Huge rise in hospital beds in England taken up by people with malnutrition

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Critics blame three-fold rise on poverty, cutbacks to meals on wheels services for the elderly and inadequate social care

 

The number of hospital beds in England taken up by patients being treated for malnutrition has almost trebled over the last 10 years, in what charities say shows the “genuinely shocking” extent of hunger and poor diet.

Official figures reveal that people with malnutrition accounted for 184,528 hospital bed days last year, a huge rise on 65,048 in 2006-07. The sharp increase is adding to the pressures on hospitals, which are already struggling with record levels of overcrowding.

Critics have said the upward trend is a result of rising poverty, deep cutbacks in recent years to meals on wheels services for the elderly and inadequate social care support, especially for older people.

Jonathan Ashworth, the shadow health secretary, unearthed the figures in a response to a recent parliamentary question submitted to the health minister Nicola Blackwood.

“These figures paint a grim picture of Britain under the Conservatives,” he said. “Real poverty is causing vulnerable people, particularly the elderly, to go hungry and undernourished so much so that they end up in hospital.

“Our research reveals a shocking picture of levels of malnutrition in 21st-century England and the impact it has on our NHS. This is unacceptable in modern Britain.”

The Department of Health figures showed that the number of bed days accounted for by someone with a primary or secondary diagnosis of malnutrition rose from 128,361 in 2010-11, the year the coalition came to power, to 184,528 last year – a 44% rise over five years.

Such patients only account for one in 256 of all hospital bed days, or 0.4% of the 47.3m total, but the financial cost is considerable as each bed costs the NHS an average of £400 a day to staff and given the condition each spell in hospital because lasts an average of 22 to 23 days.

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Simon Bottery, the director of policy at the charity Independent Age, said: “These new figures on malnutrition are genuinely shocking. As a society there is no excuse for us failing to ensure that older people are able to eat enough food, of the right quality, to stay healthy.

“Yet we have been cutting back the meals on wheels services and lunch clubs on which so many vulnerable elderly people relied and reducing the numbers who receive home care visits.”

Freedom of information requests submitted to local councils in England early last year by the then shadow care minister Liz Kendall found that 220,000 fewer people were receiving meals on wheels in late 2014 than in 2010, a fall of 63%.

Research by the National Association of Care Catering found that only 48% of local councils still provided meals on wheels, compared to 66% in 2014. Only 17% of councils in the north-west of England still do so, and 91% of providers expect the provision to fall further in the next year.

The National Institute for Health and Care Excellence classes someone as malnourished if they have a body mass index of less than 18.5, have suffered the unintentional loss of more than 10% of their weight over the last three to six months, or if they have a BMI under 20 and have unintentionally seen their weight drop by more than 5% over the previous three to six months.

The decision by the chancellor, Philip Hammond, not to give the NHS or social care any more money in his autumn statement last week would only worsen the situation, Ashworth said. “The reality is the government have failed this week to both give the NHS and social care the extra investment it needs while also failing to invest in prevention initiatives to foster healthier lifestyles. The cuts to public health budgets along with an emaciated obesity strategy are both utterly misguided,” he said.

Figures are not available for exactly how many patients accounted for the 184,528 bed days last year, but information supplied to Ashworth by the House of Commons library shows that 57% of the patients were women and that 42% were over-65s.

Worryingly, four out of five people who needed inpatient hospital care because of malnutrition were admitted as an emergency, which suggests their health had deteriorated significantly in the days before they were taken in. Not enough health and social care professionals have the time or knowledge to correctly identify malnutrition, Bottery said.

Dianne Jeffrey, the chair of the Malnutrition Task Force and Age UK, said: “If malnutrition is left untreated older people can become much more susceptible to illness and injury, are more likely to end up in hospital and on average take much longer to recover if they do become unwell.

“It is shocking that in modern times over a million older people across the UK are malnourished or at risk of malnutrition.”

A Department of Health spokesperson said: “The NHS is getting much better at spotting malnutrition and giving early treatment, and we are improving our data collection, all of which helps explain what might otherwise appear a significant rise in cases. But importantly, to prevent cases in the future, we have given £500,000 to Age UK to help reduce malnutrition among older people and will continue to train staff so early action can be taken.”

Stephen Dalton, the chief executive of the NHS Confederation, which represents hospitals, said: “Our members take malnutrition seriously. Good nutrition is a fundamental human right our citizens can expect, and vulnerable, particularly older, people are most at risk of serious consequences if denied basic compassionate care. At a time of unprecedented demand on health and social care we need to be alert and will take seriously any reliable evidence of basic care not being delivered.”

This article was amended on 29 November 2016 to correct a percentage increase. The number of bed days accounted for by someone with a primary or secondary diagnosis of malnutrition rose by 44% over five years, not 61%.

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