Based on the demographics from the ‘Integrated Care for Older People in Salford‘ document, Salford has a population of 35,000 over 65 years of age. The BAPEN commissioning toolkit suggests 14% of this age group may be at risk of malnutrition – this is almost 5,000 people in Salford.
The ‘Integrated Care…’ document further states that in excess of £100 million per annum of health and social care expenditure in Salford relates to older people, which will increase substantially as the population becomes older. The number of older people is forecast to rise by 28% by 2030, from 35,000 to 43,300.
This pilot is a unique opportunity to work in collaboration with local organisations to raise awareness of malnutrition in the elderly population.
The pilot quickly gained support from the Salford Integrated Care Programme (ICP), an organisation designed to improve health and care for older people. With its access to a variety of multi-agency partnerships and work-streams across the city and strong links with both the third and private sector, this is a useful organisation to have ties with. The ICP have created a fictional older woman, ‘Sally Ford,’ who’s needs will be taken into account as they work to tailor solutions to malnutrition:
More information about the ICP can be found here.
- Raising awareness across the community
- Developing Sally Ford Standards for nutritional care
- Ensuring good nutrition and dysphagia education
- Working with primary care regarding prescribing of oral nutritional supplements and sip feeds and raising awareness of the signs of malnutrition for staff and patients
- Age UK Salford
- Salford Royal NHS Foundation Trust
- Salford Commissioning Care Group (CCG)
- Salford City Council
- Greater Manchester West
- Salford Integrated Care Programme (ICP)
Projects undertaken (updated February 2017)
1. The Paperweight Armband
A paper armband was created that can determine whether someone is at risk of malnutrition, depending on how freely the armband can move up and down the upper arm.
As of 2017, the Armband is now being used in different areas of the UK including in Hampshire. In 2016, the University of Southampton carried out an evaluation of the Armband as a malnutrition screening tool in Hampshire. The evaluation shows us that the Armband is easy to use and good at raising awareness of malnourishment in individuals, but it is sometimes incorrectly applied and people are not always signposted or referred to further services if they are found to be at risk.
2. Raising awareness amongst older people across the community
Post cards and fridge magnets
Awareness of malnutrition was raised through post cards and fridge magnets which were shared with older people in the Salford community. On the postcards and fridge magnets were ‘simple messages’ about malnutrition – i.e. symptoms and tips to combat it. The Salford team arranged with a local café to provide free cake and coffee when an older person showed the postcard.
The funding for the printing and design of the postcards and fridge magnets came from a successful application by Inspiring Communities Together to the ‘Little Pot of Health Innovation Fund’ (an income generating community anchor organisation).
Altogether, 1000 post cards and fridge magnets were produced and distributed to older people and GP surgeries across Salford.
Created colourful information displays and posters to put up in GP practices across the city with information about natural alternatives to prescribed supplements.
Age UK Salford and dietetic assistants carried out shopping tours for older people in local Asdas and Morrisons in Swinton and Eccles. Floor plans and isle information of these local supermarkets were drawn up and given to older people.
These supermarkets were picked as they are in areas which have the largest population of older people in Salford.
Age UK Salford are continuing to run the shopping trips on an individual basis.
New diet sheets, written by older adults, dieticians and speech and language therapists, are now available for hospital and community use on the Salford Royal NHS Foundation Trust website.
3. Developing Standards for nutritional care
MUST, the tool that can identify those at risk of malnutrition, can now be used electronically at Salford Royal NHS Foundation Trust. This enables automatic calculation of weight loss and BMI.
A new catering strategy
A catering strategy is being implemented at Salford Royal NHS Foundation Trust. This sees a locum dietician working on analysing hospital menus to ensure the Salford Royal NHS Foundation Trust meets new EU legislation regarding allergens.
Making use of NICE standards
NICE standards on nutrition have been included in Salford’s Residential and Nursing Care Homes Service Specification. This means all Salford residential and nursing care homes must comply with regulations like “offer a choice of food and drink that meets nutritional and personal requirements” and “provide assistance to eat and drink” for everyone in their care.
4. Nutrition and dysphagia education
To increase knowledge, a 50 minute e-learning and assessment package on nutrition and dysphagia was created for healthcare staff across Salford.
Elsewhere, 10 GP practices with the highest SIP prescribing were identified. Community dieticians worked with these practices to reduce their spend on sip prescribing with a ‘food first’ approach. This has saved £200,000 so far and weaned some people off SIP who had been on it for over 10 years.
5. Launch information
This project was launched in 2014.
During Nutrition and Hydration week in March 2014, the project was promoted through leaflets and posters were displayed at all Age UK Salford services and reception points. Over 200 older people responded to a survey on eating well in later life and the results went towards informing Salford’s work. As an example, when asked ‘If you did find yourself losing weight without intending to – please tell us what you would do,’ 70% said they would go to their GP, suggesting that more effort is needed to help older people in the community understand about healthy eating in older age and what they could do to increase their weight and appetite (see ‘Understanding the views of older people in relation to malnutrition‘ -PDF Download).
A launch day for the project was held on the 21st May, organised by the Age UK Salford team with over 80 people attending from across Salford healthcare. Knowledge was shared on what is currently happening in Salford and their views as to areas where improvements could be made. This gave clarity on the next steps.
If you would like to know more about the work in Salford, please contact Jean Rollinson at Age UK Salford on 0161 788 7300 or e-mail firstname.lastname@example.org.
Other projects in the local area
‘Hospital Discharge, Aftercare and Reablement Service‘ (PDF Download) – An overview of Age UK Salford’s Hospital Discharge, Aftercare and Reablement Service. This offers support to patients and their families from the point of entry to the Emergency Village at Salford Royal Hospital Foundation Trust, to discharge support up to six weeks after a patient has returned home.