Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment the Government has made of the effectiveness of NICE clinical guideline CG32 on nutritional support for adults to tackle malnutrition.

The Government does not undertake reviews of the effectiveness of National Institute for Health and Care Excellence (NICE) guidelines. NICE is an independent body and has processes in place to review and update its guidelines as necessary.

NICE is responsible for publishing clinical guidelines for the National Health Service. ‘Nutrition support for adults: oral feeding, enteral tube feeding and parenteral nutrition’ (NICE Clinical Guideline 32) provides advice to the NHS to help identify patients who are malnourished or at risk of malnutrition, and was most recently reviewed by NICE in July 2017. Further information is available at the following link:

https://www.nice.org.uk/Guidance/cg32

In addition, NHS England published guidance for NHS commissioners in 2015 on improving the delivery and commissioning of nutrition and hydration care in acute services and the community. Further information is available at the following link:

https://www.england.nhs.uk/2015/10/guidance-nutritional-care/

Building on this guidance, further steps have been taken to support screening and recording of malnutrition in hospitals and other healthcare settings.

A 'Malnutrition Universal Screening Tool' has been developed by the Malnutrition Advisory Group. The tool is supported by governmental and non-governmental organisations, such as the Royal College of Nursing, and is the most commonly used screening tool in the United Kingdom. Further information is available at the following link:

http://www.malnutritionselfscreening.org/self-screening.html

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards of care, which must be met by all providers of health and adult social care. Regulation 14 of that Act relates specifically to meeting nutritional and hydration needs. During inspections of health and adult social care services, the Care Quality Commission (CQC) asks five key questions of all care services: are they safe, are they effective, are they caring, are they responsive to people’s needs and are they well-led?

Under the Effective key question, the CQC seeks to understand how services support people to ensure that they eat and drink enough to maintain a balanced diet. If a malnourished patient presents at hospital, the CQC would expect a hospital trust to record it as a primary or secondary diagnosis in the Hospital Episode Statistics database and a safeguarding alert to be made, as well as a referral to a dietician.