New research by the Malnutrition Taskforce reveals that only half (51 per cent) of health professionals thought malnutrition was a priority in their organisations. Only 47 per cent also felt confident that their knowledge and skills were sufficient to help people most at risk.[i]
The survey ‘Experiences of Patient Malnutrition’ by Dods Research also shows that half (50 per cent) of the professionals interviewed felt unsure about what services or support were available in their community.[ii]
About 1.3 million people older people in the UK suffer from malnutrition, with the vast majority (93%) of those living in the community.[iii]
Malnutrition is associated with several long term conditions, such as chronic obstructive pulmonary disease (COPD), cancer, dementia and swallowing problems (dysphagia) as well as physical disability and social factors which can affect people in later life, such as bereavement, loneliness and isolation.
Malnourished older people also:
- Visit their GP twice as often[iv]
- Experience more hospital admissions and have longer lengths of stay[v]
- Have an increased risk of infection and antibiotic use[vi]
- Have longer recovery times from surgery and illness, and increased risk of death[vii]
Furthermore, nearly one third (32%) of older people admitted to hospital or a care home from the community are already at risk of malnutrition, as are half of patients admitted to hospital from care homes.[viii]
The Malnutrition Task Force was established in 2012 to reduce preventable malnutrition amongst older people. In 2013, the Task Force was awarded a grant by the Department of Health to develop our pilot prevention programme as part of their response to the Francis Inquiry. The pilot prevention programme set out to demonstrate what could be achieved by working together across the NHS, social care, public health and with voluntary sector organisations.
Pilot sites were established in Salford, Lambeth and Southwark, Gateshead, Purbeck in Dorset and Kent. Some examples of the work include:
- In Salford the team have created a unique paper armband that can be slipped onto the upper arm of an older person to assess the risk of malnutrition without needing to use scales and measure people’s height. This is a simple, quick idea that makes it much easier for carers, volunteers and professionals visiting people in their homes to identify malnutrition and provide the right support.
- In Kent the team have developed a programme that identifies people at risk and works with the voluntary sector to help and encourage people to eat better at home, for example weighing them regularly and suggesting interventions where low weight or weight loss is an issue.
- In Gateshead the team have worked with volunteers to provide support at mealtimes in different care settings to make sure older people got the nutrition they needed
- Lambeth and Southwark created a page on a local online directory, signposting older people to food and nutrition services in their area.
- In Purbeck in Dorset the team held free internet home shopping training sessions for older people who were finding it difficult to get out and shop. These covered how to set up an account, shop for groceries and other essentials, create a regular shopping list, book a delivery time and pay for shopping securely and safely.
Dianne Jeffrey, Chair of The Malnutrition Task Force and Chairman of Age UK said:
“Eating and drinking well is a vital part of maintaining good health and independence. And while we generally think of malnutrition as a problem for low income countries, the sad fact is that many older people in the UK today are malnourished or at risk of becoming so.
“Malnutrition is a really knotty problem. While many of the interventions are relatively simple, to be really effective they require a wide range of services to come together, recognise the problem and each make a contribution towards tackling it.
“However at the moment the sad fact is in too many areas this isn’t happening, Malnutrition is often overlooked and isn’t tackled very effectively at any point in the care journey, so many people slip through the net and never receive proper help.
“The pilots we ran last year have shown us just what can be achieved when we all work together to put malnutrition at the top of the agenda. The challenge now is to make sure that every area steps up to ensure that all older people are well nourished and get the help they need.”
The Malnutrition Task Force are hosting an event in Parliament today to celebrate the success of the pilots and welcome the launch of NHS Commissioning Guidance.
For more information about the Task Force and the programme please visit www.malnutritiontaskforce.org
[i] Online survey of health and care professionals conducted by Dods Research, sample size 1518, fieldwork conducted between 9th and18th December 2015
[iii] Elia M, Russell C. Combating Malnutrition: Recommendations for Action. Report from the advisory group on
malnutrition, led by BAPEN. 2009. http://www.bapen.org.uk/pdfs/improv_nut_care_report.pdf
[iv] Guest, J. F., Panca, M., Baeyens, J.P., de Man, F., Ljungqvist, O., Pichard, C.,Wait, S & Wilson, L. (2011) ‘Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK’, Clinical Nutrition, Volume 30, Issue 4 , Pages 422-429, August 2011
[vi] Elia M, Stratton RJ, Russell C, Green C. & Pang F. (2005) ‘The cost of disease related malnutrition in the UK and economic considerations for the use of oral nutritional supplements (ONS) in adults’. Redditch: BAPEN.
[vii] Heismayr, M., Schindler, K., Pernicka, E. Schuh, C., Schoeniger-Hekele, A., Bauer, P., Laviano, A., Lovell, A.D.,
Mouhieddine, M., Schuetz, T., Schneider, S.M., Singer, P., Pichard, C., Howard, P., Jonkers, C., Grecu. I.,
Ljungqvist, O. & The NutritionDay Audit Team. (2009) Decreased food intake is a risk factor for mortality in
hospitalised patients: The NutritionDay survey 2006’, Clinical Nutrition, 28, pp 484-491.
[viii] C A Russell and M Elia (2014) Nutrition screening surveys in hospitals in the UK, 2007-2011. BAPEN