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More Still Needs To Be Done To Improve Nutritional Care For Hospital Patients says Auditor General in Report Out Today

Hospital catering services in Wales have improved and many patients are satisfied with the food they receive but more needs to be done to make sure patients get the nutritional care they need.

Today’s report found hospital catering services have improved. Many hospitals in Wales provide patients with an appropriate choice of good quality food and nurses are making efforts to clear up wards before food arrives.

Protected mealtimes times - when all non-urgent clinical activity stops on wards allowing patients to eat without interruptions and nurses are able to assist are becoming more common. Assembly Government policy initiatives have identified the standards of nutritional care that need to be applied and have encouraged ward sisters to take greater ownership of catering arrangements on their wards. The report highlights that where this strong leadership by nurses was in place, nutritional care of patients was invariably better.

However, there is still much room for improvement. Although most patients are screened for nutritional problems, important information about patients’ nutritional status is often missing. Not all patients get the help they need at mealtimes, and the recording of food intake for at risk patients is not always carried out. The report found that care plans are not always in place for patients with nutritional problems and that these patients were not always referred to a dietician for a more specialist assessment.

The report found that financial information about catering services is typically poor and needs to improve. Where it exists, it shows that catering costs varies significantly in hospitals across Wales. The daily cost of feeding a patient ranges from £1.33 to £5.66 per day while non patient catering services - provided by hospitals for staff and visitors - are heavily subsidised, often unknowingly. More also needs to be done to reduce the amount of food wasted, which remains unacceptably high on many wards, and many hospitals could generate significant savings by reducing waste to more acceptable levels.

The report, Hospital Catering and Patient Nutrition, which follows up previous Audit Commission in Wales work in 2002, makes recommendations for improvement, including:

  • The need for the Assembly Government to develop and issue standard all-Wales nursing documentation to promote consistent nutritional screening and care planning, and to help ensure important areas, such as oral health, are properly considered;
  • The need for NHS bodies to audit compliance with all aspects of the Assembly Government’s Nutritional Care Pathway, and to establish clear plans of action to address any gaps that are identified;
  • The need to develop a clear costing model for patient and non patient catering services that supports meaningful comparisons of hospital catering costs across Wales;
  • Setting clear pricing policies for non-patient catering services; and
  • Establishing local and national targets for food wastage.

Auditor General for Wales, Huw Vaughan Thomas, said today: “Hospital food plays a vital role in patients’ recovery and rehabilitation. Whilst my report points to encouraging improvements, it also shows that hospitals need to do more to ensure patients are getting the nutritional care they need. NHS organisations must recognise the importance of patient nutrition and ensure that there is effective leadership at ward level so that best practice is implemented.”

Download a copy of the report, English Welsh

Notes

Alongside the report, the Wales Audit Office is issuing a checklist for NHS board members including the questions they should ask to get assurance that hospital catering and patient nutrition arrangements in their organisation follow national guidelines and recognised best practice.

As a separate initiative, the Wales Audit Office is set to produce information for patients to make it clear what the NHS should be doing to help them eat well during their hospital stay.

The importance of good nutrition in supporting patients’ recovery has been recognised in a number of Assembly Government initiatives and documents over the last decade. The most recent of these initiatives is the Hospital Nutritional Care Pathway, which was accompanied by the development of an all-Wales food chart to record food and beverage intake. These initiatives support the 2003 Council of Europe Resolution on Food and Nutritional Care in Hospitals.

The Wales Audit Office is independent of government and is responsible for the annual audit of some £20 billion of annual public expenditure.

Its mission is to promote improvement, so that people in Wales benefit from accountable, well-managed public services that offer the best possible value for money. It is also committed to identify and spreading good practice across the Welsh public sector.

For more information please contact Sasha Mansworth on 029 2032 0517 or email sasha.mansworth@wao.gov.uk