A “ground breaking” government plan to reduce malnutrition among NHS patients has had little impact on care, an HSJ survey has revealed.
Out of more than 400 managers and health workers responding to the survey, nearly a quarter said the Department of Health’s nutrition action plan, launched in October 2007, had improved care “not much” or “not at all”.
The survey showed 17 per cent felt it had improved care “a lot”, 30 per cent said “a little”, while 29 per cent did not know.
When asked for their opinions on levels of nutritional care and management in the NHS, replies included “abominable” and “potentially lethal”.
One respondent said nutrition was “taking a back seat” compared with other priorities.
However, another said the action plan “has allowed us to structure our actions and given us an audit trail by which to measure improvement”.
A key recommendation in the national nutrition plan, which the DH hailed as “ground breaking”, was for trusts to screen inpatients for malnutrition on admission to hospital, in addition to outpatients attending their first appointment.
But only 38 per cent of NHS trusts are doing this, according to the survey.
Age Concern and Help the Aged head of public affairs Patrick South said the findings showed there were “huge inconsistencies” in the extent to which malnutrition was being tackled in hospitals. He said: “NHS trusts and the new Care Quality Commission must ensure that nutritional care is prioritised.”
The plan called for hospitals to set up nutrition screening groups or support teams, which 58 per cent of respondents said was the case at their trust. Only 37 per cent said nutritional care was championed at board level.
Fewer than one in five managers at primary care trusts or local authorities said their organisation acted swiftly where commissioned services were providing poor nutritional care.
And 22 per cent said the PCT or local authority they worked for monitored the performance of local providers using data from regulators and patients.
The majority of respondents were managers, board directors and chief executives, with 11 per cent nurses, 9 per cent consultant doctors, 5 per cent healthcare assistants, 5 per cent GPs, and 33 per cent “other”.
A DH spokesman said the nutritional action plan delivery board will “shortly” submit to ministers a final report assessing the success of the plan.
‘Taken over by flu’: Luton and Dunstable Hospital
Luton and Dunstable Hospital foundation trust is carrying out an audit in an attempt to “reinvigorate” nutritional care.
Specialist nutrition nurse Jacqui Arnold-Jellis said she hoped it would help explain why patients were not always being weighed properly on admission or assessed for their potential to become malnourished in hospital, despite this being trust policy.
She said: “I’m hoping that, through the audit, we’ll reinvigorate that interest in nutrition that has sometimes been taken over by things such as MRSA and flu.
“It’s about getting the right equipment and staff having the correct knowledge.”
The trust has a steering committee that reports to the board and consists of managers, matrons, nursing directors, pharmacists and consultants. It also meets with third sector organisations, training volunteers to feed patients at meal times.
However, Ms Arnold-Jellis was wary of using budgets or targets to improve care.
Commissioning for quality and innovation payments make a proportion of providers’ income dependent on meeting certain requirements, which could include reducing malnutrition.
She said: “I think that people will sit up and listen if there’s a penalty, but I don’t want it to be done that way as nutrition is part of nursing care.”