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Dr Mike Stroud and Ailsa Brotherton, two of the authors and members of BAPEN’s Quality Group, at the launch of the Nutritional Care Commissioning Toolkit.
Issued: Thursday 20th May 2010
Implementing Better Nutritional Care Saves Money, Saves Lives[1], and Improves Patient Safety and Experience
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BAPEN, the national charity committed to combating malnutrition, calls on the Coalition Government and the new Ministerial Health Team to make Nutritional issues a priority across health and social care
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BAPEN publishes its Practical Commissioning Toolkit to help ensure Quality Standards in Nutritional Care are met for both adults and children
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BAPEN calls on Commissioners and health and care providers to implement nutritional care policies and practices to the benefit of budgets, health outcomes and patient/resident experience
“If nutritional care policies were successfully implemented across all health and care settings, we would not only see substantial savings, as agreed by NICE [2] and the SHA Chief Nurses [3], but also improved health outcomes and patient experience in hospital and care homes,” states Dr Mike Stroud, Chair of BAPEN at the launch of the charity’s nutritional care Commissioning Toolkit (Monday 24 May 2010).
“Quality and cost-effectiveness are now a requirement across all NHS health and care services reinforced by new national standards set by the Care Quality Commission. Nutritional care meets all the criteria by delivering against safety, effectiveness, equality of access and patient and resident experience.
“And even if just 1% of the £13 billion estimated annual public expenditure associated with malnutrition [4] was saved through improved nutritional care – by reducing for example infection and complication rates, lengths of hospital stay and number of GP visits - that extra £130 million a year will be a welcome contribution to the drive for cost savings.”
BAPEN is aware that delivering high quality nutritional care is no easy task and that it requires focused policies, multidisciplinary teams, clinical leadership, educational initiatives and new management approaches. BAPEN has published today (24 May 2010), the BAPEN Toolkit for Commissioners and Providers in England: Malnutrition Matters: Meeting Quality Standards in Nutritional Care to help Commissioners, health trusts and care providers implement best nutritional care.
The Executive Summary of the Toolkit is freely available to download here. The BAPEN practical Toolkit contains guidance on defining outcomes to achieve value for money, a summary of national standards and recommendations, and seven tools to help assess local need, current provision, define pathways, education and training provision and develop service specifications, operational frameworks, quality indicators, monitoring and review processes.
In addition to the Commissioning Nutritional Care Toolkit, BAPEN has developed the ‘MUST’ (Malnutrition Universal Screening Tool) for use across all settings, e-learning modules for training in the use of ‘MUST’, and has published extensive data on the prevalence of malnutrition on admission to hospital and care (Nutrition Screening Week reports) and released many policy, patient and specialist reports. BAPEN also provides a national and regional network of meetings and contact points.
BAPEN’s four key steps to implementing nutritional care are:
1.Identify malnutrition through screening (use of ‘MUST’) and assessment
2.Implement appropriate care pathways for all identified or at risk of malnutrition
3.Train all frontline staff in the importance of nutritional care
4.Ensure management structures are in place to support best nutritional practice
The content and implementation of the Toolkit will be presented and discussed at the BAPEN 2010 ‘Malnutrition Matters’ Conference (2-3 November 2010 Harrogate).
Dr Mike Stroud concludes: “Malnutrition does matter and no NHS or social care organisation can claim it is delivering safe, effective, quality care without appropriate nutritional care policies in place. We ask the new Coalition Government and Ministerial health team to back our call to make the implementation of nutritional care an urgent national priority. Organisations that deliver good nutritional care will see improvements in clinical outcomes and patient and resident experience whilst simultaneously achieving significant reductions in costs – to the benefit of all.”
Footnotes:
[1] Stratton RJ, Green C and Elia Disease-related malnutrition: and evidence based approach to treatment, Oxford CABI 2003
[2] NICE: Nutrition Support in Adults: oral nutrition support, enteral tube feeding and parenteral nutrition CG32, London 2006
[3] NHS Institute for Innovation and Improvement: High Impact Actions for Nursing and Midwifery, 2009
[4] Elia M, Russell CA (eds.) Combating malnutrition: Recommendations for Action. A Report from the Advisory Group on Malnutrition, led by BAPEN. Redditch, BAPEN 2009
BAPEN’s Malnutrition Matters Commissioning Toolkit is endorsed and supported by BAPEN Council and the charity’s core groups (PENG, NNNG, BPNG, BAPEN Medical, Nutrition Society and PINNT the patient organisation) and the following organisations – RCP, Age UK, RCN, BDA, NPSA, BSPGHAN, NHS County Durham & Darlington, and the Patient Safety Federation.
Royal College of Physicians (RCP)
Malnourishment in patients is often a significant cause of infection and avoidable death. Better nutritional support in hospitals and care homes would allow us to improve health outcomes and generate considerable savings for the NHS. The RCP is therefore delighted to support the publication of this Commissioning Toolkit. We hope that the document by virtue of its rigour, comprehensive scope and multidisciplinary ethos is able to play a major role in fostering raised awareness levels and improved organisation of nutrition services throughout the NHS.
Professor Ian Gilmore, President
Age UK
Malnutrition is a real and pressing issue for many older people. Whether in hospital, a care home, or their own home, millions of older people do not get the support to eat or maintain an appropriate level of nutrition.
To tackle this urgent problem, providing high quality nutritional care must be a key priority for all health and care services. The BAPEN toolkit provides organisation with vital support and guidance to achieve this through commissioning targeted services and carrying out high quality care based on best practice.
We look forward to seeing the progress that is made in combating malnutrition across all health and care services, which will both improve many older people's health and reduce the need to rely on acute services.
Michelle Mitchell, Charity Director
British Dietetic Association (BDA)
“The BDA is delighted to endorse and be part of the development of this important and useful document produced by the Quality Group of BAPEN. Dietitians encounter the problem of undernutrition every day and recognise that on many occasions the suffering caused could have been avoided. Tackling this needs the entire care providing workforce to be mobilised, and those planning and commissioning care are in a position to take a strategic view on how this could be achieved.
This document provides much needed expert guidance for commissioners from well referenced and reputable sources. The diversity of endorsements from patient groups, professional bodies and Government agencies is indicative of the fact that there is a broad consensus about this issue and it is not ‘single issue politics’.
The BDA sincerely hope that this document will be widely used and will help us to prioritise nutritional care and deliver what must be our mantra in these financially difficult times - improvements in patient experience and clinical outcomes for a reduced cost.”
Helen Davidson, Chairman
National Patient Safety Agency (NPSA)
"Good nutrition is essential to high quality care. The National Patient Safety Agency believe that the BAPEN Nutritional Care Commissioning Toolkit will provide commissioners with the resources to ensure that the complexity of nutritional services are delivered to patients and service users with improvements in both quality and safety. We are therefore delighted to endorse the toolkit."
Dr Suzette Woodward, Director of Patient Safety
Caroline Lecko, Patient Safety Lead (Nutrition and Pressure Ulcers)
NHS County Durham and Darlington
“NHS County Durham and Darlington have recognised and supported innovative approaches to improve the nutritional care of our local population and in particular those people who are at risk of malnutrition. Working together with our community provider services we have commissioned ‘Focus on Undernutrition’ which we feel fulfills the recommendations of the BAPEN toolkit and ensure safe, effective and quality nutritional care is provided across a range of settings.”
Jackie Kay, Associate Clinical Director
Notes to Editors:
1.BAPEN, the British Association for Parenteral and Enteral Nutrition, is the multi-professional association and registered charity, committed to addressing malnutrition & to improving nutritional care and treatment in hospital, care & community. BAPEN is Registered Charity No. 1023927 www.bapen.org.uk
2.The BAPEN Commissioning Toolkit is free to download from the BAPEN website (from 24 May) until the end of 2010 (www.bapen.org.uk) Printed copies are available to order from the BAPEN website.
3.BAPEN’s 2010 Malnutrition Matters Conference is being held 2-3 November in Harrogate. Abstract submission deadline 2 July 2010. Early Bird delegate rates close 30 July 2010.
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