All hospital patients should be screened for malnutrition and given special meals or a feeding tube if required, a healthcare watchdog said today.
The National Institute for Health and Clinical Excellence (Nice) called for hospital patients to be weighed and measured on admission, with weekly checks done on those who stay in.
Nice, which advises the NHS on drugs and treatments, also recommended malnutrition screening for all new care home patients and people registering with a new GP. Hospital outpatients should be screened at their first appointment, with follow-up checks done where there was cause for concern.
The guidance aims to improve the treatment of the estimated 40% of hospital patients and care home residents found to be malnourished on admission. The problem is most prevalent among older patients, with 60% suffering from malnutrition compared with 5% of the population as a whole.
Nice defines anyone with a body mass index (BMI) of less than 18.5 as malnourished. The ideal BMI, calculated by dividing your weight in kilograms by your height in metres squared, is between 18.5 and 25.
Nice said the guidance could save the NHS at least £45m a year because malnourished patients stayed in hospital longer, had higher mortality rates and were three times more likely to suffer complications during surgery.
The guidance recommended that hospitals and care homes give nutritional support to people at risk of malnutrition, such as those who had eaten little or nothing for more than five days prior to admission. Extra support should also be provided to people who had difficulty eating, such as those who could not swallow properly, or did not absorb enough nutrients because of gastric or bowel disorders.
Nice called for all acute hospitals to employ at least one specialist nutrition support nurse to oversee implementation of the guidelines. It also recommended nutrition training for all healthcare professionals.
Malnutrition costs the UK £7.3bn annually - twice as much as obesity, according to the British Association for Parenteral and Enteral Nutrition.
Mike Stroud, of the Institute of Human Nutrition at the University of Southampton, who helped draw up the guidelines, said malnutrition was "a gigantic problem and enormously costly".
"Ensuring patients receive adequate nutrition is an essential part of basic patients care, yet we know malnutrition is still a big problem for the NHS," Dr Stroud said.
"The guideline contains one obvious and simple message - 'Do not let your patients starve and when you offer them nutrition support, do so by the safest, simplest, most effective route'.
"By recommending a widespread programme of screening and nutrition support, this guidance is likely to make a real difference and save lives."
