1. Optimal Nutritional Care for All UK Update report In partnership with NHS England and the Malnutrition Taskforce With support from NHS Improvement Funded by a grant from the Health Foundation

2. How are we focusing on implementing good nutritional care in England NHS England Commissioning Guidance 2015-2018 Our Vision All people will receive safe and high quality nutrition and hydration support when required, through the commissioning of person-centred and clinically effective integrated services in the community Guidance: https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdf

3. Developing our roadmap to Optimal Nutritional Care for All National Guidance for commissioners Working in partnership with NHS England and the Malnutrition Taskforce, with support from NHS Improvement and BAPEN core groups to widely disseminate the guidance and support implementation National Guidance for commissioners Working in partnership with NHS England and the Malnutrition Taskforce, with support from NHS Improvement and BAPEN core groups to widely disseminate the guidance and support implementation 2016 NHS England:Regional Chief Nurses and nuring directorate Support Commissioners to implement best practice and use system levers such as incentives (CQUiNs) Holding regional events to support the work NHS England:Regional Chief Nurses and nuring directorate Support Commissioners to implement best practice and use system levers such as incentives (CQUiNs) Holding regional events to support the work 2016-18 AHSNs Using partnerships: Creating strategic and innovative space for implementation of research and NICE Guidance into practice Lead AHSN for Nutrition ‘Wessex’ AHSNs Using partnerships: Creating strategic and innovative space for implementation of research and NICE Guidance into practice Lead AHSN for Nutrition ‘Wessex’ 2015-18 Providers 2016-18 Increased awareness of malnutrition Self Screening website launched Two films being produced promoting patient experience and good care Increased awareness of malnutrition Self Screening website launched Two films being produced promoting patient experience and good care 2016 Patients, patient groups and the Public All Providers to implement the NICE guidance and NICE Quality Standards Aiming for all GPs to follow the Malnutrition Community pathway Commissioners Engaging with Chief nurses

4. Developing the right policy and system levers Spreading Excellence in Nutritional Care at pace and scale Outcomes Framework Domain 5 Exemplar CQUINs Policy CQC Outcome 5: Meeting Nutritional Needs Regulation National Contracts Guidance on Nutrition Commissioning Guidance Policy Local CQUINs Contracts System Levers Improved Quality Improved patient Experience Reliable screening Relaible care planning Reduced LOS Improved outcome Nutritional Care Tool Ensure Implementation of NICE Quality Standards Support to Trusts to achieve aspirational standards NICE Standards Influence CCGs to deliver continous improvements in commisisoning of good nutritional care Local CQUINS/ Contracts CCGs Significant Reduction in £19.6billion spend on malnutrition Calculated using BAPEN/NIHR report Prodctivity Gains 2017-18 2015/16 2011-13

5. How are we organising implementation of optimal nutritional care in the NHS and social care system? Influence Government and Department of Health Policy Commissioners/ Contracts Providers Key Partners Clinical Nutrition Companies Catering Assciations, Services and Companies Industry NHS Commissioning Board / BAPEN Guidance for CCGs – what does ‘good’ look like All Providers to implement the ‘MTF ‘how to’ guides to prevent malnutrition in Older People Implementation of NICE Guidelines and Quality Standards. All Providers to implement the ‘MTF ‘how to’ guides to prevent malnutrition in Older People Implementation of NICE Guidelines and Quality Standards. Product Development Patient Information and Support. Product Development Patient Information and Support. Ensure nutiritonal care is embedded in contracts Ensure nutiritonal care is embedded in contracts.. Promoting Self Management Catering Standards / Access to nutritious food 2016/17 NHS England and regional commissioning boards AHSNs / NHAA/Charities/Royal Colleges/ Professional Bodies/ HEIs Patient Groups Screening and Care Planning Education of Frontline Teams

6. Key messages within the Commissioning Guidance  Focus on prevention  Scope the problem/baseline assessment  Develop integrated care pathways (Nutrition and Hydration)  Contract for quality improvement –improvement trajectory (commissioning intentions)  Monitor and evaluate outcomes delivery (BAPEN has developed a new nutritional care tool to support this))  Patient and public involvement  Education/training BAPEN is working in partnership with NHS England and the Malnutrition Taskforce to deliver regional events, chaired by the regional chief nurses to work collaboratively with commissioners and providers to implement the guidance Supported by a Health Foundation Grant Delivering regional programmes

7. Prevention and early detection is key to implementation  Self Screening in the community  Appropriate screening in primary care and community settings  Robust systems for ONS prescribing BAPEN Self-screening website

8. Using the BAPEN nutirtional care tool to track improvements in hospitals and care homes A shift from stand-alone audits to continuous quality improvement Frequent web-based data collection Swift, extensive analytics with nutrition dashboard, data tracking over time Work underway to roll out Organisational Nutritional Care Dashboard Organisational details Organisation name Ward/unit Speciality Date of collection Professional group undertaking the survey Demographics Age group Feeding route Setting Diagnosis Type of care Food, ONS, ETF, PN (tick all that apply) Nutritional Screening & Care plans Screening (score on admission and time of audit) - Objective (wt, ht, preceding wt loss, disease effect) - Subjective - Barriers to nutritional screening Nutritional care plan – documented and implemented (yes, no, in part) Re-screening Patient Experience questions Have you received all the food and drink or nutritional care you have needed? Have you received assistance to eat and drink when you have needed help? What does the new tool measure?