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Appetite for life.

A REPORT by the British Association of Parenteral and Enteral Nutrition and the National Institute for Health Research puts the cost of malnutrition in England at a staggering £19.6 billion a year, more than 15% of total public expenditure on health and social care (Elia 2015). However, this important study received little media coverage when published last November. It is possible that many trusts and healthcare professionals were not aware of its publication. If we are not aware, how can patients be? Malnutrition is expected to increase due to an ageing population. Almost one third of adults are malnourished on admittance to hospital, as are 35% of adults admitted to care homes. Malnutrition can have a detrimental effect on the functions of all parts of the body. It can delay recovery and prolong hospitalisation. A person who is undernourished will be more prone to chest infections, pressure ulcers and hypothermia. The National Institute for Health and Care Excellence (2012) quality standard for nutrition support in adults states that all people screened for risk of malnutrition should have their screening results and any nutrition support plans documented in writing and communicated in and between settings. In reality, does this happen? Do primary care or care home teams have a handover from hospital teams about nutritional care? Do nurses in primary and secondary care settings have the correct equipment to enable them to perform a nutrition screen? Do they have hoist scales for immobile patients? Do trust boards pay enough attention to nutritional care? To compound difficulties, many older people are becoming socially isolated and may be depressed or unable to go out to purchase food. There are also conflicting messages from healthcare professionals. For example, problems associated with obesity are well publicised, but the Patients Association (2011) highlighted a lack of awareness among patients about their risk of developing malnutrition, how it can be prevented and where they can seek advice and support. The charity also suggested that while the public associate good nutrition with eating a balanced diet, they do not make the link between good nutrition and maintaining a regular weight.