When someone dies on our roads as a result of an accident, there is a body and there is an investigation to find out how it happened.
For good reason you don't let the driver of the vehicle undertake the inquiry.
When Averil died as a result of the negligence and failures in the NHS trusts, that is exactly what happened. The “driver” was asked to undertake the inquiry and let the family know what happened and how it happened.
So how did the NHS hide and cover up Averil's death ?
1. The NHS initially undertook a mock investigation using their own clinicians and informed Averil's family that Averil’s care was satisfactory .............. "nothing to see here, move along".
2. The lead clinician Dr. Shapleske in charge of Averil's care then deleted her emails concerning Averil's care and death, potentially destroying vital evidence.
3. The lead clinician Dr. Shapleske then censored Averil's medical records for 18 months so that we only saw a small part of what was available.
4. The commissioners of Averil's care then paid an outside clinician that trained with Dr Shapleske and sat on the same board as Shapleke to write an independent review - again the surprise conclusion was
"nothing to see here, move along".
5. As we were told by Dr Robinson pressure was brought to bare on him to remove Averil's case from a specialist publication MARSIPAN. (Evidence the email from Shapleske to Aidan Thomas, the Chief Executive, which said we need to protect our reputation and must endeavour to get Averil's case removed). Averil’s death was also then removed from the annual report of the CPFT eating disorder service.
6. The Chair of the main NHS trust (CPFT), Julie Spence then told Averil's family that Cambridge and Peterborough NHS trust would "not answer any further questions about Averil's death".
7. In the meantime, the University medical centre (GP surgery) also simply refused to answer our correspondence even though they had failed to undertake most of the weekly tests and checks that they were supposed to do.
8. The Cambridge and Peterborough Clinical Director then wrote to the staff involved at CPFT to tell them that she would “concoct a plan” to deal with the Ombudsman's external inquiry.
Bit by bit the NHS clinicians and staff right up to the chief executives, Julie Spence, Aidan Thomas, Mark Turner, and Keith McNeal closed ranks and circled the wagons to cover up Averil's death.
So where are the missing supervision records and the deleted emails and the behind the scenes communications that resulted in Averil's case being buried?
Have they been permanently destroyed?
Will anyone involved be brave enough to stand up and be counted, tell the truth of what happened and allow Averil's family some peace and to grieve?