Prioritising nutritional care in the Health and Care Bill 2021

As the Health and Care Bill passed through its Second Reading stage in the House of Commons this evening, BSNA has urged MPs to recognise that valuable opportunity presented in the Bill to embed optimum nutrition into our health and care system as never before.

The emphasis on Integrated Care Systems (ICSs) enables us to join up primary and community, secondary (hospital) and local government care creating a holistic view of the health and care system but also of the care of the patient. Of particular importance is the provision for the introduction of statutory food care standards in hospitals, a recommendation from the Hospital Food Review last year.

This is a welcome step in prioritising nutrition for parents, however the Bill is also an opportunity to introduce standards for nutritional care across all care settings on a statutory basis, and to make nutritional care a Board level responsibility for each ICS.

Under nourished patients account for 1 in 10 GP consultations, are twice as likely to visit their GP and will require more prescriptions to treat their condition.[1]

Disease related under nutrition affects patients with kidney disease, diabetes, chronic lung disease, head and neck or gastrointestinal cancer, living with other forms of cancer, experienced a stroke, conditions which cause malabsorption, dementia, allergies, certain genetic conditions or injury and patients are spread across all age groups and in all care settings.

Three key actions must be prioritised within the standards and included within the responsibility of the ICS Board:

• Screening patients for under nutrition on entry to hospital
• If under nourished, develop a care plan and deliver that care plan whilst in hospital
• On discharge, ensure that the nutritional status of the patient is communicated to the relevant GP practice and that support is provided in the home, if necessary, to ensure that the nutritional needs of the patient are met

The Hospital Food Review identified the critical need for leadership to ensure that its recommendations are delivered. As the Health and Care Bill is considered by Parliament, BSNA will continue to press for nutrition standards to be an ICS Board level responsibility, to ensure that the success factors identified in the Review are delivered and undernutrition is tackled whether patients are in hospital, a care home or in their own homes.

[1] Elia M. The cost of malnutrition in England and potential cost savings from nutritional interventions (full report): A report on the cost of disease-related malnutrition in England and a budget impact analysis of implementing the NICE clinical guidelines/quality standard on nutritional support in adults: Malnutrition Action Group of BAPEN and the National Institute for Research Southampton Biomedical Research Centre, 2015.