Skip to main content

Nutrition Checklist Project

Feedback Report

It is estimated that there are more than three million people in the UK who are malnourished or at risk of malnourishment. Around 30% of people admitted to acute hospital and a similar proportion of those admitted to care homes are malnourished or at risk of malnourishment. Being underweight or malnourished compromises the quality of life for patients, poses a significant health risk and may indicate an underlying health problem. In addition, it is known that patients and relatives attach importance to good nutrition to help aid recovery after illness or surgery as well as to contribute to the maintenance of good health.

In 2015, NHS England published a paper 'NHS England Guidance – Commissioning Excellent Nutrition and Hydration; 2015-2018'. The Patients Association published a paper in November 2015 'Managing Adult Malnutrition in the Community' which looked at policy, practice and patient views in relation to Nutrition and Malnutrition and the hospital discharge process and established a set of recommendations to help reduce the incidence of malnutrition. The Patients Association’s paper identified a gap between policy and practice and the need to raise awareness of the issues both with professionals and with patients and relatives.

Following these reports, a small project was set up to address one aspect, namely the need for tools to help the identification (or self-identification) of people who are undernourished or in need of nutritional advice and to guide them to the appropriate sources of help.

The main existing measure in use by professionals for assessing individuals for malnutrition is the Malnutrition Universal Screening Tool (‘MUST’)3This test uses a combination of Body Mass Index (BMI) scores, rapid weight loss assessment and the impact of acute disease to assess risk. Any hospital inpatient considered at all likely to be malnourished should be assessed during their stay. ‘MUST’ is also a tool that can be used in all care settings, for example by GPs, care home staff and other professionals.

For patients, there are a number of simple self-screening questions available via the NHS Choices website4 and the recently launched (December 2015) BAPEN Malnutrition Selfscreening tool. However, judging both by information from patients and the continuing prevalence of people with malnutrition, there is scope for a less ‘clinical’ checklist which can be used in many settings to help encourage conversations about weight and nutrition and lead people towards established tools and guidance.