Elderly 'left to starve' in NHS hospitals

Those who enter hospital malnourished can get worse during their stay or become malnourished under the care of NHS staff.

The report from the charity Age UK found almost one in three nurses believes their own relative could enter hospital with nobody noticing they were malnourished.

The charity found instances of food trays left out of reach of patients while those at risk of choking were not given pured food.

The charity has also heard of elderly people receiving no help with cutting food into smaller pieces or opening lids on containers.

Food trays are also sometimes taken away untouched without any questions, according to the report.

Patient groups and opposition politicians said an inquiry was needed to end rising "ageism" where elderly patients are entering hospital malnourished and getting worse under the care of NHS staff.

And campaigners called on the health secretary Nicola Sturgeon to personally investigate reports of "criminal" elderly malnutrition on NHS wards.

Margaret Watt, chairwoman of the Scotland Patients Association, said: "We would ask the health minister to have a look and do an independent inquiry and find out how many are dying from malnutrition.

"It's criminal that people are not being attended to. It smacks of ageism that patients are not being treated by some staff properly.

"Nobody in this day and age should die of malnurishment or suffer from it while in hospital. And if we are allowing that, then we should be charged with negligence.

"It's up to us, morally, to make sure these things don't happen."

Labour's health spokeswoman Jackie Baillie said: "Nobody in Scotland should die from malnutrition. The conclusions of this report are deeply concerning and I would add my own voice to calls for ministers to launch an urgent investigation to see what can be done."

The report found fewer than half of hospitals screen older patients for malnutrition on admission and only a third screen patients during their stay.

Just 5 per cent screen on discharge, despite evidence showing good nutrition both in and out of hospital helps people get better.

The report found many hospitals are largely ignoring guidelines which say people should be screened.

The accompanying survey of 1,000 nurses found fewer than half thought their workplace screens older patients often enough.

According to 71 per cent of nurses this is due to a lack of time, other priorities and training.

Ms Watt said a patient recently approached the association reporting her experience awaiting a hip operation.Although she could not move off her back, she was given a cup of tea to drink.

Ms Watt said while visiting the A&E herself on Friday, she witnessed an elderly woman in a wheelchair slumped into a sick bowl while being ignored by two technicians.

She added: "We know there are good staff and there's a lot more good than bad.

"If staff listen to patients, these things could be sorted, but to leave it lets the problems multiply."

UK figures for 2008-9 showed almost 180,000 patients left hospital malnourished, a number that has been rising, and 239 died of malnutrition during their stay in 2007.

Malnutrition is thought to cost the NHS 7.3 billion per year, affecting 23 per cent of people under 65, increasing to 32 per cent among the over-65s.

Michelle Mitchell, charity director at Age UK, said there was still more to do.

"It's extremely worrying that nurses still don't feel confident that a fundamental problem such as malnourishment will be picked up when an older person enters hospital," she said.

"While recognition of the issue is high, not enough is being done to ensure that words are transferring into action on the wards."

Dr Peter Carter, general secretary of the Royal College of Nursing, said compulsory screening for malnutrition would tackle the inconsistency between hospitals.

He said: "In order to achieve this, it is crucial that all the appropriate screening equipment and training is provided for health and social care workers to make nutrition a priority in their workplace.

"Of paramount importance is a comprehensive review of mealtimes so that these are clearly protected and considered a priority in terms of importance and dedication of staff time."

A Scottish Government spokeswoman said: "One death from malnutrition is one too many, which is why the Scottish Government has invested more than 1.75 million in malnutrition screening for patients, nutrition champions for each board and strict new hospital food standards.

"Hospitals have protected meal times - enforced by senior charge nurses - to make sure patients who need help with eating are properly cared for.

"Where ward staff are aware that a patient has difficulties, we expect them to help that patient to eat - something that can be especially valuable with older or vulnerable patients."