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BAPEN’s approach to fighting malnutrition in the UK has been wide ranging and comprehensive. BAPEN has recognised the need to engage with ALL stakeholders, including the public, patients, health and social care professionals, charities, Industry, government and regulators to maximise awareness of the problem and to embed good nutritional care in all settings.

The success of this approach is evident in many areas. The following are just a few of the more notable examples:

Paul Burstow, Minister of State for Care Services, welcomes BAPEN’s ‘Malnutrition Matters’ Nutritional Care Commissioning Toolkit:
"I welcome the leadership shown by BAPEN and many other respected organisations that collaborated in developing this resource and I hope that care providers and commissioners will use it locally to make sure older people receive the nutritional care they are entitled to."

Paul Burstow, Minister of State for Care Services, welcomes BAPEN’s ‘Malnutrition Matters’ Nutritional Care Commissioning Toolkit:
"I welcome the leadership shown by BAPEN and many other respected organisations that collaborated in developing this resource and I hope that care providers and commissioners will use it locally to make sure older people receive the nutritional care they are entitled to."

 

BAPEN has achieved this by addressing the problem on many fronts. Some of these are explained in more detail below.

Data collection and analysis

The British Artificial Nutrition Survey (BANS) has been collecting data on patients on artificial nutrition in hospital and in the community since 1996.  These data are then analysed and reported, both by region and nationally. A report is published annually to ensure the findings are widely disseminated.

Click here to read more

BAPEN’S Nutrition Screening Weeks were established in 2007 to establish the prevalence of malnutrition in adults on admission to care across the UK. Four screening weeks have now taken place across all four seasons and detailed reports have been written on each. The results are based on a total of 31634 patients who were screened on admission to hospital, 3604 who were admitted to care homes and 1206 admitted to mental health institutions. The final amalgamated Hospital Reports were published in 2014 and the amalgamated Care Home Report was published in 2015.

BAPEN’s Health Economic Report in 2005 was a wake-up call for all involved in nutritional care – the estimated cost of malnutrition of £7.3 billion being far greater than the costs associated with obesity Click here to read more

BAPEN’s “Combating Malnutrition” report, published in 2008, estimated that public expenditure on disease-related malnutrition in the UK in 2007 was more than £13 billion a year Click here to read more

In November 2015, a new report published by the National Institute for Health Research Southampton Biomedical Research Centre (NIHR Southampton BRC) and the British Association for Parenteral and Enteral Nutrition (BAPEN), estimated that the cost of malnutrition in both adults and children in England in 2011-12 was £19.6 billion and is only set to increase with an aging population and the rising cost of health and social care. This new figure represents almost a 50% increase in estimated costs compared with the £13 billion stated in the 2007 report. Click here to read more

Development of tools

'MUST' Toolkit

BAPEN launched the ‘Malnutrition Universal Screening Tool’ (‘MUST’) in 2003 to help identify adults who are underweight and at risk of malnutrition, as well as those who are obese. The tool underwent rigorous evaluation in hospital and community settings and was found to be easy to perform and reliable. ‘MUST’ has been widely adopted and is now the most widely used nutritional screening tool in the UK. It is also commonly used in other countries worldwide.

iPhone App‘MUST’ continues to be developed to meet the needs of patients and health professionals – there is now a ‘MUST’ calculator available on the website and a ‘MUST’ app for the iPhone.

E-learning modules have been developed to support the use of ‘MUST in both the community and in hospitals. Click here to read more


Publications

BAPEN has produced many reports, setting standards and advising on best practice, on all aspects relating to the identification and management of patients who are either malnourished or at risk of malnutrition. Topics covered include:

  • The detection and management of malnutrition
  • Hospital food as treatment
  • Enteral tube feeding
  • Parenteral feeding (directly into the bloodstream) in adults and children
  • The ethics of nutrition support
  • The health economics of malnutrition, its consequences and its treatment
  • The organisation of nutritional support in hospitals
  • Improving nutritional care from the patients’ and carers’ perspective
  • Policy and action recommendations

Click here to read more

National Conferences

  • BAPEN holds an annual conference that covers all aspects of nutritional care. This allows networking and the dissemination of best practice in nutritional care and encourages participation in education and research.
  • DDF 2015 was the second combined conference of five societies and associations in the field of digestive disorders that replaced their annual conferences in that year:
    • The Association of Coloproctology of Great Britain and Ireland (ACPGBI)
    • Association of Upper Gastrointestinal Surgeons (AUGIS)
    • British Association for Parenteral and Enteral Nutrition (BAPEN)
    • British Association for the Study of the Liver (BASL)
    • British Society of Gastroenterology (BSG)
  • BAPEN members are often invited to speak at meetings of other professional societies at home and abroad
  • BAPEN members are also invited to speak at conferences on the delivery of all aspects of care
  • Teaching days are also held at the annual conference, bringing together all professions with an interest in nutrition and updating them with the latest thinking on topics of interest in nutritional care
  • Each of BAPEN’s Core groups also hold their own annual conference, maximising the opportunity for education and networking

Click here to read more

Regional meetings

  • Most regions also hold an annual meeting or teaching day, to enable access to those who can’t get to the annual conference and allow networking locally

Briefings

BAPEN issues regular press releases and briefings on topics that are relevant to nutritional care – either relating to BAPEN activities, or responding to events

BAPEN actively seeks to engage with MPs and ministers – responding eagerly to the call from Downing Street in 2000 and more recently working towards setting up an All-party Parliamentary Group in Nutrition – shortly to become the Nutrition and Hydration action Alliance and calling for Andrew Lansley to work collaboratively to eliminate avoidable malnutrition through the development of a malnutrition strategy and the appointment of a national clinical director to lead this work.

Partnership working

BAPEN works with all professional groups that have an interest in nutritional care and BAPEN members will often represent BAPEN on the working parties of other professional societies or organisations (for example the Royal College of Physicians, the British Society of Gastroenterology, NICE and recently in the production of the consensus guidelines on peri-operative fluid management (GIFTASUP) , the Association for Clinical Biochemistry, the Association of Surgeons of Great Britain and Ireland, the Society of Academic and Research Surgery, the Renal Association and the Intensive Care Society).

  • BAPEN works with numerous governmental and non-governmental organisations to produce reports. For example the report on “Screening for malnutrition in sheltered housing” was produce in association with Accent Group, City of Westminster Housing and Care, Essential Role of Sheltered Housing (ERoSH), Harrogate Neighbours, National Association of Care Catering (NACC), Nutricia UK and Richmond Housing Partnership. The “Nutrition Action Plan” included partners such as age Concern, British Medical Association, Caroline Walker Trust, Commission for Social Care Inspection, Council of Europe Alliance, English Community Care association (ECCA) and many others.
  • BAPEN responds actively to any consultation documents relating to nutritional care – for example that on the Department of Health outcomes framework recently
  • BAPEN actively promotes the involvement of its members in working parties – for example Professor Marino Elia is chairing the development of a NICE quality standard on nutritional care and Professor Mike Stroud chaired the guideline development group for the NICE guideline “Nutrition Support in Adults” and is now chairing the NICE guideline development group for IV Fluids

Education initiatives

e-learning keyboard
  • BAPEN continues to develop a wide range of educational initiatives, e-learning, tools and resources. All of these can be found in the Information and Resources section of this website.

Networking

One of the key benefits for BAPEN members is the opportunity to network with colleagues who are also working in the field of nutritional support. Networking opportunities lead to many benefits including opportunities to get involved in the work of BAPEN committees, development of new resources, planning the conference and regional events, collaborative research and perhaps most importantly sharing of best practice. If you are not already a BAPEN member, click here for more information.

Malnutrition has attracted increasing attention over the last few years. This is evident from the information in this section about what others have been doing to try and tackle the problem. The difficulty is translating standards and guidance into sustainable action on the ground and there remains much to be done. BAPEN will continue to work with all possible partners to address the problem. The BAPEN aim as stated at our annual conference in 2011 is to be part of “the generation that eliminates unnecessary malnutrition”.

The information on these pages is not comprehensive as there have been so many initiatives across the four nations. Please let us know if there is something we have missed and you feel should be included by sending an e-mail to This email address is being protected from spambots. You need JavaScript enabled to view it..

British Dietetic Association (BDA)

2006

Food Counts! (a BDA specialist group) launched the BDA Consensus statement “A Dietetic Interface with Food Service” and then developed the toolkit “Delivering Nutritional Care through Food and Beverage Service”

Click here to read more

2011

The BDA launched its “Mind the hunger gap” campaign in November 2011. This is an on-line campaign, with support for dietitians to raise the issue of approximately 1 million older people in the community eating less than one square meal a day. The BDA will also campaign at a national level to raise the issue.

The website also includes resources for the public, including a public toolkit, a food fact sheet “Malnutrition – Overcoming the Problem” and a leaflet for adults who have a poor appetite or who have lost weight “Eating Better, Feeling Better”.

Click here to read more

2012

The BDA Food Counts group has worked with hospital caterers and other stakeholders to produce the “Nutrition and Hydration Digest: Improving Outcomes through Food and Beverage services.”  This is a credible evidence based document that supports dietitians and caterers. A source of standards, guidance and good practice it also contains tools and checklists for measuring against these recognised standards. These standards need to be met and budgets should be set to enable the catering service in hospitals to do so. All dietitians will welcome this when it is published in the near future and this will help to ensure patients receive food of the nutritional quality needed for recovery.

Click here to read more

British Geriatrics Society (BGS)

BGS Good / Best Practice Guides:

2009

“Nutritional Advice in Common Clinical Situations”

2011

“Healthy Eating for Older People”

Click here to read more

British Society of Gastroenterology (BSG)

BSG Clinical guidelines:

2003

“Guidelines for enteral feeding in adult hospital patients”

2010

“The provision of a percutaneously placed enteral feeding service”

Click here to read more

The British Society of Paediatric Gastroenterology Hepatology and Nutrition (BSPGHAN)

2003

BSPGHAN produced "A Guide for Purchasers of Paediatric Gastroenterology, Hepatology and Nutrition Services" which includes guidance on nutrition.

Click here to read more

COPD Education

2011

The Respiratory Healthcare Professionals Nutritional COPD Guideline was launched at the British Thoracic Society meeting in 2011. It was designed to raise the awareness of nutrition with respiratory health professionals and their COPD patients. The Guideline provides a simple tool to aid first line nutritional management of this patient group and improve the nutritional status of COPD patients. It includes concise advice for healthcare professionals and patient information leaflets on “Eating Well for Your Lungs”, “Improving Your Nutrition” and “Nutrition Support in COPD”.

Click here to read more

Food and Nutrition Group at Help the Hospices

The Group aims to raise standards and awareness of the role of food and nutrition in palliative care.

Its members are drawn from a large number of professions working in palliative care, including doctors, nurses, dietitians, speech and language therapists, academics, physiotherapists, chefs, social workers and service users.

You can find more information about us and our activities through the following link.

http://www.helpthehospices.org.uk/our-services/running-your-hospice/food-and-nutrition/

The Group have joined with the Help the Hospices National Audit Tools Group and have produced a National Nutrition and Hydration Audit Tool for all hospices to use.

The Group also just sent out a survey to all hospices to find out their practices in relation to nutrition screening and assessment.

2009

The Group have recently produced a Consensus statement. The Consensus has been endorsed by the British Dietetic Association, the Royal College of Nursing, the Royal College of Physicians, the National Association of Care Catering, the National Council for Palliative Care and the European Association of Palliative Care

http://www.helpthehospices.org.uk/our-services/running-your-hospice/food-and-nutrition/consensus-statement

Hospital Caterers Association (HCA)

The HCA aims to promote standards of hospital and healthcare catering through education and training and to foster strong links with governments and other influential bodies to increase respect for and understanding of the role of hospital catering and the challenges it faces.

Better Hospital Food
You can access all the information about the Better Hospital Food programme through its website, including all the resources produced to support the programme (for example, the National Dish Selector, the NHS menu, the Nutritional Spreadsheet and a patient catering satisfaction questionnaire).

HCA also provide their own publications, including the good practice guide “Healthcare Food and Beverage service Standards. A guide to ward level services”.

HCA has recently published a toolkit “100 metres of success” showcasing examples of good practice.

Click here to read more

Intercollegiate Group on Nutrition (ICGN)

1997

The Academy of Medical Royal Colleges set up the ICGN in recognition of the importance of nutrition in medical practice for patient care and public health. It has established the Intercollegiate Course on Human Nutrition and has ensured that nutrition is specifically included in the curriculum for undergraduates and foundation year doctors, thus promoting nutrition education at both undergraduate and postgraduate levels.

Click here to read more

International Longevity Centre

2006

ILC was one of the contributors to “Malnutrition among Older People in the Community”. This report contains recommendations for tackling the problem of malnutrition in the community, particularly in older people.

Click here to read more

2010

ILC published the report “Personalisation, Nutrition and the Role of Community Meals.”  This report addresses the issues around meeting the nutritional needs to older people in the community and is the outcome of a roundtable discussion chaired by Baroness Greengross.

Click here to read more

National Association of Care Catering (NACC)

NACC has members from all areas of the care catering industry, including those producing and delivering food to day centres and people's homes.

Its recent “No One Should Go Hungry” campaign highlighted the problem of malnutrition in older people and called for a nutrition standard for older people. It produces a number of resources available on its website including “Spotting the signs of Malnutrition and Dehydration”, information on preventing dehydration in older people and it has produced a guide “Menu Planning and Special Diets in Care Homes”  to assist care home staff in meeting the nutritional needs of adults under their care (available from the NACC shop).

NACC is also running a Dehydration in Older People Awareness Week from 11th to 17th June 2012 and runs an annual National Community Meals Week.

NACC runs an annual training and development forum.

Click here to read more

National Confidential Enquiry into Patient Outcome and Death (NCEPOD)

2004

NCEPOD report "Scoping our practice" on therapeutic endoscopic procedures includes recommendations for Percutaneous Endoscopic Gastrostomy (PEG) insertion.

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NCEPOD report “A Mixed Bag. An enquiry into the care of hospital patients receiving parenteral nutrition.” This report demonstrated good practice in Parenteral Nutrition Care in only 19% of the cases studies. Problems identified included:

  • Inadequate consideration of enteral nutrition
  • PN not appropriate
  • Delays in recognising the need for and in starting PN
  • Poor assessment and monitoring of patients
  • Poor documentation of nutritional care

Click here to read more

Nutrition Day Wordwide

2006 to date

Nutrition Day started as a European project to audit the prevalence of malnutrition in hospitals and nursing homes and look at the effect of malnutrition on outcome. It has been running annually since 2006 and has expanded to include many countries worldwide.  Nutrition Day in 2006 provided data on 16455 patients in 25 countries and demonstrated that the length of stay increased by 6 days in patients who were malnourished and that a reduced appetite was associated with increased mortality. Units are provided with their own data for benchmarking, and the overall data has been used to investigate how the nutritional risk of patients is determined and whether such assessment influences daily nutritional care (Schindler K, Pernicka E, Laviano A, et al., How nutritional risk is assessed and managed in European hospitals: A survey of 21,007 patients findings from the 2007-2008 cross-sectional nutritionDay survey. Clin. Nutr. 2010; 29(5):552-559).

Royal College of Nursing (RCN)

2007

The RCN launched its ”Nutrition Now” campaign in 2007 following an extensive survey of its members to explore their views on patient nutrition as a clinical issue. The website has extensive resources to support the campaign, including the RCN “Principles for Nutrition and Hydration”.

Click here to read more

Royal College of General Practitioners (RCGP)

2011 - 2014

RCGP has appointed Dr Rachel Pryke to be their Clinical Champion for “Nutrition for Health.” Her role with cover both malnutrition and obesity.

Click here to read more

Royal College of Physicians

2002

“Nutrition and patients. A doctor’s responsibility.” This report was a wake-up call to the medical profession to take nutrition seriously and called for every clinician to undertake nutritional assessment of all their patients, act to prevent problems in those at risk of either malnutrition or becoming overweight and to treat those who are malnourished or obese effectively.

Click here to read more

2010

“Oral feeding difficulties and dilemmas. A guide to practical care, particularly towards the end of life.” This report is an excellent resource for those involved in taking the difficult decisions that are often required in relation to feeding at the end of life and ensures that professionals have the relevant knowledge to upderpin those decisions.

Click here to read more

2010

“MARSIPAN: management of really sick patients with anorexia nervosa.” This report was written to address the concerns about the number of deaths of young people with severe anorexia nervosa on general medical wards and provides practical advice on the management of these patients.

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The European Nutrition for Health Alliance (ENHA)

ENHA brings together public health, health and social care professionals to promote better nutrition and to tackle malnutrition in Europe. It joined with the Czech Presidency of the EU, EU health ministries and others to produce the Prague declaration in 2007, calling for an end to malnutrition. The campaign “Air, Water, Nutrition: It’s A Basic Need” aims to raise awareness of malnutrition, promote nutritional screening and education and promote policies within the EU to ensure good nutritional health.

Click here to read more

The European Society for Clinical Nutrition and Metabolism (ESPEN)

“Fight Against Malnutrition” campaign.  This campaign aims to share information about effective initiatives in tackling malnutrition in order to achieve a significant reduction in the high prevalence of malnutrition in Europe and around the world. The website includes a video on malnutrition, a forum and information on the Danish, Dutch and Spanish campaigns to combat malnutrition.

http://www.espen.org/

University of Newcastle. Institute for Ageing and Health.

1997

“Eating Matters. A Resource for Improving Dietary Care in Hospitals” Senga Bond, Professor of Nursing Research. This was put together in response to requests from nurses for help in improving standards of dietary care on the wards. Although focussed on ward staff, it was also sent to the Nursing Director in every Trust to ensure that nutrition was high on the Trust Executives agenda. The aim was to inform and educate and provide practical examples of how to improve nutritional care.

2008 - 2011

MAPP-MAL. Multidisciplinary approach to develop a prototype for the prevention of malnutrition in older people: products, people, places and procedures. This project is exploring new ways of producing and delivering food to older patients using a ‘joined-up approach’. The project has culminated in the production of “hospital foodie” - a total food and nutrition management system which aims to raise the profile of hospital food and thereby improve nutrition.

Click here to read more

Subcategories

Category for What has BAPEN done to combat malnutrition?

Category for what have others done to combat malnutrition??

Category for Good Practice in Nutritional Care.

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