NHS fuel malnutrition putting patients in danger
The NHS and care services are fuelling malnutrition by settling for “inadequate standards” that are putting patients – especially the elderly – in danger, a leading nutritionist warns.
Professor Marinos Elia said the condition continued to be under-detected and under-treated even though it affected more than three million people in Britain and cost an estimated £13 billion per year to deal with.
Adequate nourishment in hospitals and care homes is a major issue following the Mid Staffordshire hospital scandal with the Government pledging to raise standards of care – including ensuring that patients receive adequate food and fluids.
The consultant physician at Southampton General Hospital has now set up five statements for nutritional best practice on behalf of the National Institute for Health and Clinical Excellence (Nice) – the authority that helps develop health standards.
Care plan
A care plan will see details of a patient’s nutritional needs transferred with them from service to service in what the expert said was a simple and rational improvement.
“Malnutrition is a common and costly problem that leads to detrimental effects on individuals in hospitals and in the community and it needs to be taken more seriously,” Mr Elia explained.
“At present we have too many services settling for inadequate standards – the Care Quality Commission has recently confirmed that nearly a fifth of hospitals and nursing homes are not meeting at least one basic or essential standard in nutrition and hydration – and that is unacceptable.”
Malnutrition occurs when a person’s diet does not contain enough or the right balance of nutrients, leaving sufferers vulnerable to illness, delayed recovery and it weakens the effects of medical treatments.
Threat to millions
“Although malnutrition is a threat to millions of people in the UK, health services have struggled to develop clearly defined, simple and implementable plans that aim to achieve best practice.
“There is often a lack of continuity of care for individuals between care settings but, by making a documented nutrition care plan which is transferred with a patient when they move a requirement, we may start to see steady change,” the doctor explained.
In addition to a transferable care plan, the quality standard now has malnutrition screening for patients using a Malnutrition Universal Screening Tool (MUST), which was developed by Mr Elia and his team for everyone who accesses health services.
Mr Elia, who is also a professor of clinical nutrition and metabolism at the University of Southampton, added: “These are aspirational but achievable standards for supporting appropriate nutritional practice in routine clinical and social care in adults of all ages, but may be especially relevant to the elderly, who are vulnerable to malnutrition, and those with severe diseases requiring specialised care.
“If used fully and correctly, the simple quality statements will define what high quality nutritional care is and will give healthcare professionals the chance to uplift routine practice into best practice.
Simple and rational
“We simply must move from the mindset of adequate practice to best practice using simple, rational methods – we owe it to our patients.”
National surveys from the British Association for Parenteral and Enteral Nutrition (Bapen) found that 29% of adults admitted to hospital, 18% in mental health units and 35% in care homes are malnourished or at risk of malnutrition.