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Nurses will weigh all patients in bid to tackle eating disorders
Last updated at 23:37pm on 29.08.07
Doctors are worried that patients are not recovering quickly enough after surgery because of bad eating habits
Nurses will weigh every hospital patient on admission to make sure those who are malnourished are not left to starve, it emerged yesterday.
Tough new guidance will also tell staff to ensure that frail elderly patients are helped to eat their food and identify young women suffering from eating disorders.
In addition, hospitals will be charged with providing food that is easy to eat, appetising and healthy.
The initiative aims to put an end to the scandal of frail elderly people leaving hospital under-nourished because the food was unappealing or had been placed out of their reach.
The number of patients leaving hospital without basic nourishment has risen by two thirds in five years, and 13 million hospital meals are thrown away untouched by patients every year.
The plan to weigh all patients will also ensure that overweight people are identified and properly treated.
Drawn up by a range of bodies including the Department of Health, the Royal College of Nursing and the Hospital Caterers Association, the 10-point plan will be published in October.
All patients will be weighed when they arrive in hospital to identify which ones are malnourished or at risk of malnourishment.
Those unable to stand on weighing scales will have their arms and waist measured, and everyone will be re-weighed weekly.
People identified as "at risk" will receive their food on colour-coded trays to remind nurses they require special attention.
And meal times will be protected so that patients will not be disturbed by doctors' ward rounds when they are supposed to be eating. Decent food should be available 24 hours a day.
As well as older people at risk of malnourishment, underweight teenagers with suspected eating disorders will be targeted under the scheme.
Doctors say they are concerned patients are not recovering quickly enough because they were malnourished even before they came in.
Dr Rick Wilson, of the British Dietetic Association, said: "We would like to see everyone weighed because we need to know whether people are underweight or overweight so we know what type of support they need.
"The dose of certain drugs depends on people's weight, and some equipment only takes people up to a certain weight.
"Weight is an early warning system: if people are losing weight and we don't know about it they won't benefit from any of the treatment they are receiving."
Dr Wilson, who is also a nutritionist at King's College London, said when his mother was a nurse 30 years ago, weighing people on admission was general practice.
"It was someone's job every day to go round and weigh someone. We need to turn the clock back a bit.
"When you go to Sainsbury's, the checkout operator will weigh the carrots and tell you how much they cost. Somehow we don't seem to be able to weigh people in hospital."
Neil Watson-Jones, chairman of the Hospital Caterers Association, said: "It's not just about poor diet but that patients can also be put at nutritional risk because of an operation.
"The drugs they are given can alter their taste or appetite and this has to be monitored."
The Daily Mail has been highlighting hospital malnutrition as part of its Dignity for the Elderly campaign.
Yesterday Age Concern said hospital food was getting better but many wards were still not up to scratch.
Director General Gordon Lishman said: "Not one older person should go malnourished in hospital, and we are proud that this issue is now getting more of the attention it deserves.
"We welcome the commitment by ministers, hospitals and health professionals to improve the situation, but we need to see this translated into every ward in every hospital.
"The NHS has made a good start, but there is still much to be done. While we know of hospitals that have introduced protected mealtimes and red tray systems, this is still very hit-and-miss and too many hospitals are not making effective use of these systems or volunteers to help with meal times."
Vanessa Bourne, of the Patients Association, said: "Too many nurses think they are too grand to watch patients and to make sure that they eat.
"They would rather be off chatting round the nurses' station, so basic measures such as weighing have fallen off the list of priorities."
The National Institute for health and Clinical Excellence first proposed that all patients be weighed in February 2006.
But many hospitals are flouting the rules and the new guidelines are designed to ensure they comply. Failure to do so will be punished by the government's standards watchdog the Healthcare Commission.
The new 10 point plan is distilled from a series of 100 recommendations on hospital nutrition signed by EU foreign ministers in 2003.
Earlier this year junior health minister admitted many elderly people were effectively being starved in hospitals.
He said some were given just a single scoop of mash as a meal while others were "tortured" with trays of food placed just beyond their reach while nurses claimed they were too busy to help them eat.
Reader views (1)
About time. My uncle, who had cancer of the spine and could not sit up, was left to try and eat without assistance. When I queried it I was told that it was this nurse's norm not to help elderly patients eat as they lose their independence and their ability to do it themselves. So he was going to be left to starve.
- Tom Gillies, Chafford Hundred
