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Hospitals accused of starving patients: Nutritional deficiencies 'increasing NHS costs'

HOSPITAL patients are being starved because of lack of attention to their nutritional needs, experts said yesterday. As a result they take longer to recover and their care costs more.

One in 10 patients is malnourished, and if broader criteria for malnutriton are used the percentage is 40, Professor John Lennard-Jones, a leading gastro-enterologist, told a seminar in London.

Loss of appetite and difficulty in eating were common with illness, he said, but the problems were not fully appreciated by doctors or nurses. 'If someone becomes ill, all their symptoms are put down to their illness but many may be due to malnutrition.'

He said that everyone tended to assume that the weight loss in a cancer patient was caused by the cancer when it was partly to do with not receiving proper nutritional support.

Professor Lennard-Jones is chairman of the British Association of Parenteral (through a vein) and Enteral (directly to the gut) Nutrition, which is calling for the nutritional status and needs of all patients to be assessed when they are admitted to hospital.

Last year, a King's Fund Centre report found that pounds 266m a year could be saved from the NHS bill if malnutrition in patients was avoided. But only a third of hospitals have nutrition teams.

Dr Simon Allison, consultant physician at Queen's Medical Centre, Nottingham, said that a hospital could save a great deal of money by providing proper nutrition management. 'In the absence of a nutrition team, 28 per cent of patients fed intravenously develop septicaemia. Expert teams reduce the complication to under 3 per cent. It has been calculated that the prevention of 16 episodes of such infection may save pounds 25,000 to pounds 80,000 per year.'

He said that nutrition management was where kidney treatment was 30 or 40 years ago.

Good nutrition will keep very ill people alive for longer, and modern nutritional support raises ethical questions. But his calculations show that in terms of recovery and quality of life, nutritional support is good value for money.

Patients who are able to digest their food but unable to eat normally can be fed via the nose directly into the stomach or bowel. Patients who cannot digest their food can be fed through a vein.