Hospital nutrition should be locked into the government's quality agenda for the NHS, according to a report for the Nuffield Trust launched today.

The report highlights recent research which found that 40 per cent of patients were undernourished on admission to a teaching hospital and 75 per cent lost weight during their stay.

It says improved nutrition would cut complications, reduce length of stay and potentially save money.

A recent King's Fund report suggested that better nutrition could cut hospital stays by five days for 10 per cent of patients, and save£266m across the NHS each year.

Despite such evidence, co-author of the Nuffield report Dr Alan Maryon- Davis said there was little 'underlying awareness' of the importance of nutrition among managers and doctors.

'You get a report and people hold a few meetings and then the issue vanishes again,' he said. 'Managers need to realise this is a big problem and they could save money if they could get the service properly organised.'

Managing Nutrition in Hospital says there has been 'a lack of incentive' for hospital managers to improve nutrition, linked to an 'absence of recognition of the importance of the issue' by 'policy makers at the centre'.

But it argues that the 'emergence of a much greater emphasis on quality' has opened 'a real opportunity' to gain recognition for nutrition as 'an integral component of clinical care, rather than a hotel function'.

The report calls for the National Institute for Clinical Excellence to develop national standards for hospital nutrition urgently.

It also calls for national service frameworks, particularly the one proposed for the care of elderly people, to include nutrition.

And it recommends that 'assessing the extent to which proper nutrition of at-risk patients is achieved should be a basic element of the new clinical governance framework'.

'NICE will have its work cut out,' Dr Maryon-Davis said. 'But I think it is a reasonable hope that nutrition will get a look in pretty soon.'

The report says commissioners should take more interest in the issue and include hospital nutrition in health improvement programmes and service agreements.

It says trusts should:

weigh patients on admission and discharge, and identify 'at risk' patients as they are admitted;

draw up nutritional plans for patients 'as an integral component of their clinical management' and give responsibility for delivering the plans to ward nursing staff; set agreed guidelines for caterers and ensure that contracts are monitored.

Managing Nutrition in Hospital: a policy analysis for the Nuffield Trust. The Nuffield Trust. 59 New Cavendish Street, London W1M 7RD.£10.50.