The British Dietetic Association (BDA) has recently published a new policy statement The Management of Malnourished Adults in All Community and All Health and Care Settings.
Who is the BDA?
The BDA is the leading organisation in nutrition and dietetics in the UK. Its expert members develop policy in a range of fields including health policy, nutrition policy and practice and dietetics. These evidence-based and referenced policy statements are available to policy makers, the public and media to provide clear statements of the BDA’s position on a range of important topics.
BDA Policy Statement on malnutrition
This policy statement has been created to highlight the growing issue of malnutrition and the integral role of dietitians in addressing the nutritional care of vulnerable populations in community health and social care settings. This is to ensure that every individual has access to good quality nutrition that meets their nutritional, clinical and personal needs.
Why is this so important?
The potential for good nutrition to improve the health of the vulnerable population is large and well documented. Malnutrition should not be, but is, a very real and current problem in the UK population with national surveys showing that prevalence of malnutrition is still unacceptably high. And it is costly. The cost associated with malnutrition in England (2011-2012) has been estimated as £19.6 billion, equating to approximately 15% of the health and social care budget – that’s huge!
The overall cost of treating a malnourished patient is two to three times more than treating a non-malnourished patient. Nutritional support for adults was ranked as the third highest cost saving intervention associated with the implementation of the UK guidelines on managing malnutrition, NICE Clinical Guideline (CG32)/Quality Standard (QS24).
There is still much to do
There have been significant advances in the status of food in community healthcare settings as nutrition is recognised as key to the health and wellbeing of patients and residents. However, there is still much to do, including early intervention by building sustainable support in the community. In care homes, the prevalence of malnutrition has been reported to be 36% and 24% in older adults and younger adults, respectively. It is therefore essential to address the whole spectrum of nutritional care through strategies that prevent, detect and treat malnutrition in community healthcare settings.
What do the BDA recommend?
Recommendations in this policy document include:
- Everyone should have access to a nutritious, high-quality diet that meets their individual nutritional requirements and for those unable to meet their nutritional requirements through food alone to have timely access to nutrition support. Systems must be in place in the community health and social care settings to identify and support those at risk of a suboptimal diet and hydration.
- Dietitians should lead the coordinated and integrated approach to addressing the nutritional care of vulnerable populations in community health and social care settings. Dietetic-led nutrition support services are well placed to develop and initiate the correct evidence-based nutritional care policies and guidelines and ensure that those at risk of malnutrition (social or disease-related) are identified and managed appropriately; including those individuals with psycho-social related malnutrition.
- All public sector catering specifications, including the NHS and care homes have a requirement to meet nutritional standards suitable for the setting and the population they are serving. This should be supported by appropriate expertise from dietitians, caterers and procurement professionals.
- Commissioners recognise the value and potential cost savings of preventing malnutrition and commission services that ensure all people identified as being at risk of malnutrition are offered nutrition support interventions that aim to meet personalised nutritional requirements. Screening and early intervention in those identified as being at risk of malnutrition have been shown to be cost-effective approaches in the prevention and treatment of malnutrition. Additionally, regular screening and monitoring, and investment in services (e.g. meals on wheels/community meal services) all allow for saving opportunities.
The United Nations Human Rights Council states that everyone has ‘the right to have regular, permanent and free access, either directly or by means of financial purchases, to quantitatively and qualitatively adequate and sufficient food corresponding to the cultural traditions of the people to which the consumer belongs, and which ensures a physical and mental, individual and collective, fulfilling and dignified life free of fear.’
Care homes and dietitians working together can go some way to achieving this.
You can find the BDA Policy Statement on their website.
