Food for thought

A few weeks ago the Royal College of Nursing (RCN) Congress dominated the headlines as nurses overwhelmingly voted in favour of a motion of no confidence in Andrew Lansley. While NHS reform was the main topic of conversation at the 4 day Congress, it was not the only issue being discussed.

Hospital food by celesteh, via FlickrWe attended the RCN congress to talk about a current problem in our hospitals – older patients becoming malnourished. The statistics show that the number of people entering and leaving hospital malnourished has steadily risen each year – in 2008-09 over 185,000 people left hospital malnourished.

The nurses we spoke to all agreed that this is a problem, but they disagreed over the cause. Many nurses believed that it is caused by the poor quality of food: “Have you seen the food they serve?” “The food looks like slop” are two comments we heard time and time again. Their proposed solution is straightforward – hospitals need to spend more on food so patients can have nutrient rich and appealing food.

While improving the quality of food will help, it will not fully solve the problem. Good quality food is important but hospitals also need to ensure that older people receive the help they need during mealtimes. What’s the point of having a five-star meal if no-one helps you to remove the packaging?

Older people regularly tell us they do not get the help they need at mealtimes – this help could be as simple as ensuring the food tray is placed within reach, to removing packaging as well as assistance with feeding. Without this support older patients go without food and often end up leaving hospital malnourished.

Nurses have told us that the biggest barrier to ensuring patients receive help is time – mealtimes are too short and there are simply not enough nurses to help everyone who requires support at mealtimes. There is no one solution to this; mealtimes could be staggered or extended, hospital volunteers could support patients during mealtimes or more nurses could be employed on wards.

What is clear is that immediate action is required to stop this scandal, otherwise the number of people leaving hospital malnourished will continue to rise.

Find out more about Age UK’s Hungry to be Heard campaign, fighting malnutrition in hospitals.

5 responses to “Food for thought

  1. Tony Armstrong

    Yes, some NHS food is terrible but some is quite edible and even vaguely enjoyable (in my recent experience). However, the issue of time is somewhat of a red herring – there is always plenty of time to leave dishes hanging around for long periods. Clearly, nursing staff do not wish to upset the status quo and are not prepared to cut across functional lines to ensure that patient care is put first. This (like cleaning) is an area where the ward nursing staff no longer have complete control of the ward activities.
    However, the fact that nursing staff are not prepared to champion the cause of patient care demonstrates that their training does not make this vital aspect a priority.
    Patient care would improve immeasurably with a management shift away from managing narrow functional specialisms to one of managing processes; in this case the care of the patient from admittance to discharge, everything else is (or should be) subservient to the high quality and fault-free running of this process.
    The NHS has much to learn from modern manufacturing in this respect. Trained in Japan and the USA, I saw, in my long career (and later implemented at board level) systems whereby even the lowliest team member had the absolute authority (plus the expectation that they would) stop a process that had developed a fault and was running outside parameters. All team members were highly trained in problem analysis and solving techniques to ensure that any system was continually improved. High quality (of operation of any system) does not cost, it saves money, especially by its focus upon the efficiency of processes.
    We have the wrong people running the NHS!

    • How right you are Tony! Using methods that work in industry would go a long way to resolving many of the issues associated with poor patient care. It is not just the nursing staff who deliver patient care, but everyone from cleaners, catering staff right through to the CEO of the hospital or trust.
      So many people in senior roles have only had exposure to the administrative & procedural aspects of the NHS & little or no experience of what happens in other walks of life. Imaginative thinking is therefore restricted in what can be done to make things better.

  2. My elderly mother became severely malnourished while she was in a Leicester hospital. I approached the local newspaper and together we launched a campaign. I was as successful as one individual can be in raising awareness of issues of neglect in wards full of frail elderly patients. I was even taken round the ward where my mother had been and shown changes that had been made in response to my complaints. But I have recently heard of similar issues. There are not enough members of staff on a ward and, of those who are on duty, too many of them don’t care for the problem to go away. I have itemised the progress that I made on my blog at http://rosalindadam.blogspot.com/2011/03/people-are-frightened-of-complaining.html and I intend to continue my involvement. Our frail elderly deserve all the support, care and love that we can give them.

  3. Tony Armstrong

    Well done, Rosalind and good luck with your efforts. I have written elsewhere on Age Concern about a similar experience with my own mother. However, I stand by my belief that the problem is not one of under-staffing per se at ward level but that of a complex mix of issues with bad management and inappropriate organisation overall. Nevertheless, the RCN and nursing at ward level is a large part of the problem; training and attitudes need to change

  4. This is a good post highlighting an important issue and I am glad to see you were taking nurses to task at the RCN conference.
    But where were you at your own Age UK conference earlier this year when you had the perfect opportunity to question Jo Webber of the NHS Confederation. ( See my “grumblesmiles” blog 10th March.) She was given a platform to extol the virtues of how well the NHS was doing, how committed the staff were to learning lessons, and how patient satisfaction was very high and improving all the time. No mention of your report on malnutrician and the poor treatement of older people in the NHS.
    In this scandalous situation we don’t need the polite diplomacy of the all shiney new AGE UK. How about bringing back the rage of old age? Then there is at least a chance you may be heard.

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