Whittington Hospital has already “learned lessons” after mentally ill Matt Groom suffered a six-hour wait to be seen by a psychiatrist, his inquest heard.

It said any patient seeking mental health assistance is now referred within an hour.

After a drunk and disorderly charge against 36-year-old Mr Groom was dropped by Highbury Corner Magistrates’ Court on June 15, he was told to visit the Archway hospital.

Accompanied by brother Joe and uncle John, he arrived at 1.35pm but became increasingly anxious and agitated as he saw two doctors and one mental health nurse - but not a psychiatrist.

During the afternoon, he demanded the nurse to section him, told of voices in his head, said there was a conspiracy against him and threatened violence if he didn’t see a psychiatrist soon.

It was just before 8pm when criminal solicitor Mr Groom - from Islington but most recently of Poplar, Tower Hamlets - was finally given a mental health assessment.

Mr Groom, whose family had been concerned about his wellbeing for weeks, walked out of the assessment at 8.23pm and eventually ran away from the hospital.

He died after stepping in front of a lorry on the M11, near Debden, at around 10.50pm.

Coroner Mary Hassell ruled out suicide on Wednesday as he was “psychotic”. A verdict is due on Thursday (November 12).

Dr Lucinda Donaldson, a consultant psychologist at Whittington Hospital, attended both days of the hearing even though she had no role in Mr Groom’s care.

Coroner Ms Hassell explained why she had been called to St Pancras Coroners Court: “I wanted someone in your position to listen to the evidence and tell me if you think, from a medical point of view, there’s any aspect of care that you would have liked to be offered in a different way another time.”

Dr Donaldson responded: “In terms of clinical decision making, I can’t find fault.”

But she admitted: “It would have been incredibly stressful to have been waiting for that amount of time. I imagine he was exasperated, afraid and desperate.

“We have taken steps and learned lessons. In terms of referrals, any patient asking for mental health assistance is referred directly within the hour.

“But it’s not the system that was in place for Matt, and I appreciate it’s too late for him and his family.”