On Friday 6th January 2012 the Prime Minister stated that regular nursing rounds need to return to hospitals to improve levels of patient care and ensure that vulnerable patients are properly fed and hydrated. The comment was made by the Prime Minister during a visit to the Salford Royal NHS Foundation Hospital Trust which has done a piece of work on implementing the ‘MUST’ tool in a highly reliable way using quality improvement approaches. David Cameron praised the hospital for its ‘absolutely excellent record’ in nursing care. He said "They have very high standards of care and brilliant systems in place to make sure their standards don’t slip. I think it’s a model for other hospitals to follow."

Salford Royal Consultant Dietitian Kirstine Farrer said: “All patients are screened using the ‘MUST’ tool on admission – 90% of these within six hours of admission, which allows the implementation of a nurse care pathway and timely referrals on to the dietetic team. By having a multi-professional approach to nutritional care within the Trust we have been able to put in place a quality improvement project based on the Model for Improvement and take action to improve practice as required. Ward teams receive monthly feedback on their results to create ownership, maintain enthusiasm and generate momentum for improvement. It was identified that strong ward leadership was a key factor in success.”

If nutritional screening using a validated screening tool such as ‘MUST’ was implemented nationwide and appropriate action taken levels of nutritional care in hospitals would be hugely improved. Around 1 in 3 adults admitted to hospitals in the UK are already at risk of malnutrition and need to be identified early so nutritional care can be provided. BAPEN's 'MUST' tool includes a focus on nutritional care planning and the management of malnutrition in addition to screening so the prevalence of patients at risk of malnutrition in our hospitals and the related cost burden of over £6 billion per annum* could be greatly reduced.

‘MUST’ (the Malnutrition Universal Screening Tool) has been designed to help healthcare professionals identify adults who are at risk of malnutrition and ensure appropriate care planning.

* £6b is the proportion of the >£13b total UK expenditure on disease-related malnutrition that relates to hospital costs.

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