President's Message
Dr Trevor Smith, BAPEN President
I am pleased to be writing to you under better circumstances than I did at the start of this year. I would like to both applaud and thank all of you for your work in health and social care through a very difficult winter period, which I think we are all glad to see the back of. I am pleased to update you on BAPEN’s recent activity, despite the ongoing pressures of the pandemic.
The Lancet letter
In March, a letter written by me and four colleagues was published in The Lancet. In the letter, we set out our concerns about malnutrition risk in hospitalised COVID-19 patients who are receiving continuous positive airway pressure (CPAP). I felt that this letter was very important, and I hope it contributes to a better understanding of the nutritional risk COVID patients are particularly vulnerable to. We referenced very worrying reports of patients with COVID who were treated with CPAP and who developed starvation ketosis. These reports and our other experiences have proved just how vulnerable COVID-19 patients are to malnutrition, something I am sure many of you will also have anecdotal experience of. I am sure you will agree that it is vital for healthcare professionals with expertise in nutrition to be involved in the care of these vulnerable patients. Please do have a read of the letter here.
All-Party Parliamentary Group
March was a busy month for BAPEN as I was also invited to present on behalf of BAPEN at an All-Party Parliamentary Group (APPG) for Ageing and Older People on malnutrition. I spoke of the need for a greater and more widespread understanding of malnutrition and its prevalence in the UK. This kind of event, where we have the opportunity to communicate directly to parliamentarians, is important, arguably more so than ever right now considering the impact COVID has had on our health system across acute and community settings. The session was well attended, and it was fantastic to speak to such an engaged audience. APPGs are a great platform to raise awareness of issues and to reach people and stakeholders we may not otherwise be able to. I followed Dianne Jeffrey to the podium. Dianne is Chair of the Malnutrition Task Force, and one of our new Trustees (do have a read of the article in this month’s issue about our new additions to our Board of Trustees). Of course, BAPEN works very well in partnership with the MTF for UK Malnutrition Awareness Week, and our area of interest in disease-related malnutrition is complementary to their work. Together, I feel we make a compelling case, which we will continue to share in a parliamentary setting when we have the opportunity.
Aerosol Generating Procedures Alliance
In my previous column, I provided you with an update on the work of the Aerosol Generating Procedures Alliance, chaired by Dr Barry Jones of our Independent Advisory Committee. Since my last update, the Alliance has continued in its efforts to campaign for enhanced PPE protection, including FFP3 masks, for all frontline workers in hospital and care settings. BAPEN, as a member of the AGP Alliance, supported the Royal College of Nursing’s independent review published in March. The review examined the various guidelines for the prevention and control of COVID-19 in health care settings in the UK. The RCN identified the issues surrounding PPE as a ‘major source of anxiety’ – certainly, an anxiety that BAPEN shares. The report advocates that the evidence relating to airborne transmission, the ventilation of health care premises and the implications for the use of face-protection need to be re-considered.
The findings of the independent review were reported on by the BBC and the ensuing news coverage provoked a commercial company, CMT Healthcare, to commit to providing FFP3 masks free of charge to any nurse, doctor or frontline member of staff on request. This is an admirable move, but it should not come to this. The government needs to take stock of new evidence and urgently update its guidance accordingly so that those who have worked so hard for the care of their patients can be safe in their place of work.
New guidance from the Royal College of Physicians
I would like to draw your attention to updated guidance which the Royal College of Physicians has recently published on how to support people who have eating and drinking difficulties. Several BAPEN Council members made significant contributions to the content of the report, and BAPEN has endorsed the guidance. The report is a guide to practical care and clinical assistance, with a particular focus on the complexities that can arise around nutrition and hydration towards the end of life. As the report acknowledges, the ability to eat and drink hinges on a complex and coordinated system, resulting in significant potential for things to go wrong. I urge you to have a read of the guidance and share it with colleagues as well so that we can enhance clinical knowledge and practice amongst all those who are responsible for delivering care to patients. The guidance is available to read here.
BAPEN 2021 Conference abstract submissions
I am very much looking forward to conference this year, and I am delighted that abstract submissions are now open! Our Annual Conference (in whatever format it takes) is a real highlight in the calendar, and provides a great forum for us to learn from one another and really benefit from the nature of our multi-disciplinary organisation. There is an opportunity to present results in a variety of categories to reflect the diversity of BAPEN membership. The deadline for entry is Friday 25th June. For more information please see, the Conference section of this issue of In Touch, or our website here.
In Touch survey
On a final note, please fill out our survey about how you use In Touch! We would really value your feedback. It only takes a few minutes, and you can fill it out here.
Once again, I am grateful and proud of all your hard work over what has now been over a year of the pandemic crisis. Do keep well.
Trevor
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