The Wessex AHSN is supporting a number of projects aimed at evaluating integrated approaches to undernutrition screening and care planning. Both our pan-Dorset Malnutrition Programme (see below) and our OPEN Eastleigh project have been featured in a recent Public Health England review, published in February 2017, entitled "Helping older people maintain a healthy diet: A review of what works".
Pan-Dorset Malnutrition Programme
Dorset launched its Joint Nutritional Care Strategy for Adults in May 2013 which began as a partnership initiative to provide the highest levels of good practice in nutritional care for vulnerable adults.
One of the initial projects was a pilot implementing nutritional care pathways for health and social care teams in the community linked to a single GP practice. A significant number of vulnerable adults were screened with a particular focus on nutrition and identified as at risk of undernutrition. These individuals were unlikely to have been identified prior to the project, as the majority of staff had not previously been trained to undertake nutritional screening. An electronic data collection form was then developed to support this work.
The initiative was rolled out across five GP practices in Purbeck in 2015, and then into the Christchurch locality in early 2016, involving a total of 13 GP practices. The Purbeck pilot was one of five national Malnutrition Taskforce pilots.
The successes and positive outcomes of piloting this work in Purbeck and Christchurch has led to the roll out of this integrated approach for community based undernutrition screening and nutritional care support pan Dorset, starting in early 2017.
Between the start of the initial pilot and April 2018, a total of 3586 people have been screened for undernutrition, with approximately 25% of people at 'medium' or 'high' risk of undernutrition (using the 'MUST' screening tool). 69% of people screened in the Purbeck and Christchurch pilots had been screened by teams not screening prior to the intervention. A total of 631 health and social care have been trained to screen and treat and care plan for undernutrition.
Evaluating a new integrated procedure for nutritional screening and care planning in Southern Health NHS Foundation Trust
We are currently involved in a service development project for integrated community teams (ICTs) within Southern Health NHS Foundation Trust, to implement a new procedure for nutritional screening and care for older people, drawing on our OPEN toolkit. The new procedure will first be implemented by ICTs in Andover, Winchester and Basingstoke, with plans to roll out across the Trust if successful. The project has involved the following elements to date:
For more information on this service development project, please contact us at nutrition@wessexahsn.net. For further information about the INSCCOPe project, please contact Prof Jane Murphy at jmurphy@bournemouth.ac.uk