1. The Malnutrition Task Force : Prevention and early intervention of malnutrition in later life Margit Physant Project Manager

2. The Malnutrition Task Force Independent group of experts across health, social care and local government united to address the problem of preventable malnutrition in older people

3. Our mission To ensure the prevention and treatment of malnutrition is embedded in all care and community support services and awareness is raised amongst older people and their families

4. About Malnutrition

5. Malnutrition : definition Undernutrition: low body weight with(out) weight loss NICE definition – a body mass index (BMI) of less than 18.5 kg/m2 – unintentional weight loss greater than 10% within the last 3–6 months – a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3–6 months

6. Malnutrition Over a million older people (1:10) Devastating Declining mobility Decreased resistance to infection Delayed healing Dizziness, leading to falls Depression Deteriorating quality of life Death!

7. Contributing factors 93% of people with malnutrition are in the community

8. Our ageing population

9. Costs of Malnutrition Severely malnourished people – see their GP twice as often – have 3 times the number of hospital admissions – stay in hospital more than 3 days longer – incur £1,440 pp in the year following diagnosis Increases dependency on family, carers and support services.

10. Invest to save Screening, early intervention and treatment as per NICE guideline could save £71,800 per 100,000 population The cost of treating care homes residents diagnosed with malnutrition is twice that of screening all care home residents Community meals have social return on investment of between £2.90 and £5.20 for every pound spent

11. Hertfordshire Community Meals A social return on investment analysis Service users: improved health, happier, safer, increased independence. Family/carers: increased ability to work, more leisure time, less stress and improved relationships For every £1 invested, the likely social value created through these outcomes is around £5.28 Divided as 49% for clients, 14% for family/carers, 29% for the State and 8% for Local Authority

12. What we did

13. What does good look like? Engagement with wide range of stakeholders Workshops Learning examples/case studies Existing tools and guidance Principles for best practice in nutrition and hydration care

14. Best practice principles 1.Raising awareness 2.Working together 3.Identifying malnutrition 4.Personalised care, support and treatment 5.Monitoring and evaluation

16. 1 st principle: Raising awareness Public and professionals must understand importance of good nutrition and hydration dangers of malnutrition what to look out for where to get help/ signpost people to Derbyshire,Dorset,D.Council Focus groups: older people

17. Raising Awareness: Dairy Council Campaign Raise awareness of public and health professionals ‘Bring it back’ campaign Free materials: poster, leaflet, postcards flowchart for professionals Visit www.milk.co.uk

18. Organisations and individuals working together will provide a more complete service. A combined approach across the community and within health care, social care, the third sector and the commercial sector is essential Caterers and food providers working with clinicians and therapists Local Health and Wellbeing Boards, Adult Social Care, care homes, hospitals Include the older person and relatives 2 nd principle: Working together

19. Organisations and individuals must be well equipped to identify malnutrition in older people Assess the prevalence of malnutrition in the local population BAPEN tool(s) even an app! www.bapen.org.uk Screen people across all care settings Identify the cause of malnutrition and remedy the situation 3 rd principle: Identifying malnutrition

20. Forming and implementing a personalised plan for and with each older person is crucial Use NICE guidance or care pathway Managing Adult Malnutrition in the Community (BAPEN) www.malnutritionpathway.co.uk Start support for ‘non’ clinical management 4 th principle: Managing malnutrition

21. Monitoring and reviewing the older person’s progress and outcome is critical. Monitoring the structures and processes to ensure good nutrition and hydration care is implemented Service user feedback (incl. relatives) Annual Adult Social Care Survey 5 th principle: Monitoring and evaluating

22. Implementation Guides for Food and beverage providers Hospitals Care homes Local communities Commissioners Available to download from www.malnutritiontaskforce.org.uk

23. Thank you ! Margit Physant Project Manager, Malnutrition Task Force Email: margit@malnutritiontaskforce.org.uk Direct tel. 020 3033 1469 (Tues-Thursdays) Website: www.malnutritiontaskforce.org.uk or follow us on twitter @MalnutritionTF