Age UK Malnutrition Taskforce update

Published: 20 February 2013

It is estimated that nearly one million older people in England are at risk of malnutrition. The Care Quality Commission State of Care report (23 Nov 2012) underlined how big the problem of malnutrition has become for older people in care homes and hospitals, with 15 per cent of the hospitals, 20 per cent of nursing homes and 11 per cent of residential care homes in the report failed to meet the dignity and nutritional needs of older people.

The Malnutrition Task Force was set up to set up to raise awareness, identify and manage malnutrition in older people and to help prevent people being caught in a spiral of decline as medical professionals often fail to spot the warning signs of malnutrition. The Task Force, chaired by Age UK Chair Dianne Jeffrey, sits under the umbrella of the Partnership for Improving Dignity in Care of Older People and aims to share its expertise to develop practical solutions across the NHS, residential care and in the community.

Tracy Paine is representing the RCN Older People’s Forum on the group and other members include local government, commissioners, professional associations, GPs, dieticians, NHS service providers and community meal providers.

Malnutrition Task Force top five messages

  1. There are three million people in the UK suffering from or at risk of malnutrition; 93 per cent are in the community and over a million are over 65. Malnutrition costs the public sector £13 billion annually.
  2. People with or at risk of malnutrition have 65 per cent more GP visits, 82 per cent more hospital stays and stay 30 per cent longer in hospital. They also take longer to recover from illness or surgery.
  3. People are going into hospital (28 per cent) and care homes (40 per cent) with malnutrition.
  4. Malnutrition is under-diagnosed and all too often accepted as a normal sign of ageing.
  5. It is unacceptable that malnutrition exists on this scale when it is preventable when caused by poverty, difficulty in shopping or cooking or difficulty in supporting oneself to eat and drink. There is a huge amount that can be done.

Malnutrition and nutritional risk are usually defined by a low bodyweight, unintended weight loss or poor recent nutritional intake. The problems affect many people but older people are more at risk due to factors including physiological changes, poor appetite, low income, practical difficulties in shopping and cooking, poorer mental and oral health, acute or chronic illness and social isolation. Social and professional perceptions that older people are typically thinner can mask the issue and mean it is less likely to be picked up.

Malnutrition is a significant health issue and the taskforce is calling for public health to monitor the prevalence of malnutrition through a national diet and nutrition survey and health survey in England. Malnutrition in older people needs to be prioritised in NHS and public health and social care with outcome measures and a malnutrition strategy to be developed.

Nurses need to ensure that malnutrition is prioritised as the fundamental element of harm-free care. For example, unintentional weight loss should be monitored. Measures will need to be put in place to demonstrate it is being achieved, such as the Commissioning for Quality and Innovation (CQUIN) payment framework, and commissioning specifications need to have the management of malnutrition within them.

There will also be a requirement for screening of individuals over the age of 75 in people’s own homes and care settings and management plans with monitoring for those at risk.

It is also important that awareness raised is raised within care homes and the community. Care and support staff should be trained to assess and signpost individuals to the right support. There is a need for investment in keeping people healthy and independent longer through preventing malnutrition, working in partnership with local Health and Wellbeing Boards. Families, friends and older people themselves need to be made more aware of the risks of malnutrition and know how to seek help.

Malnutrition is everyone’s business. However, the task force would like to see a ministerial lead responsible for championing and monitoring the work and also that awareness of the problem of malnutrition be reflected and measured in all health and social care work. The task force has identified an urgent need for greater professional awareness of this condition as a priority. For further information go to the Malnutrition Task Force website

Tracy Paine, RCN Older People’s Forum steering committee member, is the RCN’s representative on the task force.