Disease related malnutrition cannot be wholly eradicated, but it can be better managed by the NHS and social care
It is vital to recognise that for disease related malnutrition, the goal is to minimise the impact, writes the British Specialist Nutrition Association (BSNA).
Almost no week goes by without a story in the media or notice from Public Health England about the UK’s obesity crisis, and the associated health problems such as the rise in type 2 diabetes, heart disease and osteoarthritis that are reducing people’s quality of life and placing ever higher demand on NHS and social care services.
At the same time, the issue of malnutrition in the UK is receiving more attention – as numbers visiting food banks increase, schools identify more children going without proper meals and vulnerable people find themselves unable to access nutritious and sustaining food and drink.
Policy makers are rightly spending considerable time and effort to understand the issues driving these challenges and to develop effective solutions. In the case of malnutrition, it is seen as shocking that in a wealthy nation such as the UK, malnutrition not only exists but is increasing.
Malnutrition affects at least 3 million people in the UK – 1 in 3 people in care homes, 1 in 10 visiting their GP and 1 in 4 people admitted to hospital are malnourished. Nearly £20bn is spent by health and care services to treat malnutrition each year. It costs over £5,000 more to treat someone who is malnourished than a well-nourished person and it affects all parts of the country regardless of relative wealth.
It is vital to recognise that for disease related malnutrition, the goal is to minimise the impact. This includes patients who have had surgery as a result of head and neck or gastrointestinal cancer, those living with other forms of cancer, those who have had a stroke or have dementia, certain genetic conditions – the list is long.
Health and care staff need to be able to identify a person at risk of malnutrition or who is already becoming malnourished, to know what support is needed and what medical intervention may be required to manage patients. Foods for Special Medical Purposes (FSMPs) are a vital tool in managing disease related malnutrition as they are designed to meet the nutritional or dietary needs of people who are temporarily or permanently unable to get enough nutrition from normal foods.
NICE suggests that better nutritional care could provide the sixth largest cost saving to the NHS. The use of oral nutritional supplements can help reduce the rate and length of hospital stays – with better dietary advice and the provision of oral supplements reducing complications such as infections and wound breakdown by 70 per cent and mortality by 40 per cent.
While disease related malnutrition cannot be wholly eradicated it can be better managed by the NHS and social care. Better identification, recording and management of malnutrition across health and care settings is needed – with more effective commissioning of nutritional support and prescribing of nutritional supplements.
We at BSNA believe NHS England and CQC need to give nutrition and hydration services greater priority, by appointing a senior accountable officer to raise the importance of this part of care for patients. A joint strategy and campaign to tackle malnutrition needs to be developed by NHS England and Public Health England, recognising the particular issue of disease related malnutrition in all care settings. We look forward to meeting with parliamentarians to discuss the challenges faced by patients at risk of malnutrition and how the NHS Long Term Plan can shape greater support for the future.