Request
Confirm or deny if NHS East Midlands has instructed its constituent Primary Care Trusts to include indicators relating to malnutrition in the Commissioning for Quality and Innovation (CQUIN) schemes which they agree with providers.
Details of the indicators relating to malnutrition which tNHS East Midlands' constituent Primary Care Trusts include in the Commissioning for Quality and Innovation schemes which they agree with providers.
Confirm or deny if NHS East Midlands is aware of the British Association for Parenteral and Enteral Nutrition (BAPEN)'s Malnutrition matters: meeting quality standard in nutritional care toolkit, published May 2010; available here: http://www.bapen.org.uk/pds/toolkit-for-commissioners.pdf
The steps NHS East Midlands is taking to ensure use of the British Association for Parenteral and Enteral Nutrition (BAPEN)'s Malnutrition matters: meeting quality standards in nutritional care toolkit, forcommissioners.pdf amongst commissioners and providers in NHS East Midlands' area.
Confirm or deny that the Strategic Health Authority has made an assessment of the prevalence of malnutrition in the region.
Supply details of the assessment of the prevalence of malnutrition undertaken in NHS East Midlands' area.
Supply all communications which NHS East Midlands has had with the Department of Health in the last 12 months which refer to malnutrition.
Supply all communications which NHS East Midlands has had with its constituent Primary Care Trusts in the last 12 months which refer to malnutrition.
Our Response
I refer to your letter concerning malnutrition. I can confirm in accordance with S.1 (1) of the Freedom of Information Act 2000 (FOIA) that we do not hold all of the information that you have requested. However, I will address each of your concerns in turn:
Request 1
Request 2
Bassetlaw Provider Arm & Bassetlaw PCT (Community Provider)
All patients will receive nutritional advice, as appropriate to the service they are accessing. The CQUIN measure applies to the following services, the score will be overall and measured by an audit:
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Podiatry
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All Adult Rehab
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All patients on SNAP
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Health Visiting
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School Nursing
Derby City Provider Arm & Derby City PCT (Community Provider)
Nutrition and Hydration - the percentage of patients who have a nutritional assessment using the MUST (Malnutrition Universal Screening Tool).
Nottingham City Provider Arm & Nottingham City PCT (Community Provider)
Percentage of Learning Disability service users admitted to in-patient/ day care facilities with a MUST screening score of 1 have an observational care plan documented in the clinical notes and those with a score of 2 have a treatment plan evident within clinical notes.
To monitor, measure and increase the number of patients receiving a MUST screening tool within 7 days of admission to an in-patient/ day care facility to 100% from current baseline by the end of Q4 2010/11. Service users with a MUST screening tool score of 1 to have an observation care plan and those scoring 2 have a treatment care plan.
Nottinghamshire Healthcare Trust and NHS Nottingham City (Mental Health Provider)
Percentage of Learning Disability service users admitted to in-patient/ day care facilities receiving a MUST screening.
To monitor, measure and increase the number of patients receiving a MUST screening tool within 7 days of admission to an in-patient/ day care facility to 100% from current baseline by the end of Q4 2010/11. Service users with a MUST screening tool score of 1 to have an observation care plan and those scoring 2 have a treatment care plan.
Request 3
Request 4-6
NHS East Midlands recognises the importance of nutrition. I would like to point out that nutrition is integral to a number of areas of work that NHS East Midlands promotes and actively supports such as:
Releasing Time to Care
High Impact Actions
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These were developed following a ‘call for action’ which asked frontline staff to submit examples of high quality and cost effective care that, if adopted widely across the NHS, would make a transformational difference. One of these is Keeping Nourished - getting better, aimed at stopping inappropriate weight loss and dehydration in NHS provided care
Patient Environment Action Teams (PEAT)
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food
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cleanliness
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infection control
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patient environment (including bathroom areas, lighting, floors and patient areas)
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It is an annual self-assessment each provider with more than 10 beds undertakes and has been in place since 2000 has and includes a section on the quality of hospital food. We do monitor the scores on these year on year.
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NHS sites and NHS trusts are each given scores from 1 (unacceptable) to 5 (excellent) for standards of environment, food and dignity and privacy within buildings).
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Assessments are carried out by NHS staff (nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dieticians and estates directors).
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Patients, patient representatives and members of the public are also part of this assessment process. Results are published by all the organisations.
Request 7-8
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_116563.pdf
I hope that this information is of use. If you are dissatisfied with the way in which we have dealt with your request you can ask us to review our decision by writing to:-
Mr Moosa Patel
Director of Corporate Affairs
NHS East Midlands
Octavia House
Interchange Business Park
Bostock's Lane
Sandiacre
Nottingham
NG10 5QG
If at the conclusion of any review you remain dissatisfied you may complain to the Information Commissioner who can be contacted at:-
The Office of the Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
