Addressing the hidden health problem of malnutrition

Kirstine Farrer Consultant Dietitian

Salford Royal NHS Foundation Trustkirstine.farrer@srft.nhs.uk

Communities - little or no contact with services

Communities in contact with

services

Care Homes

Hospital

93

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2

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edWho is at risk?

The Cost of Malnutrition

Public expenditure associated with <3 million individuals in UK who are malnourished or at risk of malnutrition

2003 - >£7.3 billion p.a

2007 - >£13 billion p.a.

2014 - >£15 billion p.a.

NICE Cost Saving Guidance places effective treatment of malnutrition as 3rd in ranking of potential biggest cost savers to the NHS

Salford

• Total population is 218,000• Eight neighbourhoods• Although there are diverse levels of affluence, Salford is ranked as

one of the most deprived local authority areas in England with life expectancy lower than the England average

• Population of people aged 65 and over is 35,000 • Number of older people is forecast to rise by 28% by 2030• Large Orthodox Jewish community• 14% (nearly 5000) of people aged 65 and over may be at risk of

malnutrition (using BAPEN commissioning toolkit)

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45

May10/apr11 May11/apr12 May12/apr13 May13/apr14

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Hospital admissions relating to malnutrition, Salford,May 2010/April 2011 - May 2013/April 2014

Salford Greater Manchester England

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100

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0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90 plus

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Age band

Hospital admissions with malnutrition as a diagnosis by age band, Salford and Greater Manchester

Apr10/May11 to Apr13/May14 (4 year pooled)

Salford Greater Manchester

5 Pilot sites:Salford, Lambeth, Dorset, Gateshead and Kent

Raising awareness Working together

Identifying malnutritionPersonalising care and support

Monitoring and evaluating

Aims

• To share the work of the MTF and drum up enthusiasm

• To understand the current state and identifying gaps

• To help shape the priorities for taking the work forward

On the day

• Over 80 people in attendance

• Presentations – understanding the scale of the problem

• Interactive group work – scenario planning

• Video – developed for the event: https://www.youtube.com/watch?v=SFIzFMw6iJ8

• Pledge Tree

Outcomes

• Great evaluation

• Learning developed into workstreams

• Pledges

• Film clip – developed at the event: https://www.youtube.com/watch?v=Z7tH6Z91mKs&feature=youtu.be

Project Launch Event

Work Stream Remits

1. ICP Standards of Nutritional Care Across Organisations to reflect the NIHCE Quality Standards

2. Nutrition and Dysphagia Education for Staff across Salford ICP

3. Raising Awareness

4. Working with Community and Primary Care

ExSocial Media Campaign Marketing Campaign

materials

Diet sheets developed for acute and community settings written by older adults, dietitians and speech and language therapists

Raising Awareness

Shopping Trip

Progress

• First shopping trip took place in November – six people in attendance

• Preparation included:• Targeting appropriate older people to attend• Discussions with ASDA regarding preparation for the day• Pull up poster purchased to have on show at the event

to encourage others to find out more• Leaflets available • Development of floor plan for ASDA in Swinton• Information on what to look out for in each aisle• Attendees rewarded with a cup of tea and biscuit for

participating.• Staff on hand to support (community dietitians, dietetic

assistants, AgeUK etc)• Film clip developed:

http://communityreporter.net/videos/malnutrition-task-force-trip-asda

Raising awareness across the community

Progress

• Film clips on YouTube• Communications Sheet

The Salford Together Nutrition ArmbandSalford Royal NHS Foundation Trust ©

Patient Information Displays

Progress

• 10 practices identified as part of their high sip feed prescribing

• Poster developed by dietitian and Age UK Salford

• Leaflets previously outlined will be included

• Floor plans and isle information for both ASDA and Morrisons

Nutrition and Dysphagia Training

Paper written to outline the need for malnutrition and hydration to become mandatory across the integrated care programme.

Raising Awareness - Social Media Activity

Care homes and care home providers

• NICE standards and Salford Together Standards in relation to nutrition have been included in the development of the Quality Assurance Framework – go live date to be confirmed

Progress

Residential and Nursing Care Homes and Home Care Provider Contracts.

Local provider contracts have been revised to include Key Performance Indicators about nutrition

Progress

Evaluation and Dissemination of Pilot Programme

After a thorough evaluation there will be written reports for

each of the five sites assessing the change management

process and how successful the pilot programme has been

along with lessons learnt

Sharing the learning of the projects to wider stakeholders

Salford Steering Group MembershipName Job Title Place of work

David Haynes Chief Executive Age UK, Salford

Jean Rollinson Director of Service Development Age UK, Salford

Kirstine Farrer Consultant Dietitian Salford Royal NHS FT

Brenda Blackett Lead Nutrition Nurse Salford Royal NHS FT

Katie Foster/Tony Ward Team Leader, Community Dietetics Salford Royal NHS FT

Sarah Cleverly Project Manager (supports the care home/mental health agenda)

Greater Manchester West Mental Health Trust

Stephanie Webb Project Manager (supports community agenda)

Integrated Care Programme

Claire Vaughan Head of Medicines Management Salford Clinical Commissioning Group

Paul Walsh Integrated Commissioning Manager Salford City Council

Julia Wood AQuA Affiliate

Governance Reports to Salford Integrated Care Programme on a monthly basis

Follow our progress

Upgraded website www.malnutritiontaskforce.org.uk

Follow us on Twitter @MalnutritionTF

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