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.

Click here to read more

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

Age Concern 2006 to date

Age Concern launched their “Hungry to be Heard” campaign in 2006, calling for action from the Department of Health, the Healthcare Commission and the NHS to end the scandal of malnutrition in hospital. They highlighted the on-going problem, despite the previous attempts to address these problems, such as the Better Hospital Food Programme and the Core Standards relating to nutrition issued by the Department of Health. The report gives some graphic examples of the problems patients had encountered in hospital and sets out seven steps to end malnutrition in hospitals. In addition to the main report, they produced a number of useful resources to help patients and staff to implement their recommendations and address the problem.

“Hungry to be Heard. The scandal of malnourished older people in hospital.”

As part of the original campaign, Age UK worked with the RCN to  produce some information leaflets:

“Spotting the signs of malnutrition”
“Helping an older patient to eat”
and a card for patients to fill in in advance: “Nutrition on admission”

Age UK

(formerly Age Concern & Help the Aged)
2010 to date

Age UK issued a further report “Still Hungry to be Heard. The scandal of people in later life becoming malnourished in hospital” in response to on-going concerns that malnutrition in hospitals continued to be a significant problem for older people. This report calls for all wards to implement the seven steps recommended in the 2006 report, for compulsory recording of screening for the risk of malnutrition on admission to hospital and for the Care Quality Commission to undertake a comprehensive review of hospital mealtimes.

Click here to read more

Age UK 2012 to date

Age UK continues to campaign for the end of malnutrition in hospitals and is currently calling for people to email Andrew Lansley, Secretary of state for Health to call on him to require hospitals to publish malnutrition data in a form the public can understand.

Age UK is one of BAPEN’s partners supporting the Malnutrition Task Force.

CARERS UK
the voice of carers
2012 to date

Carers UK in collaboration with Nutricia launched their report “Malnutrition and caring. The hidden cost for families”.

Click here to read more

This report is part of their “Care about nutrition, care with nutrition campaign”. This campaign aims to help carers with information and support on the importance and benefits of good nutritional care.

Click here to read more

The Caroline Walker Trust

The Caroline Walker Trust (CWT) - Improving public health through good food

Caroline Walker Trust logo

1998

“Eating well for older people with dementia. A good practice guide for residential and nursing homes and others involved in caring for older people with dementia. Report of an expert working group.” Voices (Voluntary Organisations involved in Caring in the Elderly Sector).

2004

“Eating well for older people”. These guidelines support the nutritional care of older people in residential and community care.

2011

“Eating well for older people and older people with dementia: Practical Guide.” Helen Crawley and Erica Hocking. This report includes a report and materials that can be used by those caring for older people to support them to eat well.

Click here to read more

Centre for Housing Support 2009 The Good Practice Guide (Issue No. 9) “Addressing Malnutrition” published with support from the Group on Nutrition in Sheltered Housing. This guide includes information on screening for malnutrition, the impact of malnutrition and working with others to address malnutrition.

Click here to read more
The Patients Association 2011 to date

The Patients Association conducted a survey on malnutrition in the community and in hospitals and published a report of the findings “Malnutrition in the community and hospital setting”. The results of the survey were presented at the BAPEN annual conference in Harrogate in November 2011. The report calls for action from the Department of Health, from GPs and Local Authorities and form the Public Health Director to ensure that there is adequate information about malnutrition available, that nutritional screening is mandatory in all care settings, that the resources are available for good nutritional care and that this care covers the whole “malnutrition journey” across different care settings.

Click here to read more

The Patients Association has also produced a leaflet “Malnutrition – how to spot the signs and what to expect from treatment” to send to all GP surgeries in the UK.

Click here to read more

Social Care Institute for Excellence (SCIE) 2009 - 2012

SCIE is a charity that improves the lives of people who use care services by sharing knowledge about what works. It has published guidance on eating and nutritional care, focussing particularly on older people. Its guidance includes:

Nutritional care and older people – an at a glance summary published in March 2009 as part of the Nutrition Action Plan

Eating and nutritional care in practice – a Dignity in Care factsheet published in June 2010, with more detailed information also available on the website

Dementia Gateway: eating well for people with dementia – a web resource published in November 2009

Nutritional care for older people – a Social Care TV video published in May 2012 and aimed at commissioners, managers, front-line care workers and carers.

Click here to read more

Sustain
The alliance for better food and farming
2004 to date Sustain launched their Pilot Hospital Food Project in January 2004. This was a 2 year project with four London Hospitals to increase the proportion of locally produced nutritious food served. This was extended in 2006 and became the Good Food on the Public Plate (GFPP) project, reflecting the fact that the project now includes all public sector organisations.

Click here to read more

Sustain is also running a “Good Food for Our Money” campaign, calling on the government to introduce legally-binding hospital food standards. They have also produced reports “A Decade of Hospital Food Failure” and  “Yet more hospital food failure” that give a good overview of the initiatives and their costs over the last decade.

Click here to read more

ENGLAND

Department of Health

1995

Nutrition Guidelines for Hospital Catering

“We cannot overemphasize the importance of providing food of the appropriate nutritional content in a form and manner that patients will enjoy. Food can help increase the effectiveness of medical treatments and aid patients’ recovery, and has to be seen as essential in creating patient comfort and well-being.”

This quote shows that the importance of nutrition in the care of patients was recognised long ago and yet we are still fighting the same battle.

Department of Health

2000

Care Homes for Older People. National Minimum Standards. Care Homes Regulations. This includes standards relating to nutritional assessment, appropriate food provision and assistance with food.

Click here to read more

Department of Health

2000

NHS Plan. A plan for investment. A plan for reform. This promised to deliver: a 24 hour catering service with a new hospital menu, a national franchise for NHS catering, housekeepers on half of all wards by 2004, dietitians to advise and check on the nutritional values of hospital food, unannounced inspections of the quality of hospital food, a minimum menu framework and standard for meals and 24 hour availability of food with a new website to provide information and resources for the NHS team (Better Hospital Food).

Click here to read more

Better Hospital Food programme aimed to:

  • produce a comprehensive range of tasty, nutritious and interesting recipes that every NHS hospital could use
  • redesign hospital printed menus to make them more accessible and easier to understand
  • introduce 24-hour catering services to ensure food is available night and day
  • ensure hot food is available in hospitals at both midday and early evening mealtimes.

The website contains a wealth of information on the delivery of hospital catering services, including the national dish selector and links to many useful resources.

The programme was disbanded in 2006, but the resources are now hosted on the Hospital Caterers Association website.

Click here to read more

National Patient Safety Agency (NPSA)

2000

Patient Environment Action Teams (PEAT) annual inspections established. PEAT is self assessed and provides a framework for inspecting standards to demonstrate how well individual healthcare organisations believe they are performing in key areas including:

  • Food
  • Cleanliness
  • Infection control
  • Patient environment

Assessments are carried out by NHS staff (nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dieticians and estates directors). Patients, patient representatives and members of the public are also part of this assessment process. NHS sites and NHS trusts are each given scores from 1 (unacceptable) to 5 (excellent) for standards of environment, food and dignity and privacy within buildings).

Click here to read more

Department of Health

2001

National Service Framework for Older People. This included the development of a single assessment process for health and social care for older people, with nutrition screening and assessment as a key part of this process.

Click here to read more

Department of Health

2005/06-2007/08

Department of Health issued "National Standards, Local Action: Health and Local Care Standards 2005/06 - 2007-08." This included nutritional care as a core standard.

Standard C15 states:

 'Where food is provided, healthcare organisations have systems in place to ensure that:

a) patients are provided with a choice and that it is prepared safely and provides a balanced diet and

b) patients' individual nutritional, personal and clinical dietary requirements are met, including any necessary help with feeding and access to food 24 hours a day'

Click here to read more

National Institute for Clinical Excellence (NICE)

2006

NICE Clinical Guideline 32 Nutrition Support in Adults. This guideline covers the care of patients with malnutrition or at risk of malnutrition in hospital and in the community. It sets out some key recommendations in relation to screening for malnutrition, the need for nutritional support and the organisational structures that needed to be in place to support this.

Click here to read more

2011

NICE identifies nutrition as one of the most cost effective investments. The conservative estimate of a saving of £28,472 per £100,000 is based on the implementation of the recommendation in Clinical Guideline CG32 "Nutrition Support in adults". Costs arising from this guideline included improving systematic screening, assessment and treatment of malnourished patients. If this was fully implemented and resulted in better nourished patients then this would lead to reduced complications such as secondary chest infections, pressure ulcers, wound abscesses and cardiac failure. Conservative estimates of reduced admissions and reduced length of stay for admitted patients, reduced demand for GP and outpatient appointments indicate significant savings are possible.

Click here to read more

2012

NICE Quality Standard CG 138 Patient experience in adult NHS services. This quality standard include the following statement relating to nutrition and hydration: "Patients have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety."

Click here to read more

Department of Health

2007

Improving Nutritional Care: A joint Action Plan from the Department of Health and Nutrition Summit stakeholders. The Nutrition Action Plan outlines how nutritional care and hydration can be improved and suggests five key priority areas through which managers and staff working in health and social care can address this. BAPEN and NNNG were stakeholders in this important publication. The Nutrition action plan was launched in October 2007 by Ivan Lewis, MP, Under Secretary of State for Care Services, as part of the Dignity in Care campaign.

Click here to read more

National Patient Safety Agency (NPSA)

2007

Ensuring safer practice for adults with learning disabilities who have dysphagia. The report highlights best practice and provides resource materials to give practical help.

Click here to read more

2009

NPSA Nutrition Fact Sheets launched. These factsheets identify the issues that healthcare staff need to consider for each of the10 Key Characteristics of Good Nutritional Care. They provide information on what the issues are, what actions can be taken and the resources available. The factsheets draw together current guidance, evidence base and best practice examples.

Click here to read more

2011

NPSA Rapid response report "Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants"

Click here to read more

2011

NPSA Dysphagia Expert reference group launch Dysphagia Diet Food Texture Descriptors

Click here to read more

2012

NPSA rapid response report "Harm from flushing of nasogastric tubes before confirmation of placement "

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NHS Core Learning Unit

(Skills for Health)

2008 to date

The online training programme “Food, Nutrition and Hydration and Social Care” launched. This is a learning programme aimed at nurses, carers, health care assistants and volunteers in the Health and Care sector. There are also other modules covering nutrition and hydration basics, dysphagia and feeding at the end of life.

Click here to read more

Department of Health

2010

Essence of Care. Benchmarks for Food and Drink.

Essence of Care 2010. Benchmarks for food and drink. This guide details 10 benchmarks for the provision of food and drink. These comprise: 1. Promoting health, information, availability, provision, presentation, environment, screening and assessment, planning, implementation, evaluation and revision of care, assistance and monitoring.

Click here to read more

NHS Institute for Innovation and Improvement

2012

Chief Nurses make nutritional care one of their eight "High impact actions". The High Impact Actions for Nursing and Midwifery were developed following a ‘call for action’ which asked frontline staff to submit examples of high quality and cost effective care that, if adopted widely across the NHS, would make a transformational difference. The Essential Collection, including 'Keeping nourished - getting better' aims to highlight just some of the stories behind those submissions by providing details not only of what was done, but also ‘how they did it’. These examples are intended to provide illustrations of good practice which you may not already have seen. Most importantly they are examples of how real people have made a real difference. The Essential Collection is not designed to be tell you ‘how to’ make the changes; but it does signpost you to some of the many excellent resources already available that relate to the areas identified within the High Impact Actions.

Click here to read more

Care Quality Commission (CQC)

2011

CQC Registration Standards - Outcome 5 - Meeting Nutritional Needs.  The essential standards of quality and safety are central the regulation of health and social care. Each standard has an association outcome that CQC expects all people who use the services to experience as a result of the care they receive. The CQC website includes a number of resources to support providers in ensuring that they meet these outcomes. CQC also undertakes regular inspections and publishes reports of their findings. The “Dignity and Nutrition for Older People” review was a targeted inspection programme of NHS hospitals that showed that of the 100 hospitals inspected, 45 met the standards, 35 needed to improve in one or both standards and 20 did not meet one or both of the standards. In terms of nutrition, the issues raised were patients not being given the help they needed to eat and being interrupted at mealtimes and leaving their food unfinished.

Click here to read more

NPSA and Patient Safety First

2012

NPSA and Patient Safety First Nutrition and Hydration week. On 23 January 2012 the National Patient Safety Agency (NPSA) and Patient Safety First hosted a week focused on nutrition and hydration: 'A taste of patient safety'. The website has a range of useful resources, including Webex sessions with presentations that can be viewed on line.

Click here to read more

NORTHERN IRELAND

Department of Health, Social Services and Public Safety

2007

Get your 10 a day! The Nursing Care standards for Patient Food in Hospital. Department of Health, Social Services and Public Safety. Northern Ireland. This document is based on the 10 Key Characteristics of Good Nutritional Care and translates them into a framework for action.

Click here to read more

Department of Health, Social Services and Public Safety

2011-2016

Promoting Good Nutrition – a strategy for good nutritional care for adults in all care settings in Northern Ireland. This strategy aims to build on “Get Your 10 a Day!” to include all health and social care settings including peoples own homes. This will be achieved through the adoption and translation of the Council of Europe Alliance UK’s 10 Key Characteristics which form the basis of good nutritional care.

Click here to read more

SCOTLAND

The Scottish Government

2000

The Scottish Government publishes its NHS plan "Our National Health: A plan for action, a plan for change". This plan cites the importance of nutrition for the well-being of its patients and population.

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The Scottish Government

2002

The Scottish Government published its “Promoting Nutrition for Older Adult In-Patients in NHS Hospitals in Scotland” by the National Nursing, Midwifery and Health Visiting Advisory Committee. This aim of the report was to support change and promote nutrition as a key element of patient care by providing professionals with practical guidance on how to implement the nutritional standards as set down in the Nursing Homes Scotland Core Standards for Nutritional Care, but applied to all NHS Care facilities.

Click here to read more

Healthcare Improvement Scotland

2003

Food, Fluid and Nutritional Care in Hospitals Standards. These standards were developed by NHS Quality Improvement Scotland and included sections on a strategic approach to food delivery and nutritional care, assessment and screening, food delivery in practice and training and education. The standards were used to assess performance in the provision of food, fluid and nutritional care in NHS Boards throughout Scotland.

Click here to read more

The Scottish Government

2008

"Food in hospitals. National Catering and Nutrition specification for Food and Fluid Provision in Hospitals in Scotland" published by the Scottish Government. This document recognises that it is fundamental that hospitals provide appropriate food, fluid and nutritional care to manage any nutritional risk, to improve health and well-being and optimise the wider clinical management of all patients.

Click here to read more

Consumer Focus Scotland and Community Food and Health (Scotland)

2011

Meals and Messages. A focus on food services for older people living in the community in Scotland.

Click here to read more

NHS Scotland

2011

Doctors Online Training System (DOTS) launched a Nutrition Training Module compulsory for all foundation doctors in Scotland

Healthcare Improvement Scotland

2012

Improving Nutrition… Improving Care final report. This report makes it clear that nutritional care must remain a national, local and individual priority. The report also details the next steps for ensuring the integration and alignment of nutritional care across Scotland.

Click here to read more

WALES

Welsh Government

2002

The All-Wales Catering / Nutrition Group for the Welsh Assembly Government published the "Nutrition and Catering Framework" setting out how it expects Trusts to deliver nutrition to all patients.

Click here to read more

Welsh Government

2003

Welsh Government publishes “Fundamentals of care: guidance for health and social care staff: improving the quality of fundamental aspects of health and social care for adults”. This includes practice indicators for eating and drinking, to ensure good nutritional care.

Click here to read more

All Wales Medicines Strategy Group (AWMSG)

2006

All Wales Medicines Strategy Group (AWMSG) publish a report on the key clinical and organisational priorities for the provision of sip feeds (updated May 2012)

Click here to read more

Welsh Consumer Council

2008

The Welsh Consumer Council convened a round table meeting to discuss how best to address malnutrition among older people in the community and produced a discussion paper. The Malnutrition Roundtable report calls for increased recognition of the problem and a co-ordinated national strategy for tacking this issue.  It recommends adequate resources, targeted awareness campaigns, training, nutrition screening and treatment to address the needs of those who are at risk of malnutrition.

Click here to read more

Aneurin Bevan Health Board

2010

Guidelines for the treatment of under nutrition in the community including advice on oral nutritional supplement (sip feeding) prescribing. This guideline was produced to standardise the management of malnutrition in the community.

Click here to read more

Welsh Government

2011

Nutrition in community settings. A pathway and resource pack for Health and Social Care Professionals, the Third Sector, Care Home Staff, Relatives and Carers. This web based resource includes All Wales food and fluid record charts, information leaflets on recognising the risk of malnutrition and advice on improving food intake.

Click here to read more

Welsh Government

2011

All Wales Nutrition and Catering Standards for Food and Fluid Provision for Hospital
Inpatients

Click here to read more

EUROPE

Council of Europe

2003

Resolution ResAP (2003)3 on food and nutritional care in hospitals (Adopted by the Committee of Ministers on 12 November 2003 at the 860th meeting of the Ministers' Deputies)

Click here to read more

The recommendations within the resolution (of which there were more than one hundred) were summarised into the “10 Key Characteristics of good nutritional care in hospitals”

Click here to read more

European Union

2007

Prague Declaration.

On 11th June the European Nutrition for Health Alliance (ENHA) joined with the Czech Presidency of the EU, EU health ministries, the European Society for Clinical Nutrition and Metabolism (ESPEN), health care professionals and health insurance groups to call for an end to malnutrition.

“Malnutrition, including disease related malnutrition are urgent public health problems and action need to be taken to prevent malnutrition continuing to compromise quality of life, cause unnecessary morbidity and mortality and continue to undermine the effectiveness of European health care systems.”

Click here to read more

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