HEALTHCARE DELIVERY
Calls toeliminate avoidable malnutrition
The British Association for Parenteral and Enteral Nutrition is calling on the Government to develop a National Nutritional Strategy, following its latest screening survey which finds that malnutrition continues to affect one-in-four adults on admission to hospitals.
Malnutrition is reported to affect around 5% of the UK population (approximately 3 million people), yet many patients, carers, healthcare professionals, commissioners, senior managers and chief executives are unaware of how common it is. As a result, malnutrition continues to go unrecognised and untreated, leading to worse health and clinical outcomes in all social and NHS care settings. At the 2012 Digestive Disorders Federation Conference, held in Liverpool, The British Association for Parenteral and Enteral Nutrition (BAPEN) called for improved awareness of the problem and highlighted the need for a national, integrated strategy to improve nutrition across all healthcare and community settings. In a commissioning toolkit
(Malnutrition Matters – Meeting Quality Standards in Nutritional Care, May 2010), BAPEN previously commented that ‘improved nutritional care could result in substantial financial returns’ for the health service – calculating that even a 1% saving could amount to an estimated £130 million per year. The organisation
pointed out that malnourished individuals go to their GP more often, are admitted to hospital more frequently, stay on wards for longer, succumb to infections, and are at greater risk of being admitted to long- term care and of dying unnecessarily.
Nutritional care for hospital patients Earlier this year, Andrew Lansley, the previous Health Secretary, announced plans to tackle the issue of ‘patients leaving hospital malnourished’ and promised that ‘NHS hospital food will improve’. However, BAPEN warned that hospital food is only part of the problem and pointed out that a national malnutrition and hydration strategy is required to improve all aspects of nutrition provision across the NHS and social care. The organisation reported that:
“The high prevalence of ‘malnutrition’ on admission to hospital and during a hospital stay is not a trivial problem that can be ignored and is not, as commonly cited, a problem caused by ‘hospital food’.” Dr Ailsa Brotherton, BAPEN’s
‘Good nutritional care must become a priority for the Department of Health, with approaches including all elements of good nutritional care rather than
simply focusing on hospital food.’ Mike Stroud.
30 THE CLINICAL SERVICES JOURNAL
honorary secretary, said: “There is a clear need for system-wide approaches and improvement to detect malnutrition early in both community and acute settings and to ensure that individuals who are ‘at risk’ receive appropriate nutritional care. In
addition to appropriate, good quality hospital food, good nutritional care includes: nutritional screening (and repeat screening as appropriate), a detailed nutritional assessment for ‘at risk’ patients and the development and implementation of an appropriate personalised nutritional care plan, which may include oral nutritional supplements, enteral tube feeding or, in some cases, parenteral nutrition. “Developing highly reliable systems of
integrated nutritional care has become a priority focus for BAPEN and we are developing a number of resources, including a Nutrition Improvement Guide that will help NHS and Social Care organisations to deliver improved care. “However, to deliver improvements at
pace and scale, BAPEN recognises the importance of the Department of Health developing a national nutrition and hydration strategy and the appointment of a National Clinical Director for Malnutrition to lead this work for the NHS.” Dr Mike Stroud, chair of BAPEN’s
quality improvement committee and chair of the NICE guidance development groups for both nutritional support in adults and IV fluids, stated: “The Department of Health is fully aware of the importance of nutrition and is currently considering the improvements required. Nevertheless, we are now asking the Health Secretary to take responsibility for eliminating avoidable malnutrition in the NHS. In order to achieve this, good nutritional care must become a priority for the Department of Health, with approaches including all elements of good nutritional care rather than simply
NOVEMBER 2012
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72