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Sean Horstead outlined his concerns in a report to prevent future deaths, which was published this week. He has sent his report to five parties, including Health Secretary Matt Hancock, and has asked for responses by April 28. Mr Horstead, assistant coroner for Cambridgeshire, said responses “must contain details of action taken or proposed to be taken, setting out the timetable for action”. He added: “Otherwise you must explain why no action is proposed.” Mr Horstead concluded last November the death of 19-year-old university student Averil Hart was avoidable and was contributed to by neglect. Averil was discharged from the eating disorder clinic at Addenbrooke’s Hospital in Cambridge in August 2012 and started her creative writing course at the University of East Anglia in Norwich the following month.

United kingdomMatt hancockMaria jakesEmma brownMadeline wallaceAmanda bowlesAveril hartA department of healthUniversity of east anglia in norwichColchester royal grammar schoolParliamentary health service ombudsmanHealth secretary matt hancockEast angliaSocial careஒன்றுபட்டது கிஂக்டம்மேட் ஹான்காக்