Sir George calls for £13 billion cost of malnutrition to be tackled
10 Feb 2009
GY and Rhonda Smith
GY and Rhonda Smith
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Local MP Sir George Young joined colleagues from across all parties calling for action to tackle the impact of malnutrition in the UK. Three million people are living at risk of malnutrition in the UK, with the cost of the condition now estimated to be £13 billion every year, a new report reveals today.

The report, Combating Malnutrition: Recommendations for Action, is the culmination of work undertaken by a group of experts in malnutrition, led by BAPEN. Launched in Parliament, the report sets out how the vast majority of those at risk of the condition are living in the community – and not in care homes and hospitals, where the focus of Government action has been to date. It also sets out how the disproportionate burden of malnutrition in deprived areas exacerbates health inequalities.

Sir George Young MP said: “It’s shocking that so many people in the UK are malnourished and that, on average, as many as 4,500 people in every constituency could be at risk.

“Given that the population of the UK is ageing and long-term conditions are set to rise, we need to take action now to bring this hidden problem out into open, and take action to identify and help those suffering from malnutrition.”

The report puts forward 25 actions that the Government needs to lead in order to reduce both the cost of the condition to the taxpayer, and the number of those at risk. Key among these is a call to increase the number of patients who are ‘screened’ for their risk of malnutrition both in the community and on admission to care – recommendations made by NHS watchdog NICE three years ago.

Many of the recommendations are calls for the importance of malnutrition to be reflected in existing Government policies, such as in Payment by Results and in the GP contract, and covered by existing regulatory inspections.

It follows an earlier report, Improving Nutritional Care and Treatment: Perspectives and Recommendations from Population Groups, Patients and Carers, published by BAPEN in January 2009 which sets out what patients, carers and population groups expect in terms of the nutritional care they receive.

Commenting, Professor Marinos Elia, Chair of the Advisory Group which worked on the report, and the immediate past Chair of BAPEN, said: “The evidence is clear and the time is right. Improving the nutritional status of all in the community as well as in hospital and care influences health outcomes and quality of life. The policy and regulation frameworks are in place into which many measures to combat malnutrition can be easily slotted. Government and the NHS together with the social care, housing and community sectors must now press forward with embedding nutritional care and treatment into daily practice to combat malnutrition where it starts – in the community.”



1. The report, Combating Malnutrition: Recommendations for Action, was issued on 10 February 2009. The report sets out how, amongst other findings:

• Malnutrition costs the UK £13 billion a year
• At any point in time, three million people are living at a high risk of malnutrition, with the vast majority (93%) living in the community including 2-3% sheltered housing, and the remainder in either hospitals or care homes
• In absolute terms, the majority of people at risk of malnutrition are under the age of 65 years
• Malnutrition is associated with a range of socio-economic factors, and the condition potentially exacerbates health inequalities
• Without action, the burden of malnutrition is set to rise as a result of, for example, an ageing population and an increase in long-term conditions associated with malnutrition (such as dementia)

Amongst the report’s 25 recommendations are that:

• The barriers to conducting nutritional ‘screening’ – such as the poor education and training of staff, the lack of provision of weighing and measuring equipment, and the absence of incentives to conduct nutritional screening (as opposed to recording obesity, which does have incentives) – must be removed, so that malnutrition can be easily tackled in the community.
• The new health and social care regulator, the Care Quality Commission, should ensure that ‘nutrition tsars’ are appointed in hospitals and care homes
• A Government target should be established to reduce those at risk of malnutrition
• The Department of Health should issue guidance for commissioners describing how a patient’s nutritional care needs should be identified and then managed across all components of the care pathway

Many of the report’s recommendations – such as establishing incentives to encourage the nutritional screening of patients – can be incorporated into existing Government policies, such as Payment by Results, the Quality and Outcomes Framework of the GP contract, and in the World-Class Commissioning assurance framework for Primary Care Trusts.

2. The report is the result of work following on from a day of discussion in 12 June 2008 by the following experts in the area of malnutrition, who formed the Advisory Group on Malnutrition led by BAPEN:

• Professor Marinos Elia, Institute of Human Nutrition, University of Southampton/ Southampton University Hospitals Trust (Chair of the Malnutrition Action Group and immediate past Chair of BAPEN)
• Debbie Dzik-Jurasz, Royal College of Nursing
• Jane Fletcher, National Nurses Nutrition Group
• Imogen Parry, Essential Role of Sheltered Housing (ERoSH)
• Margit Physant, Age Concern England
• Christine Russell, BAPEN
• Professor Alan Sinclair, Bedfordshire and Hertfordshire Postgraduate Medical School
• Vera Todorovic, Doncaster and Bassetlaw Hospitals NHS Foundation Trust
• Dr Lisa Wilson, International Longevity Centre
• Rick Wilson, King’s College Hospital NHS Foundation Trust

The Advisory Group’s work was supported by an unrestricted educational grant from the Infant and Dietetic Foods Association (IDFA).

3. Detailed calculations for the estimated cost to the public purse of disease-related malnutrition in the UK are included in the appendix of the attached report. The calculations in the appendix were prepared separately to the Advisory Group by Professor Marinos Elia and by Dr Rebecca Stratton, and discussed by the Advisory Group.

4. Professor Marinos Elia is available for interview. For all media enquiries, please contact Rhonda Smith, Minerva PRC Ltd, on +44 (0)1264 710428, +44 (0)7887 714957, or at

5. The report will be launched in Parliament on 10 February. A cross-party Parliamentary motion in support of the report is being tabled.

6. BAPEN (British Association for Parenteral and Enteral Nutrition) is the multi-disciplinary charity committed to raising awareness of and addressing malnutrition and its consequences and raising standards in nutritional care and treatment across hospital, care and community settings. BAPEN’s website is at:

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