BAPEN’s 30th Birthday
This year marks BAPEN’s 30th birthday. Our organisation has come a long way since its establishment three decades ago, and we are proud of the progress we have made – together with our core groups – to advance the nutritional care of patients and the wider community. We wanted to capture and reflect on just some of our key historical moments and achievements.
BAPEN was founded in 1992, with the very first Chairman as Professor John Lennard Jones. Since then, there have been eight Chairs and Presidents of BAPEN. In its first five years, BAPEN received recognition as a specialist body by the Royal Colleges – a huge achievement to reach so early on. Multi-disciplinary courses were launched, and we are proud that this multi-disciplinary and collaborative learning is still at the core of our values.
In 1996, British Artificial Nutrition Survey (BANS) was established, bringing together home enteral tube feeding (HETF) and home parenteral nutrition (HPN) registers. The group was established to audit and publish data on the extent and standard of nutrition support across the United Kingdom. Robust data, like that collected by BANS, is crucial for supporting local and national needs to ultimately improve patient care and this is a key reason why BANS remains one of our standing committees today. Five years later, in 2001, the first ever BANS survey was run, covering trends in prevalence and growth of artificial nutrition, age distribution of patients on HETF and HPN, and much more.
As the organisation moved into the new millennium, BAPEN’s aims to communicate in the wider healthcare arena were consolidated by the late Professor Chris Pennington. Multi-professional working was second nature to Chris, and he constantly supported the non-medical professions in their quest to have their expertise equally acknowledged in the field of clinical nutrition.
2003 was a big year for BAPEN, as our Malnutrition Universal Screening Tool (‘MUST’) was launched. ‘MUST’ is a brilliant reflection of BAPEN’s multi-disciplinary and collaborative ethos. The tool was developed by the Malnutrition Advisory Group (MAG), one of BAPEN’s standing committees, under the leadership of Prof Marinos Elia, and supported by the British Dietetic Association (BDA), the Royal College of Nursing, and the Registered Nursing Home Association. ‘MUST’ was rigorously evaluated in both hospital and community settings to ensure that it was quick, easy, and reliable to use. As the most commonly used screening tool in the UK and recommended by NICE, the success of ‘MUST’ is certainly one of our organisation’s great legacies.
In 2004, BAPEN Medical was founded by Professor Jeremy Powell-Tuck for those who have a special interest in furthering the medical and surgical component of BAPEN’s objectives. The group aims to support the education and training of doctors at all levels, encourage research and development, and foster collaborations between members’ research groups, medical specialties, and between health professionals.
Between 2007 and 2011, four consecutive Nutrition Screening Week surveys launched. These surveys sought to assess individuals admitted to hospitals, care homes, and mental health units at different times of the year. The emphasis was placed on admission in order to establish the prevalence of malnutrition as identified by screening. These four surveys involved 34,699 patients and have provided integral benchmarking data for local and UK-wide results.
In 2010, the Malnutrition Matters – Meeting Quality Standards in Nutritional Care Toolkit was published by the BAPEN Quality Group to help health and care organisations to develop and implement a variety of approaches to nutritional care. This line of work was progressed with the unveiling of BAPEN’s ‘Decision Trees’ in 2012 – a new tool to enhance the nutritional care of patients. The Decision Trees were designed by experts in their field and peer-reviewed by members of the BAPEN council to offer a pragmatic and effective tool to assist in the care of those at risk of malnutrition and its consequences.
The launch of the first ever community-based Malnutrition Self-Screening Tool to identify those living in the community at risk of malnutrition was a key achievement in 2015. Welcomed contemporaneously by Carers UK and the BDA, the tool enabled patients to identify malnutrition in themselves and then take appropriate steps to treat it for the first time with the support of online resources.
BAPEN developed its campaign work when in 2018, UK Malnutrition Awareness Week (UKMAW) was born in partnership with the Malnutrition Task Force. UKMAW has run annually since then, raising awareness of malnutrition amongst the public, healthcare professionals, politicians and policy-makers. Year-on-year the campaign has gone from strength-to-strength, now attracting support from major professional bodies such as the Royal College of Physicians, as well as chief patient advocacy groups who enable us to speak indirectly to a wider audience of at-risk patients, such as Macmillan Cancer Support, Dementia UK, and Crohn’s & Colitis UK. We have featured on broadcast television and radio, hosted a parliamentary drop-in event, coined the #MAWconversations social media hashtag, and generated hundreds of thousands of conversations in acute settings, care homes, the community, and online.
As the pandemic hit the world, BAPEN worked hard to develop resources which took into consideration the change in work pressures and practices. Our Core Groups, Standing Committees and Special Interest Groups were instrumental in the composition of these materials. Resources included practical guidance for using ‘MUST’ during the pandemic, statements on HPN and home enteral nutrition provision, NG tube placement checks, to name a few. This extensive suite of resources produced in such a high-pressure environment for healthcare professionals is definitely a proud moment for BAPEN.
This development of resources was representative of a wider – and ongoing – drive for making education more accessible and further emphasising the importance of sharing of best practice. Our special interest group BIFA launched an ongoing Top Tips series for BAPEN members, and NGSIG published a position paper, ‘Time to put patient safety first’ covering key ways in which nasogastric tube safety has been compromised across Trusts and Health Boards, leading to avoidable Never Events. Conference webinars were recorded and available to view on demand in 2020 and 2021.
In November 2020, BAPEN joined the Inequalities in Health Alliance (IHA). The IHA is a coalition of not-for-profit organisations working in health, social care and beyond who collectively campaign for a cross-government strategy to reduce health inequalities. In September 2021, the IHA, with BAPEN as a signatory, wrote to the Prime Minister outlining the need for an explicit nationwide cross-government approach to help identify the policy changes required on national issues that will be relevant for all communities.
In 2021, the BAPEN President Dr Trevor Smith presented on behalf of BAPEN at an All-Party Parliamentary Group (APPG) for Ageing and Older People on malnutrition. Dr Smith spoke of the need for a greater and more widespread understanding of malnutrition and its prevalence in the UK. This opportunity to communicate directly to parliamentarians is crucial for demonstrating just how much of an impact malnutrition, particularly in light of the pandemic, has on our health system across acute and community settings. Dianne Jeffrey also spoke at the APPG. As well as being Chair of the Malnutrition Task Force, Dianne is one of three new Trustees brought on towards the end of 2020. Phil Lyons, Roger Phillips and Dianne brought with them a wealth of experience to further improve how we operate and engage as an organisation.
Over the past 30 years, BAPEN has worked consistently to raise awareness of malnutrition within our healthcare system, and beyond. Our Core Groups have been and still are instrumental in this work. Their respective work and our collective multi-disciplinary nature facilitates our strong and rounded approach to patient care. We are proud to have been a catalyst for change, and while there remains much work to do, we welcome our members and new prospective members’ involvement in our organisation so that – together – we can continue to effect real change.
Disclaimer: Please note this article represents a snapshot summation of just some of the key points in BAPEN’s 30-year history. More information will be provided at Conference.