strengthen how adult eating disorder services work together.”

If you are affected by any of the issues in this story, you can talk in confidence to eating disorders charity Beat by calling its adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Averil Hart: Neglect and systemic failures caused anorexia death

Systemic failures and neglect caused the death of a teenager who had severe anorexia, a coroner has said.

Averil Hart, 19, from Newton in Suffolk, died from anorexia on 15 December 2012, a week after collapsing at her university flat in Norwich.

The coroner identified seven areas that he said contributed to her death.

They included a “gross failure” not to give nutritional support at Norfolk and Norwich University Hospital (NNUH), which he said amounted to neglect.

A Prevention of Future Deaths report has been written by coroner Sean Horstead after he identified a theme between Miss Hart’s case and four other anorexia deaths.

Amanda Bowles, Madeline Wallace, Emma Brown and Maria Jakes died between 2017 and 2018.

Mr Horstead said a gap in formally commissioned medical monitoring as seen in Miss Hart’s case continued, and “gives rise to risk of future deaths”.

Nic Hart, Miss Hart’s father, said: “It’s a huge relief to hear the coroner come to the conclusions we all knew to be the case.

“My heart bleeds for those families who have lost loved ones after Averil died.”

Miss Hart died at Addenbrooke’s Hospital in Cambridge, after an emergency transfer from NNUH.

On the final day of the four-week inquest in Peterborough, Mr Horstead read out a narrative conclusion.

“The failure to adequately plan for or provide any nutritional support to Averil over the course of her four days at North Norfolk University Hospital, in the context of her severely malnourished condition recognised on admission, was a gross failure that had a direct causal connection with, and more than minimally contributed to, the death,” he said.

“Averil Hart’s death was therefore contributed to by neglect.”

The coroner identified a total of seven areas which he said directly or possibly contributed to her death:

Delays at Addenbrooke’s were ruled possibly causative as her condition had deteriorated significantly by the time she arrived.

NNUH medical director Prof Erika Denton said: “We acknowledge the devastating impact that Averil’s death has had on her family and we offer our sincere condolences for their loss.

“We recognise that the care and treatment we gave to Averil was not of the quality that we or our patients expect, for which we are very sorry and offer an unreserved apology.

“We have endeavoured to learn and make improvements to our services, including expanding our clinical nutrition team with expert consultants, nurses and dieticians, additional specialist under-nutrition training for staff, and enhanced, 24/7 access to services that can support staff in caring for patients with particular mental health needs.

“We remain committed to improving services for our most vulnerable patients.”

If you are affected by any of the issues in this story, you can talk in confidence to eating disorders charity Beat by calling its adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Boris Johnson: Deal to be done on post-Brexit EU trade

Boris Johnson has said he believes there is “a deal to be done” on post-Brexit trade with the EU.

But while the UK prime minister “very much hopes” to come to an agreement, he said the country was “very well prepared” to move on without one.

Mr Johnson made the comments ahead of a call with EU Commission President Ursula von der Leyen on Saturday.

It comes as the National Audit Office warned of “significant disruption” when the Brexit transition period ends.

The UK left the EU on 31 January and entered a transition period – continuing to follow many EU rules – while a trade deal was negotiated.

But while both sides said a deal needed to be done in October, they have yet to come to an agreement, and talks between the negotiating teams have intensified.

The transition period is due to come to an end on 31 December, meaning the UK would trade with the bloc on World Trade Organisation rules if a deal is not in place.

Critics say this could cause damage to the UK economy, but the government insists the country will prosper with or without a deal.

Earlier this week, both the UK and EU’s chief trade negotiators warned of “wide” and “serious divergences” between the two sides.

Sticking points include fishing rights, competition rules and how a deal would be enforced.

Asked on Friday if the UK could get a deal in the next 10 days, Mr Johnson said: “I very much hope that we will, but obviously that depends on our friends and partners across the Channel.

“I think there is a deal to be done, if they want to do it.

“If not, the country is, of course, very well prepared. As I have said before, we can do very well with on Australian terms [without a deal], if that is what we have to go for.”

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