Preventing malnutrition in later life

NHS England launch new Guidance: Commissioning Excellent Nutrition and Hydration

NHS England today launch new guidance for commissioners on commissioning for the nutrition and hydration needs of their population and delivering excellent nutrition and hydration care in acute services and the community.

The aim of the guidance is to support commissioners to address these issues and develop strategies to improve local services.

The Malnutrition Task Force will be taking a lead role in supporting the rollout and dissemination of the guidance.

Malnutrition and dehydration are both causes and consequences of illness, have significant impacts on health outcomes and should be integral to all care pathways. But as recent Reports have shown, this isn’t always the case, with the likes of the Francis Report and a recent report from the LSE(1) highlighting that patients in community and healthcare settings often receive inadequate nutrition and hydration.

Through the guidance, NHS England’s vision is to ensure:

All people will receive safe and high quality nutrition and hydration support when required, through the commissioning of person-centred and clinically effective integrated services in the community and in health care commissioned settings.”

The guidance outlines:

  1. Why commissioners should make nutrition and hydration a priority
  2. How to tackle the problem
  3. How to assess the impact of commissioned services
  4. How commissioners have begun to tackle the problem via commissioning
  5. Further resources to help commissioners address the issue

Please click here to read ‘Guidance – Commissioning Excellent Nutrition and Hydration 2015-18

Jane Cummings, Chief Nursing Officer for England, said:

 “The link between nutrition and hydration and a person’s health is a fundamental part of any stage of life, but all the more so for the sick or vulnerable. Person-focussed, quality compassionate care involves looking at what matters to a person as a whole, not only concentrating on their specific medical condition. This document draws together resources and research which will stimulate thinking about and approaches to the central role of nutrition and hydration in caring for people.”

 Suzanne Rastrick, Chief Allied Health Professions Officer, NHS England, said:

“This is a practical guide, not only for commissioners but also for providers and other key stakeholders including service users. It will encourage local dialogue to improve nutrition and hydration and as a consequence realise other important benefits such as reducing risk of falls and making best use of nutritional supplements. It emphasises a person-centred approach and helpfully gathers together the evidence.”

Dianne Jeffrey, Chair of the Malnutrition Task Force and Chairman of Age UK  said:

 “There are countless reasons why we need to take nutrition and hydration issues seriously. People, particularly older people, who are malnourished and dehydrated are more likely to become ill, will take longer to recover from surgery and illness and have longer stays in hospital. Yet despite these compelling reasons to take action, recent reports still show nutrition and hydration are not a top priority in many care settings.

 “So I’m delighted today to see the new guidance from NHS England which puts nutrition and hydration at the heart of good health and care where it belongs, supporting commissioners to deliver compassionate, person-centred and clinically effective nutrition and hydration services. Getting this right for the millions of people at risk of malnutrition and dehydration or who need help with eating and drinking is vital. After all it’s only what we would want for ourselves or a loved one.


There are a number of presentations we have produced in conjunction with the guidance. Please feel free to use them.

  1. General overview of commissioning guidance –Aimed at commissioners summarising the guidance. Please feel free to present from these slides.
  2. A practical example of implementing the guidance How Salford implemented good nutrition and hydration practice and services in their local area
  3. Measuring data – How you can use a BAPEN tool to measure the quality of nutritional care delivered. Please note, we have temporarily taken these slides down. They will be available again in due course so please check back soon.


For more information on the Guidance, please contact: Siobhan Lendzionowski, Leadership Support Manager – Patient Experience at NHS England on or Lesley Carter, Programme Manager at Malnutrition Task Force on

(1) Older people’s experiences of dignity and nutrition during hospital stays: Secondary data analysis using the Adult Inpatient Survey – Tania Burchardt and Polly Vizard


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