Millions of malnourished 'go unnoticed'
The problems of obesity and overeating in our society receive a lot of attention.
But in this week's Scrubbing Up, Katherine Murphy of the Patients Association calls for more action to help the millions in the UK whose malnutrition is "unnoticed, unheard and unsupported".
It is unbelievable that in the UK today there are more than 3m people either malnourished or at risk of malnutrition.
What is alarming is that 93% of these patients are not in hospital but are living in the community.
It is our most vulnerable members of society who are most at risk.
This includes the elderly, those who are housebound or who have limited mobility and do not have a social support network in place to assist with tasks such as food shopping and cooking.
Patients are discharged from hospital and can be left isolated with no social care support.
They "fall through the gaps" and miss out on key support services, such as home help and meals on wheels.
People suffering from malnutrition are more vulnerable to infection, take longer for their wounds to heal or to recover from illness, have weaker muscles and may become depressed.
The malnourished also visit their GP twice as often and are three times more likely to be admitted to hospital.
For malnourished patients, their length of stay in hospital is increased by three days.
Because of this use of healthcare resources, malnutrition costs the UK in excess of £13bn a year.
With the NHS asked to save £20bn by 2014, tackling malnutrition would not only benefit individual patients but would go a long way to helping the NHS achieve these financial savings.
However, a year after the coalition government announced its plans to reform the NHS, we are no clearer as to how these reforms will tackle the issue of malnutrition.
Our recent survey of over 5,000 adults painted a depressing picture of malnutrition in the community.
Not enough is being done to screen for malnutrition in the community.
Unintentional weight loss is one of the key physical signs of malnutrition.
Monitoring weight is an easy, inexpensive way for patients and carers to keep a proper record to check if they are at risk of malnutrition.
By promoting the simple message that weight monitoring helps identify those at risk of malnutrition, local authorities - who will take on local responsibility for health and public health - could help the public identify those at risk.
Monitoring weight is quick, cheap and easy and can be done inside and outside the home.
Community centres, day centres and lunch clubs, as well as support groups could all play a role in helping to monitor the weight of those who use them.
We keep hearing about the Big Society - well surely this would be the Big Society in action?
Patients - particularly the elderly - rely on their GP for providing information and support, but very few had managed to obtain information on local services and were unsure of the help available for those suffering from malnutrition.
Half of carers wanted to know who to go to for help if they had concerns with a third interested in community support services.
Despite this, less than a third of patients with concerns about malnutrition will have had contact with a dietitian.
We need to make sure the new Clinical Commissioning Groups (CCGs), which are to replace primary care trusts, provide information on local malnutrition services from diagnosis to treatment, follow up and monitoring in the community.
We also want local authorities to ring-fence funding for community-based dietetics services and ensure that patients who need to see a dietitian are able to do so.
The Department of Health must educate CCGs and local authorities to the financial cost of malnutrition and emphasise why prevention, with effective community services and patient information is so much cheaper than cure.
Action is needed on this important issue.