A National Assembly committee has described as ‘intolerable’ delays in implementing measures to improve patient nutrition and hydration in hospitals across Wales.
The Public Accounts Committee identified a lack of leadership at the highest levels to explain why recommendations in a report by its predecessor in 2011 had still not been implemented.
The Committee said a Wales-wide approach was essential in providing patients with appetising and nutritionally balanced diets to help speed up their recovery from illness or injury.
But Members found that they could not identify one director on Welsh health boards as being responsible for ensuring quality patient nutrition and hydration.
Members were exasperated to learn that a lead nurse specialist had not been appointed by NHS Wales to establish an ‘All-Wales Nutritional Care Pathway’, and that one may not be appointed for another three years.
Members pointed out that this would mean almost a decade would have passed since the Committee’s predecessor made a recommendation to that effect in a report published in 2011.
The ‘All-Wales Nutritional Care Pathway’ would standardise an approach to patient nutrition by focusing on their needs at the point of entry, taking into account factors such as dietary requirements and religious beliefs.
An all-Wales IT system to help support the pathway has still not been procured. Again, the Committee was told delays had prevented its delivery, and that several health boards had come up with their own solutions.
Continuing the theme of a lack of leadership, the Committee was concerned at the disparity between patient satisfaction survey results produced by Welsh health boards, and the more personal experiences given to friends, relatives and even Assembly Members themselves. They want to understand why there is such a difference in views.
Staff training was identified as a problem area for many health boards. Although training in patient nutrition is seen as mandatory, many staff had not undertaken it due to lack of opportunities, time pressures or other priorities.
“Hospital catering and patient nutrition is a key element in ensuring that people make a full and healthy recovery while in hospital,” said Nick Ramsay AM, Chair of the Public Accounts Committee.
“During our evidence session, the Chief Nursing Officer stressed that 'nutrition and hydration are one of those things that, to be frank, is almost as important as the medication that people receive'.
“We found a story of a distinct lack of leadership, stagnant activity and frustratingly slow progress in a number of important areas.
“Although there are some positive results, key elements of the original report from 2011 have still not been implemented.
“It is entirely unacceptable that almost a decade will have passed before these matters are resolved and patients receive efficient and effective meal services that provide the basics of appetising and nutritious food and water to remain hydrated.”
The Committee makes 10 recommendations in its report, including:
- That the Welsh Government makes public the results of future all-Wales patient surveys in a timely fashion;
- That the Welsh Government works with health boards to develop and put in place the most effective methods for delivering training including consideration of e-learning, and group training;
- That a review of workforce planning arrangements within the NHS Wales Informatics Service is undertaken to ensure that future vacancies or gaps in resources do not cause significant delays to key work streams; and
- That the Welsh Government revise the target for reducing food waste to challenge the health boards to minimise waste and maximise savings.