Essence of Care


Improving Standards of Nutritional Care The Essence of Care Audit Project


EMMA PARSONS Research Fellow, School of Medicine, Diabetes and Nutritional Sciences Division, King's College London


A range of national clinical audits are currently used to monitor and improve health services in England. They are seen to be important measures of care provision within the NHS that allow providers to benchmark their services against other centres and implement improvements to care pathways where necessary. Given that malnutrition is common across care settings, national clinical audits of the standards of nutritional care may prove to be useful tools in improving nutritional care.


The Healthcare Quality Improvement Partnership (HQIP) have awarded a contract to King’s College London to develop an audit to measure the quality of nutritional care provided across all care settings, based upon the Essence of Care Benchmarks for Food and Drink (DH, 2010). The Essence of Care Benchmarks represent a major step forward in putting the patient experience at the heart of plans for quality improvement in this aspect of healthcare. They highlight ten factors along the patient pathway which have been identified by a variety of evidence as leading to the agreed outcome, which is for patients to be enabled to consume food which meets their individual needs. They echo themes suggested by the Nutrition Action Plan and the Care Quality Commission standards for healthcare providers. Given the variety of guidance that has been


produced, there is a clear need to address the standards of nutrition being provided both in hospitals and the community, to ensure people receive good nutritional care. The ten factors suggested by the Essence of Care include general indicators, promoting health, information about food provision, the availability, provision and presentation of food, the eating environment, nutritional screening and assessment, care planning, assistance with meals and monitoring of intake. These can easily be re-ordered into a nutritional care pathway, focusing on the patient journey within any care setting. The report provides further guidance for each of the ten factors, to ensure good nutritional care can be benchmarked. As the report focuses firmly on the needs, wants and preferences of people and carers, audit of the care provided by the


organisation, nurses and other members of the multidisciplinary team and patients’ perspectives on their care will be considered.


This exciting one year development project at


King’s College London aims to develop nutritional audit standards and test the feasibility of audit tools for use in both the hospital and care home settings. It will focus primarily on older people, given the rising elderly population and high prevalence of malnutrition within this population. It will explore the feasibility of auditing all ten factors of the Essence of Care Benchmarks for Food and Drink, in association with guidance from other key sources. The project aims to produce a range of tools that may aid the comprehensive assessment and improvement of the quality of nutritional care being provided by a range of healthcare organisations in England.


References: • Care Quality Commission (2010), Essential standards of quality and safety. London • Department of Health (2007) Improving nutritional care: Nutrition action plan. http://www.dh.gov.uk/ en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079931 • Department of Health (2010) Essence of Care 2010: Benchmarks for Food and Drink. http://www.dh.gov.uk/ en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119969


BAPEN In Touch No.60 February 2011 4


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