BAPEN Conference How to Succeed in Audit


Following the success of the ‘How to succeed in Research’ symposium last year, the focus this year turned to ‘How to succeed in audit’. Professor John McLaughlin, Professor of Gastroenterology, School of Translational Medicine, Faculty of Medical and Human Sciences, University of Manchester, chaired this session in which delegates learned key facts about current frameworks and practice for clinical nutrition, personal experiences and useful tips from successful audit projects. Dr Sorrel Burden started the session outlining the impact of audit on implementing a screening programme using ‘MUST’, explaining that the audit had found ‘MUST’ to be a superior tool compared to the Trusts previous tool and that the weighing scales audit had led to capital investment for hoist scales. Sorrel demonstrated year on year improvements as a result of the audits which included training with link nurses in 2008, work with modern matrons in 2009, support from senior management in 2011 with nutrition screening and ‘MUST’ now being part of the Trust induction training. The next aim is to make this training mandatory. Emma Parsons, a Research Fellow at King’s College London, presented work on an important project aiming to measure quality of nutritional care through audit, developing a national clinical audit of Essence of Care (Food and Nutrition).


Dr Emma Donaldson’s presentation was a superb presentation about a journey from audit to quality improvement in which Emma described the Model for Improvement and the work that has been undertaken at Salford Royal Foundation NHS Trust to improve screening using ‘MUST’.


Close of Conference


Dr Tim Bowling gave the closing remarks, concluding that 2011 was a “fantastic conference” and thanking Pete Turner and his colleagues on the conference committee for their phenomenal amount of hard work and wishing everyone a safe journey home. Tim concluded by saying he is looking forward to seeing everyone for the BAPEN Conference being held within the DDF, Liverpool, 17th – 20th June 2012. Visit www.bapen@ddf2012. Registration is now open, please do register for your early bird discount and make sure that you tick the box to say you are a BAPEN member to obtain significant discounts on the daily delegate rate or 4-day package.


Factoids – BAPEN 2011 Malnutrition Matters


• Two full days of Conference • Two pre-Conference Teaching Days and the PEN Group Study Day • Over 580 delegates • 49 speakers • 9 mainstream symposia • 7 original communications presented in main symposia • 10 original communications presented in one chaired session • 75 posters displayed throughout the Conference • 2 satellite symposia, one breakfast briefing, two sponsored symposia • 35 exhibitors


BAPEN members are able to access speakers’ slides via the Members’ area on the charity’s website: www.bapen.org.uk


9 BAPEN In Touch No.63 January 2012


“The F Word Debate: Food First, Fortification or Fully Balanced Formula”


The final symposium of the conference was a debate chaired by Peter Turner, Chair of BAPEN Programmes committee. Despite the growing body of evidence that oral nutritional supplements can be extremely beneficial, a great deal of controversy remains about their use. Are they really better than food in all situations? Is food fortification a valid alternative? This debate set out to answer these questions. Pete Turner called for a vote at the outset of the debate and it was clear that the majority of the audience was in favour of ‘Food First’ (an estimated 75%). Dr Mike Stroud was about to face a significant challenge; could he persuade any delegates to change their mind and vote for ONS as the first line of treatment in tackling malnutrition.


Mike had cleverly been to every session at


this year’s conference that had presented the latest evidence for the use of ONS and combined this with the best of the published evidence to put forward a very strong argument for the evidence base for the use of ONS in the treatment of disease related malnutrition (DRM) making a clear distinction between DRM and other causes such as poverty. He used Dr Baldwin’s own systematic reviews to point out to the audience the poor evidence base for ‘food first’. Dr Christine Baldwin, Lecturer in Nutrition


& Dietetics, King’s College London, put forward a very well considered argument for ‘Food First’ drawing on the wider benefits of food and appealing to the dietitians in the audience by promoting the skills and the role of dietitians in treating malnutrition (without ONS).


When Pete offered an opportunity for questions and comments from the floor, in true debate style the discussion became spirited, heated and at times fractious (in a fun and friendly way). Supporters of food first talked again about the social aspects of eating whilst the ONS supporters were quick to get to the microphones to point out the strength of evidence for ONS. After much critical debate there was a re-vote and an incredibly close finish so huge congratulations to Dr Stroud for shifting the opinion of at least 25% of the audience in favour of ONS as an effective first line treatment for DRM. Pete Turner, chair, concluded the final vote was an equal 50:50 (though some of us do suspect that Mike Stroud narrowly won!!).


In a truly collaborative style, we agreed that there is an urgent need to develop an evidence based consensus statement/guideline and we committed to work collaboratively to deliver this. Watch out for the consultation on the Food/ONS Guidelines – we are now working on this and we will be seeking your views in 2012.


Dr Mike Stroud and Christine Baldwin enjoy a lively debate!


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