Preventing malnutrition in later life

Lambeth and Southwark

Area

Lambeth and Southwark are two densely populated boroughs in south London with a combined population of nearly 600,000. Lambeth has nearly 303,000 residents and Southwark around 294,000.

Both boroughs have relatively high levels of deprivation. The 2010 Index of Multiple Deprivation (IMD) places Southwark as the 41st most deprived local authority in England (out of 326) and the 12th most deprived borough in London (out of 33). Lambeth meanwhile was placed 29th in England and is the 9th Highest in London.

Aim

The pilot, known as the Lambeth and Southwark Action on Malnutrition Project (LAMP), aims to improve the detection and management of malnutrition across the two boroughs.

Participating organisations

The pilot is receiving funding from the Guy’s & St Thomas’ Charity.

The pilot team involves managers, clinicians and academics from across King’s Health Partners, one of only six Academic Health Science Centres (AHSCs) in England designated by the Department of Health.

The project is also supported by;

  • Lambeth Clinical Commissioning Group
  • Southwark Clinical Commissioning Group
  • Southwark and Lambeth Integrated Care (SLIC)

Progress (as of January 2015)

Raising awareness

  • Running road shows with Age UK Lambeth. Very important contacts with the community have been established as a result of the 20 road shows that took place between August and December 2014.
  • Created a page on a local online directory, signposting older people to food and nutrition services in the local area. See it here.
  • Hosted a multi-disciplinary conference in June 2014, which was attended by 71 delegates from a variety of health and social care agencies including the CQC, care homes, voluntary sector organisations, commissioners and Public Health England
  • Organising a conference which will be held in March 2015 (similar to the above one, but putting the focus on social care rather than clinical care around malnutrition)
  • Developing resources (booklets, information leaflets and training packages) for health and social care staff, aiming to help staff understand the problems of malnutrition. Also providing information about the detection and management of malnutrition to non-nutrition specialists, like social workers and district nurses
  • Achieved coverage about our work in the media, namely the South London press and a BBC afternoon programme
  • Have a presence on Guy’s and St. Thomas’ Charity website

Screening and care planning

  • Working with Southwark and Lambeth Integrated Care (SLIC) to design and test two different dietetic care models i.e. the one-to-one care model and the educator/facilitator model
  • Defining common care pathways for malnutrition across each borough including clear signposting to dietetic and other services and appropriate use of oral nutritional supplements
  • Promoting the use of the validated malnutrition screening tool, MUST
  • Training health and social care staff on detecting and first line managing malnutrition and when to refer for specialist support from a dietitian
  • Working with local voluntary sector organisations to promote detection of malnutrition. These include the Safe and Independent Living (SAIL) projects of Age UK Southwark and Lewisham and Age UK Lambeth
  • Training care home staff in detection and management of malnutrition

Co-ordinated care (i.e. facilitating communication and documentation regarding nutrition among community care providers)

  • Working with commissioning managers and contract monitors at local councils on the quality of nutritional care in care homes, meals on wheels and other council provisions
  • Included MUST in the Holistic Health Needs Assessment (conducted by GPs and practice nurses on older people through SLIC) and training will be provided to assessors
  • Will include MUST and dietetic referral forms on EMiS (GP electronic patient record system) and training will be provided to staff who will screen patients
  • Will include MUST and dietetic referral forms on RiO (community patient administration and record system) and training will be provided to staff who will screen patients

Measuring the impact of improving services to individuals at risk of malnutrition

  • Conducted baseline audits of nutritional care documentation in care homes, intermediate care and mental health services. To see information about the ‘care home’ part of this work, please click ‘Exploring documented nutritional care in older peoples’ care homes‘ – PDF Download.
  • Conducted focus groups to determine how health and social care staff currently detect and manage malnutrition and how ordinary citizens feel about service provision. For more information, please click ‘Exploring the perceptions and needs of citizens and healthcare professionals about malnutrition services – PDF Download
  • Conducted an audit of documentation relating to nutritional status and nutritional care on discharge from acute settings across Lambeth and Southwark
  • Defined outcome measures for the two different models of dietetic care
  • Designed data collection tools
  • Started to collect outcome data

Contact

For all enquiries relating to the project please contact:
Dr Elizabeth Weekes, Consultant Dietitian & Research Lead, Guys’ & St Thomas’ NHS Foundation Trust
Email: Elizabeth.weekes@gstt.nhs.uk
Tel: 0207 188 2014

Links

London Borough of Lambeth:

http://www.lambeth.gov.uk

London Borough of Southwark:

http://www.southwark.gov.uk

Guys and St. Thomas’s NHS Foundation Trust:

http://www.guysandstthomas.nhs.uk/Home.aspx

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Malnutrition Task Force
Tavis House
1 - 6 Tavistock Square
London WC1H 9NA

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