Of 543 adults screened on admission to mental health units, 19% of individuals were ‘malnourished’ (10% high risk, 9% medium risk). There was no significant difference in prevalence between acute units (16%), long-stay units (19%) and combined acute and long stay units (21%).

About 8 out of 10 units that participated in the 2011 survey reported that they had a screening policy in place. Over 90% of units audited their screening practice, mainly every year. Almost 40% of units had access to a nutrition support team and almost all units had access to nutrition and dietetic services.

65 out of the 67 units reported using a nutrition screening tool and of these ‘MUST’ was used in 75%. Local tools were used in 23% of centres that used a screening tool. Lectures / workshops either alone or in combination with other forms of training were the most commonly used format for training staff on nutritional screening. 10% of units reported receiving no training on nutritional screening.

All mental health units are asked to participate using the the BAPEN Nutritional Care Tool during four weeks throughout the year. Set an aim to complete the tool on all individuals in your care during these weeks;

The four weeks selected are:-

Week commencing 12th December 2016

Week commencing 13th March 2017

Week commencing 12th June 2017

Week commencing 11th September 2017

The more you use the tool, the better the quality of the dashboard it will produce; with this in mind, the gold standard would be to use this tool on a monthly basis to collect data over time.

In the BAPEN national nutrition screening weeks, malnutrition was found to be a major social health problem affecting 35% of care home residents; the majority of residents were high risk requiring treatment.

'MUST' was the screening tool of choice in the majority of care homes. The survey showed that there is room for improvement in key aspects of nutritional care, such as the awareness about the existence of weighing scale standards (only 56% reported awareness in 2011) and audits on nutritional screening; one quarter of care homes did not undertake audits on nutritional screening. It is also crucial to ensure that residents who are malnourished have an individualised nutritional care plan which is properly implemented. Monitoring residents nutritional care, including tracking weight and weight changes over time are also important. A key element of this tool is the resident experience section which will support care homes to ensure that residents are requiring sufficient support to meet their nutritional needs.

BAPEN has designed the nutritional care tool to be suitable for care homes and the tool had been extensively tested in care homes. Some care homes reported difficulties recording a residents diagnosis so we have added an option to 'opt out' of this question by selecting 'not available'.

The BAPEN nutritional care tool has been designed to support care homes to:
I) measure the quality of nutritional care provided
2) identify areas of best practice
3) highlight where variation exists between homes

All care homes are asked to participate during four weeks throughout the year. Set an aim to complete the tool on all residents during these weeks;

The four weeks selected are:-

Week commencing 12th December 2016

Week commencing 13th March 2017

Week commencing 12th June 2017

Week commencing 11th September 2017

Welcome to the BAPEN Nutritional Care Tool

NEWS: Four new data collection weeks have been agreed, starting in December 2016!  We found this to be the most effective way to get a volume of data that is really meaningful at a national level.  The weeks agreed are:

  • Week commencing 11th December 2017
  • Week commencing 12th March 2018 (Nutrition and Hydration week)
  • Week Commencing 11th June 2018
  • Week commencing 10th September 2018

Please don't let this put you off using the tool in-between these times, we want this tool be be useful to you in your context, no matter when you choose to collect!

Measuring Nutritional Care: screening, nutritional care processes, outcomes and patient experience

Every provider organisation is required by the Health and Social Act 2008 (Regulated Activities) Regulations 2014 (Regulation 14) to make sure the individuals in care have enough to eat and drink to meet their nutrition and hydration needs and receive the support they need to do so.  Individuals “must have their nutritional needs assessed and food must be provided to meet those needs. This includes where people are prescribed nutritional supplements and/or parenteral nutrition” (Source: CQC website)

Despite best efforts of many organisations and individuals, the costs associated with malnutrition, within the UK have continued to rise; a cost likely to continue to increase without a different approach. The personal cost to individuals and their families is also significant, with an increased mortality rate, increased admissions to hospital, increased pressure ulcers, falls and infections and an overall decrease in quality of life. Combating malnutrition in the UK remains a significant challenge requiring a mind-set shift in how we work together to find innovative solutions.

Why is there a need for a new measurement tool with a different approach?

We know from the national nutrition screening week data that the prevalence of malnutrition remains high (with 24-30% of patients admitted to a UK hospital malnourished or at risk of malnutrition). Whilst numerous nutrition initiatives (many of them national) such as ‘protected mealtimes’ and ‘Nutrition Now’ (Royal College of Nursing), and the publication of numerous standards, including the NICE guidance, have helped to raise the profile of nutrition, these figures show more has to be done, not just in hospitals but across a range of care settings.

Purpose and benefits of the BAPEN Nutritional Care Tool

Building on the work undertaken during the Nutrition Screening Weeks, which really helped create a country-wide picture of the prevalence of malnutrition in the UK, BAPEN has developed a new web-based Nutritional Care Tool which will enable organisations to monitor nutritional screening, the effectiveness of nutritional care they provide and patient experience. We appreciate that the complexities of delivering good nutritional care make measurement fraught with difficulty. However, we believe that measurement is key to delivering further improvements in the quality of nutritional care . We have therefore developed and tested a new measurement tool. This tool utilises quality improvement methodology (i.e. these data are intended to identify improvement opportunities within an organisation, not performance management or research). The tool therefore includes;

  • Process measures; screening and care planning
  • Outcome measures – weight loss (trackable over time for the duration of admission)
  • Patient experience measures of nutritional care received

The tool has been designed to complement the other work that BAPEN has previously undertaken.  BAPEN produces a wide range of tools, resources and guidelines designed to help healthcare professionals in hospitals, care homes and the community prevent malnutrition occurring when possible and treat it properly when it does occur.  BAPEN’s publications and resources are available on the BAPEN website.  Many are available to download as PDF files and some printed publications can be ordered online in the BAPEN online shop.

The BAPEN Nutritional Care Tool overview:

  • The Tool is free to all NHS and social care organisations
  • Completion takes approximately 5 minutes per individual. 
  • The data are instantly available to frontline teams to monitor care and deliver improvements.
  • Improvements in nutritional care can be delivered whilst the patient is still in your care
  • The Tool is completely voluntary so it is up to you how frequently you use it and the scale of use

Where next?

This site has everything you need to get started with using the BAPEN Nutritional Care Tool. You can review the data items collected here, and learn how to get your organisation set up on the data collection here.  If you have any issues please contact This email address is being protected from spambots. You need JavaScript enabled to view it.  for support.

Tell us what you think!

We're keen to hear about your experience of using this tool; click on the 'Feedback' menu item under 'Data collection' to complete our short survey (opens a new window).  Your feedback will be used directly by our developers to improve your experience of data collection!

Dr. Mike Stroud

Former BAPEN President