Following a Public Policy Projects hosted roundtable in Stratford-upon-Avon, Warwickshire, a new report is published today to better understand the evolving public policy environment around nutrition.  The importance of nutrition to the integrated care debate report calls for nutrition and the management of malnutrition to be recognised and implemented as an integral part of care pathways within integrated systems of care.

The report focuses on nutrition services, products and diagnostics as the NHS moves towards a much more locally integrated system of delivery. In partnership with Nutricia, the report looks at how the NHS Long Term Plan ensures that in ten years’ time there is a service fit for the future.

Despite the publication of the Long Term Plan, nutrition, and particularly the management of malnutrition, are not currently a priority for the NHS and social care providers. While there is considerable work and investment being allocated to reduce the incidence of obesity and the increase in diet-related diabetes, malnutrition (undernutrition) is not given the same focus despite its significant impact on health outcomes and its role in the management of other conditions.

The report produced following the roundtable also calls for a new clinical lead for nutrition at the Department of Health and Social Care and includes a malnutrition risk score in the NHS Health Check as standard.

Commenting on the report, former Health Secretary of State and Public Policy Projects Chair Rt Hon Stephen Dorrell said: “By integrating the management of undernutrition into patient care it can be brought to the forefront of the mind of the clinician and allow for the development of a clear patient pathway. It is my hope that the recommendations made in this report will provide NHS England and the Department of Health and Social Care with concrete steps for tackling undernutrition and malnutrition in the future.”

Recommendations:

  1. Appoint a clinical lead for nutrition at the Department of Health and Social Care and NHS England.
  2. Include a malnutrition risk score in the NHS Health Check as standard for all primary care providers.
  3. Embed the malnutrition risk score alongside frailty screening for the elderly to address the links between frailty and malnutrition.
  4. Include nutritional training in all medical school and nursing undergraduate and post graduate training programmes as recognised by the GMC.
  5. Embed support for nutrition within all Integrated Care Systems (ICS) and appoint a clinical lead to oversee the implementation of policies in this area as set out by the national lead.
  6. Ensure regulatory bodies, including CQC, include a nutritional consideration in inspections and regulation of health and social care providers, ensuring all staff adhere to NICE guidelines in relation to malnutrition.
  7. Facilitate a framework and process to enable the effective gathering, management and analysis of malnutrition data.
  8. Implement the Malnutrition Universal Screening Tool (‘MUST’) at identified key points in the patient pathway.
  9. Implement a review of processes to address instances where patients are screened for malnutrition, this is identified, and minimal or no action is taken. A process should be put in place to ensure that, in instances such as this, sufficient action is taken to implement a malnutrition care plan for the patients to mitigate the damage to their health outcomes.

The full report can be found on the Accountable Care Journal Health Library.