Improving nutrition and hydration through creative and innovative solutions

Malnutrition Task Force member Caroline Lecko tells us all about the great work taking place in the National Nursing Quality Improvement team at NHS England and NHS Improvement.

I am a registered nurse working with the National Nursing Quality Improvement team at NHS England and NHS Improvement. The nursing quality improvement team aim to motivate, inspire and unlock the potential of staff at all levels to improve people’s quality and experience of care, and staff experience, by supporting the development of clinically led creative and innovative solutions.

The main part of my role involves supporting my colleagues to improve the provision of nutrition and hydration for the people in our care using quality improvement techniques and tools.

You may have already heard about the number of people in our country that are either at risk of malnutrition or malnourished. I do think it’s worth repeating.

In Britain, malnutrition affects 3 million individuals, which totals nearly 5% of the entire population.  I do sometimes struggle to put these numbers into context and then I remind myself that this more than the total population of some of the countries that people visit for their holidays. Quite a sobering thought.

Moreover, the prevalence of malnutrition is estimated to be just over 33% among adults over the age of 65 and 25% among adults under the age of 65 on hospital admission. For these people the clinical consequences of malnutrition, have the potential to result in increased hospital admissions, readmissions, longer length of stay, and greater healthcare needs in the community, including more frequent GP visits.

This can have a significant impact on someone’s quality of life and cost our healthcare systems a lot of money.

Given the high prevalence of malnutrition and potential to realise savings through improved nutrition care, we really do need to identify the optimal approaches to quality measurement and improvement.

Over the last eighteen months, or so, I lead a nutrition quality improvement programme with 41 volunteer NHS organisations.

A range of trusts volunteered to take part from different care settings including acute, community, mental health and integrated trusts, and many of the trust’s teams included representatives from nursing, dietetics, speech and language therapists, catering managers, doctors and quality improvement leads.

It was brilliant to have these multi-professional teams from such a range of different organisations.

What these teams achieved over a short period of time was so amazing. You can find out more at

I have also had the opportunity to work with an amazing group of dietitians to develop some resources to raise awareness of the role that nutrition plays in the prevention and management of pressure ulcers. We have developed some evidence based Top Tips, case studies and practical guidance to support clinical care using EAT – evidence, assessment, take action. You will find all of these resources and more on the NHS Improvement website at

We also collaborated with our colleagues at the British Dietetic Association to produce a Pressure Ulcers Food Fact Sheet which is packed full of helpful information which can be shared with patients, service users and carers. This is available at

Over the coming months I am hoping to continue to develop resources to support the delivery of high-quality nutritional care. So, as they say watch this space……