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Research project: Development project for national Audit for Essence of Care - Dormant

Currently Active: 

Nutrition is a fundamental aspect of care and yet the quality of nutritional care given to people in hospitals and care homes is hugely variable. This project sets out to identify how a national audit could be undertaken and what criteria should be audited.

Many people in hospitals and care homes become malnourished because they do not get food they can eat or the help they need to eat it.  People who require puréed food have been offered only solid foods. Others with special dietary requirements, such as needing gluten-free or halal food, are not catered for.   Patients miss meals because they don't get the help they need to eat them. If they have arthritis or a broken wrist, for example, they may struggle on their own to unwrap their food or open a packet.  The importance of food and drink in patients' recovery and well being is widely recognised.

Despite this, research continues to show that malnutrition remains a major problem within a variety of care settings.   Malnutrition is under-recognised and under-treated in the UK. In 2007, it was estimated that treating the consequences of malnutrition cost the NHS in excess of £13 billion per year.   At any given point in time, more than three million people in the UK are either malnourished or at risk of malnutrition. The vast majority of these (93%) are living in the community, with 5% in care homes and 2% in hospital. National nutrition screening week surveys carried out by BAPEN have reported the prevalence of malnutrition to range from 28-34% in hospitals and 30-42% in care homes. In both hospitals and care homes older people were found to be at a greater risk of malnutrition.   Up to 14% of older people aged over 65 years in the UK are malnourished.

A range of national clinical audits are currently used to monitor and improve health services in England. They are seen to be important measures of care provision within the NHS that allow providers to benchmark their services against other centres and implement improvements to care pathways where necessary. Given that malnutrition is common across care settings, national clinical audits of the standards of nutritional care may prove to be useful tools in improving nutritional care. There has not previously been a national clinical audit of nutrition in health and social care

Download NHS Essence of care 2010 Benchmarks of food and drink

Project team

Peter Griffiths

Project funder

Health Quality Improvement Partnership


Associated research themes

Workforce: re-configurations and enabling and measuring workforce effectiveness

Related research groups

Health Work and Systems
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