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PLUS: Diary Dates, Core Group Updates and much more...s

Issue No. 50 August 2008

Council Matters

BAPEN ‘Malnutrition Matters’Conference 2008

Committee Group Updates

Nutrition InformaticsA vision for the future

Welcome

Chairman’s Report...

PROFESSOR MARINOS ELIA,

HONORARY CHAIRMAN

I begin this issue of In Touch by offering a warmwelcome to Mike Fryer and Faye Eagle of CompleteMedia & Marketing Ltd. (CM2), who are nowmanaging the production of In Touch for BAPEN.Complete Media and Marketing Ltd (CM2), is not newto nutrition. Indeed, it is dedicated to medical, healthand functional nutrition, and has grown rapidly sinceMike established the company in 2000. Amongst itspublications is Complete Nutrition, which many of youwill know, and now has a readership of over 12,000 inthe UK. Further information about CM2 can be foundat www.nutrition2me.com. If you have suggestionsabout articles or the future direction of In Touch,please let us know (Faye Eagle would be particularlyinterested in hearing from you - [email protected];Tel: 01992 538001; Fax: 01992 538002).I take this opportunity to mention some other recentdevelopments associated with BAPEN’s fight against malnutrition.Earlier this year, I signed, on behalf of BAPEN, anagreement with the Secretary of State for Health(Connecting for Health) to allow the ‘MalnutritionUniversal Screening Tool’ (‘MUST’) to be incorporatedinto the NHS National Programme for IT. In this waythe ‘MUST’ can become available to all NHS staff inthe UK, the Isle of Man and the Channel Islands (andpotentially also to staff working for our armed forcesabroad). It is hoped that the software will becomeavailable later this year. BAPEN will be happy toadvise on specific issues, as required. ChristineRussell and Vera Todorovic, have already been amajor help in facilitating the process with theDepartment of Health. The increasing popularity ofthe ‘MUST’ has probably occurred because it can beused on all types of patients in all care settings by avariety of healthcare workers. It links clinical withpublic health nutrition, primary with secondary careand nutritional screening with nutritional care. With the reorganisation of the health and socialservices in England there are opportunities topromote malnutrition so that it becomes embeddedin the infrastructure of the new system. Amongst theproposed changes in the NHS are the amalgamationof the Healthcare Commission, the Commission forSocial Care Inspection, and the Mental Health ActCommission to form the Care Quality Commission,the Darzi reorganisation of the NHS, which includesthe controversial polyclinics, and Vital Signs, a threetier system of PCT priorities in the NHS. BAPEN hasresponded to a consultation on the Care QualityCommission, which had already considered aspectson nutritional care. Little or no consideration appearsto have been given to malnutrition by governmentalagencies concerned with the other two proposeddevelopments. For this reason, in June 2008 a roundtable discussion amongst a range of experts onmalnutrition from different backgrounds took place

to summarisethe clinical,economic andpolitical status ofmalnutrition in theUK. A report targetingparliamentarians and other health planners isexpected to be launched later this year. We aregrateful to the Infant and Dietetic Foods Associationfor providing BAPEN with an unrestricted grant toallow this development to occur.At the centre of BAPEN’s activities are patients andtheir carers. However, their voices are often not heard,or not heard loudly enough. For this reason BAPENarranged another round table discussion at thebeginning of July so that the voices of a wide range ofpatient/carer representatives of organisations could beheard. They perceived malnutrition to be common,that problems associated with treatment are alsocommon, and, as expected, a wide range ofsuggestions were made to improve nutritional care indifferent care settings and during the patient journeyfrom one care setting to another. A report of thismeeting is also expected to be launched later this yearand to complement our other report on politicalopportunities for improving nutritional care.In the meantime, BAPEN continues to gather nationaldata in its fight to combat malnutrition. Some data arespecific, for example, those from the British ArtificialNutrition Survey (BANS), which have helped establishstrategic proposals for specialised services such ashome parenteral nutrition services (see recent report[April 2008] ‘A Strategic Framework for IntestinalFailure and Home Parenteral Nutrition Services forAdults in England) which can be downloaded from theweb (www.nscteam.org.uk/ifstrategy.htm). Otherdata are of a more general nature, such as thoseassociated with detection and prevalence ofmalnutrition. These have helped establish strategicplans, including those indicated in the government’sNutrition Action Plan (Improving Nutritional Care2007). In July, BAPEN and collaborators conducted the2008 Nutrition Screening Week survey but the datastill have to be analysed. The implications of the 2007survey are summarised in a report which can bedownloaded from the BAPEN website(www.bapen.org.uk), as well as in an editorial in theAugust issue of Clinical Medicine (volume 8, issueNo.4, p.364-5). My thanks to all those involved in alltypes of data collection for BAPEN.One of the future challenges is integration of allthese and other nutritional activities undertaken byBAPEN and other organisations and agencies so thatthere can be a smooth transition and consistencyalong the delivery chain, from ministers to patients. Ihope that BAPEN can have a role in this importantand difficult task that faces us.

British Association for Parenteral and EnteralNutrition A multi-professional association and registered charityestablished in 1992. Its membership is drawn fromdoctors, dietitians, nutritionists, nurses, patients,pharmacists, and from the health policy, industry, publichealth and research sectors.

Principal Functions

• Enhance understanding and management of malnutrition.

• Establish a clinical governance framework tounderpin the nutrition management of all patients.

• Enhance knowledge and skills inclinical nutritionthrough education and training.

• Communicate the benefits of clinical and cost-effective optimal nutritional care to all healthcareprofessionals, policy makers and the public.

• Fund a multi-professional research programme toenhance understanding of malnutrition and itstreatment.

The Newsletter of the British Association forParenteral and Enteral Nutrition.

Printed version: ISSN 1479-3806.

On-line version: ISSN 1479-3814.

All contents and correspondence are published at thediscretion of the editors and do not necessarily reflectthe opinions of BAPEN. The editors reserve the right toamend or reject all material received. No reproduction ofmaterial published within the newsletter is permittedwithout written permission from the editors. BAPENaccepts no liability arising out of or in connection withthe newsletter.

BAPEN is a Registered Charity No: 1023927.

Tackling malnutrition from multiple directions

Contents:

BAPEN Membership 2

What’s New 3

Media Matters 6

Nutrition Informatics 7

Core Group Updates 9

Commitee Group Updates 11

Council Matters 12

Dairy Dates 13

BAPEN Contacts 14

BAPEN Conference 15

1 BAPEN In Touch No.50 August 2008

How to join BAPEN if you are not a member of a Core Group

Visit www.bapen.org.uk to join online/ download an application form or contact the BAPEN Office on:Tel: 01527 457850 Fax: 01527 458718Secure Hold Business Centre, Studley Road, Redditch,Worcs, B98 7LG

How to join BAPEN if you are a member of a Core Group

If you are a member of the following Core Groups you are entitled to join BAPEN at a substantially discounted rate, pleasesee details below:

BAPEN Medical – For further information visit: www.bapen.org.uk/abt_med.html, where you can register online ordownload an application form

BPNG – You can join both the BPNG and BAPEN at the same time by visiting: www.bapendatabase.org.uk/bpng_registration_1.php or join BAPEN directly by registering online via: www.bapen.org.uk or contacting the BAPEN office.

NNNG – Members are asked to join BAPEN directly by registering online via: www.bapen.org.uk or contacting theBAPEN office. For further information, please email: Jane Fletcher, NNNG Secretary: [email protected]

PENG – For further information, visit: www.peng.org.uk, where you can download an application form

BAPEN MEMBERSHIP HAS CHANGEDDon’t miss out…join BAPEN now…During the last year a number of changes have been introduced which

affect how you become a member of BAPEN.The details belowexplain the benefits of being a member of BAPEN

and how to become one.

There are two levels of BAPEN membership. A full membership is either acquired by registeringdirectly on the BAPEN website, or by paying a small ‘extra’ when joining one of the core groups(see below). An affiliate membership is a member of a core group but without specificallyelecting to be a full member of BAPEN.The table below explains the differences in benefits.

Core Group Member – Full BAPEN Member Affiliate Member of BAPEN

BAPEN Conference reduced delegate fee X a

Eligible to vote at BAPEN AGM X a

BAPEN Regional meetings reduced delegate fee X a

BAPEN website members access X a

In Touch E News a a

In Touch print X a

ESPEN reduced membership fee X a

ESPEN reduced Congress fee X a

Personal copy of Clinical Nutrition X a(via ESPEN Membership)

2BAPEN In Touch No.50 August 2008

What’s New

• NEWS • NEWS • NEWS • NEWS • NEWS • NEWS • Keeping you up-to-date with the latest news, views, reviews & developments

Highlights from the North East Thames Regional

BAPEN MeetingAndrea Cartwright, Nutrition Nurse Specialist

The inaugural meeting of North East Thames BAPEN was held at the Education Centre, QueensHospital, Romford. This is an impressive new hospital, with excellent facilities for meetings. Themeeting was supported by Calea, Fresenius Kabi, BBraun and Nestlé, who all exhibited in the socialarea and financially contributed to the refreshments and evening buffet, so a big thank you to them.

The meeting was organised by JeremyNightingale (Regional Representative) andSheena Visram (Secretary and Treasurer),with a little help from me (never put me incharge of catering again!). The aim of themeeting was to provide the opportunity tonetwork with colleagues from within ourarea, and to stimulate discussion aroundnutrition support issues. This was achieved;so thank you to them for organising the day.Jeremy Nightingale opened the meeting byshowing us that the North Thames area waslarge, and included all London Hospitalsnorth of the Thames and extended north toLuton, Colchester and east to Southend.Within the region the group aims to improvethe nutritional care of patients and to raiseawareness about malnutrition in those careworkers who are currently unaware (i.e.preach to the non-converted). Dr RodneyBurnham, Consultant Gastroenterologist andPhysician at Queens Hospital and Registrar tothe Royal College of Physicians, started theafternoon with a look at nutritional care inhospital and beyond. Queens Hospital hashad a Nutrition Support Team since 1987,one of the first in the country, and areresponsible for stimulating many doctors’and nurses’ interest in nutrition support(Jeremy Nightingale and myself included).

I gave a talk on the importance ofnutrition screening, and described thebarriers experienced by staff on the wards toprovide effective screening. From my recentexperience on the ward, I was able to show

that the forms a nurse has to complete toadmit a patient may take 45 minutes to do. Ialso gave a brief overview of the results fromNutrition Screening Week 07.Sarah Zeraschi, Nutrition Pharmacist fromBasildon Hospital, followed with a practicaldemonstration of the problems of drug-nutrient interactions. We were suitablyimpressed by the solid mass that forms whensucralfate and an enteral/oral sip feed aremixed together.

Justine Bayes (PINNT Secretary) gave aninteresting talk from the patient view point,before Professor Alistair Forbes presented twointeractive case studies to get the ‘little greycells’ working, and stimulate debate amongstthe audience. Case studies always go downwell, and help to build practical knowledge ina ‘safe’ environment.

As the afternoon became evening,Professor Powell-Tuck finished the day with afew slides (should I say quite a few slides!)discussing malnutrition, problems withrefeeding, salt and fluid balance, linking themnicely to some of the work he did when DavidBlaine came out of his box!

There was something for everyone, andtime over supper to make acquaintances. We hope to organise another meeting forearly 2009, so keep an eye on your inbox ifyou are registered with North East Thames Regional BAPEN or email Sheena on:[email protected] if you want tobe notified.

Speakers Front row (L - R): Justine Bayes, Andrea Cartwright, Sarah Zeraschi , Sheena Visram. Back row (L -R): Alastair Forbes, Jeremy Powell-Tuck, Rodney Burnham, Jeremy Nightingale

BAPEN Appoints NewPublishing Partner...

CM2, the company behindtitles such as CompleteNutrition Magazine, hasrecently been appointed byBAPEN as publishing partner.

Charged with working closely with BAPEN tomanage, produce and take forward their printand online member publications, CM2 are nowresponsible for the production of ‘In Touch’ and‘BAPEN News’ . As you have no doubt noticed, this newpartnership is already producing results, withthe last issue of ‘BAPEN News’ and this issue of‘In Touch’ sporting new, fresh and dynamic looks,which we very much hope you like.CM2 specialise in nutrition publishing for healthprofessionals and in addition to producing theirown titles, have extensive experience workingwith, and producing publications for nutritionAssociations around the world.Commenting on the new appointment, Mike Fryer, MD of CM2 said:“We’re delighted to have been chosen to workwith BAPEN to help take forward their keymember publications. I think that the combination of CM2’s knowledgeof nutrition publishing, and BAPEN’scommitment to furnish their members with greatnutrition information and unrivalled support, willproduce great results. We will be working hard toensure that the work we do supports BAPEN’score aims whole-heartedly”CM2’s publisher, Faye Eagle, will be managing theproduction of ‘In Touch’ and ‘BAPEN News’. Yourthoughts about this issue andsuggestions on what youwould like to seeincluded are verywelcome. Please email: [email protected] call: 01992 538001

Mike Fryer Faye Eagle


The NHS Core Learning Unit has recentlylaunched the ‘Food Nutrition and Hydrationand Social Care’ online training programme.The two hour programme is aimed at nurses,carers, health care assistants, care assistantsand volunteers in the Health and Care sector.The programme is part of the NutritionAction Plan and is designed to supportexisting initiates by bringing together keytools, techniques and best practice.

Debates about food in care settings havebeen raised time and time again. The clinicalimportance of nutrition was recognised byFlorence Nightingale back in 1859:

“Every careful observer of the sick willagree in this that thousands of patients areannually starved in the midst of plentyfrom want of attention to the ways whichalone make it possible for them to takefood... have a rule of thought about yourpatient’s diet, consider, remember howmuch he has had and how much he oughtto have today.”

Yet malnutrition and dehydration still remainprevalent in today’s health and care sectors.And with about 40% of new admissions tohospital judged to be malnourished and afurther 10% of people being cared for in thecommunity in a similar state, it’s an issue thatneeds urgently addressing. Whatever thereasons, many service users are notconsuming food, enough food, or the righttype of food. This has significant healthimpacts and also undermines the dignity ofthe people involved.The online training programme aims to:• Increase understanding of the importance

of nutrition and hydration as essentialingredients of life

• Help recognise why people becomemalnourished and/or dehydrated incare settings

• Identify practical ways for carers toensure that patients / service usersconsume their food and drink

• Identify key best practice andbenchmarks related to food and nutrition

The key messages that all learners will takeaway from this programme are that:• Food and water are very important to

quality of life; without them you die• Meals are as important as medication• The service user’s dignity is central to

quality care

The programme was developed by a technicalmanagement group made up of cross sectorexperts in the field of food and nutrition whoconstructed the content, while a projectmanagement group checked each of themodules to ensure that they are fit forpurpose. A stand-alone module on the Basicsof Nutrition and Hydration will follow later inAugust with additional modules due forrelease in the new year.Access to all of the modules is viawww.corelearningunit.nhs.uk and can beaccessed anywhere, anytime with a computerconnected to the internet. Thanks to fundingfrom the 10 Strategic Health Authoritiesaccess is free for all NHS Trust and PCT staffin England simply by going to the abovewebsite address and registering for anaccount, which only takes a few minutes. Atthe end of the programme each learnerreceives a printable certificate which can beadded to their portfolio. For more information on this trainingprogramme please contact the NHS CoreLearning Unit at:[email protected] note: The figures for malnutrition quoted withinthe above text are not based on criteria used in ‘MUST’ anddo not reflect the current prevalence of malnutrition onadmission to care as identified in BAPEN’s NutritionScreening Week last year.

What’s New

NHS Core Learning Unit LaunchesOnline Training ProgrammeRobin Beck,Events Coordinator,NHS Core Learning Unit

Thank you to all co-ordinators at hospitalsand care homes who participated in BAPEN’ssecond Nutrition Screening Week earlier thismonth (1st – 3rd July). Your support for thisimportant initiative is much appreciated.

BAPEN also thanks the RCN and BDA for theircollaboration and the NPSA, Department ofHealth in England, Scottish Government, WelshAssembly and the Chief Nursing Officer ofNorthern Ireland for their support.

If participants would like to provide feedback

on what worked well and what could beimproved, please email that information to:[email protected]

244 centres registered to take partrepresenting 154 hospitals and 90 care homesacross the UK. The data are now being entered inpreparation for analysis and the results will bepresented at the BAPEN Conference in Harrogateon Tuesday 4th November. Once the full report hasbeen produced, we will analyse each centre’s dataand send them a report so they can benchmark

their local data against the national picture.Despite fewer centres participating this year,

the information will add to our existing data andmay give some indication of any seasonal variationin the prevalence of malnutrition on admission tohospital and care.

RReeggiisstteerr ffoorr BBAAPPEENN 22000088 ‘‘MMaallnnuuttrriittiioonn MMaatttteerrss’’ ttoo hheeaarr tthheerreessuullttss ooff NNSSWW0088 ffiirrsstt--hhaanndd!!For reference - Guidance Notes and Forms for Hospitals,Mental Health Units and Care Homes and an FAQ (FrequentlyAsked Questions) document are available to view at:www.bapen.org.uk/ce_nsw_guidance_notes.html

Thank You for Supporting NSW 08!

Christine Russell & Marinos Elia Joint Project Leads for NSW08

Have you experience ofimplementing guidelines fornutrition such as NICE?

Are you able to share thatexperience – whethersuccessful or challenging?

Have you a few momentsto submit a short summaryfor consideration forBAPEN 2009 and theBAPEN website?

Your professional colleagues will love tolearn from your experience and BAPENwill provide the platform to disseminatethat experience.

As well as being uploaded on the BAPENwebsite and discussed at BAPENConference, successful summaries will alsobe forwarded to NICE for consideration fortheir website.

Full details are available on the BAPENwebsite: www.bapen.org.uk

The deadlines for the applications are: - 28th February 2009- 30th June 2009- 28th February 2010- 30th June 2010

Shared Learning InitiativeNICE/BAPEN


Good opportunities to discuss issues with both the sponsors,speakers and other delegates during the break times

Despite the rain it was very well-attended,with more than 70 delegates representingpharmacists, clinicians, nurses, dietitians andpharmacy technicians. We even managed totempt Professor Gil Hardy, the vice-presidentof AusPEN, to attend and speak!

What’s New

The second South Region BAPEN nutrition day was held on 7thJuly this year,with a theme of ‘peri-operative nutrition support’.Peter Austin South Regional BAPEN Representative

All Change! Nutrition Plans, Policy & Practice - BAPEN’s 2008‘Malnutrition Matters’ is a gold-mine of information for all committed toand involved in best practice nutritional care and treatment

Nutrition Screening toTackle Malnutrition amongOlder People in theCommunity in Wales The Welsh Consumer Council convened aRound Table meeting in early 2008 to discusshow best to address malnutrition among olderpeople in the community. The main focus forthe meeting was the opportunities presentedby the use of appropriate use of nutritionscreening tools and potential barriers toimplementation.

The aim? To raise awareness and stimulatedebate on how to tackle malnutrition amongolder people living independently in Wales. Low awareness of the prevalence and impact ofmalnutrition, lack of training among health andsocial care staff, perceived difficulties with theuse of screening tools such as ‘MUST’ anddiverse local initiatives were all cited as realbarriers to a co-ordinated approach to tacklingthis major public health issue.A multi-agency approach to this multi-causalissue was agreed by participants as part of theroute to success, but this must be accompaniedby a step-change in national policy and a sea-change in culture. Tackling Malnutrition among Older People inthe Community – a discussion paper from theWelsh Consumer Council is available fromwww.wales-consumer.org.uk. The results fromBAPEN’s work with sheltered housing (theGNASH Project) are awaited with interest bythis group in Wales!

The programme comprised a series of talks, aswell as original communications, and covered themanagement of surgical patients with nutritionalneeds in a practical way that was related to theevidence where available. Delegates were lookedafter well at Paultons Park and this was reflectedin the very positive feedback we received on theday. Fifty-four delegates completed a feedbackform and all rated the programme, organisationand value as either good or excellent. Wereceived kind industry sponsorship, primarilyfrom Abbott, BBraun, Clinovia, Nutricia, Vygonand Willow but also Hospira and Vitaflo. We arevery grateful for the support that we received

from all of these companies as this kept thedelegate fees at a very reasonable level toencourage attendance.Next year, the third South Region BAPEN daywill take place on Monday 6th July 2009, andthe theme will be ‘practical nutrition support’.Places will be limited so please do apply early.It will be at Paultons Park again so if theprogramme doesn’t entirely tempt you toattend, perhaps the chocolate fudge cake,afternoon cream tea or roller-coaster ride willtip it in favour! The programme andapplication form will be available [email protected]

Do you know howstandards for and

regulation about nutrition policy& practice is changing in hospital, care and thecommunity? Do you know precisely what theDepartment of Health’s Nutrition Action Planhas been working on and will deliver? There ischange afoot which will impact on policy andpractice in nutrition care in all care settingsand affect your daily professional life. Do you know what BAPEN has been involved in

during 2008? Do you know about the resultsfrom BAPEN’s data collection through NutritionScreening Week (NSW08) and BANS (BritishArtificial Nutrition Survey) now being collectedelectronically? Have you heard about BAPEN’sparliamentary activity and its work with patientsupport groups? Do you know what GNASHstands for and what BAPEN will achieve throughits partnership working with sheltered housing?

Hear from regulators, managers and BAPEN the

answers to these questions and much more duringthe opening plenary session of the ‘MalnutritionMatters’ Conference in Harrogate 4th November. Book your place today – don’t delay!Registration, accommodation and programmedetails are on the BAPEN websitewww.bapen.co.uk – note Early BirdRegistration fees are available until 26thSeptember 2008. Registration fees held at2007 rates. See you in Harrogate!

NCEPOD Launches Study of Hospital Parenteral NutritionJim Stewart,Consultant Gastroenterologist Clinical Co-ordinator NCEPODThis year the National Confidential Enquiryinto Patient Outcome and Death (NCEPOD) islaunching a national enquiry into the use ofparenteral nutrition (PN) in hospital patients.

The study will look at the key areas ofprescription and practice, as well asorganisational factors around the use of PN.Both children and adults will be included inthe study.

This will be the first national audit of PNpractice ever undertaken; and it is our intentionthat the final report will give firmrecommendations for PN practice based on thestudy findings. Like all NCEPOD studies this willbe a questionnaire based enquiry. Thus in due

course clinicians may well receive saidquestionnaires and we would be grateful if theycould be filled out and returned promptly as perinstructions.

In addition, we will be advertising foradvisors to help analyse the data returned. Wewill need clinicians, nutrition nurses anddietitians to sit on the Advisor Group. Pleaselook out for the advert.

NCEPOD is extremely grateful to BAPEN forthe help and support it has given in helping setup this study and the use of its website topromote [email protected]


Media Matters

Ivan Lewis is rarely out of theheadline news these days – andnot simply because he is a LabourGovernment Health Minister! Care Services Minister Lewis has not only beenbusy being responsible for the ImprovingNutritional Care Action Plan (with stakeholderssuch as BAPEN) but also he has been whizzinground the country with Dignity & RespectAmbassador Michael ‘Parky’ Parkinson, launchingthe National Carer’s Strategy, the consultationdocument on the National Dementia Strategy(comments until 11th September) and the End ofLife Strategy.All these Strategy documents are available todownload from the DH website:www.dh.gov.uk/en/index.htm When he has not been busy launching these newinitiatives and ‘pressing the flesh’, Ivan Lewis hasbeen at the House of Commons answeringquestions on his areas of responsibility posedoften by Conservative Shadow front bench Healthteam member Stephen O’Brien. Topics posed to Ivan Lewis by O’Brien in the firsthalf of 2008 and as reported in Hansard (theOfficial Publication of our Governmentwww.parliament.the-stationery-office.co.uk)included progress on implementation of theNutrition Action Plan via the Governance Board,population data on under-nutrition, co-operationwith other European Countries re: malnutrition,and data regarding the numbers leaving Englishhospital ‘malnourished’. This latter question &answer made the headlines as the current dataappeared to show a dramatic rise over previousyears in those leaving hospital malnourished.Whilst this data was interpreted incorrectly, theresulting furore from Trusts and reported in themedia, who found themselves inadvertently top orbottom of the ‘League’ with regard tomalnutrition, did help to raise awareness furtherof the issue! If you see coverage of BAPEN in the general, localor specialist press please do let us know via thisemail address [email protected].

From Parliament to Patients andPopulation Groups

Watch out for news from BAPEN’s recentlyconvened Expert and Patient Group meetingsconvened to debate and discuss the best ways toraise awareness among parliamentarians, policymakers and the public of the need to maintainmomentum across hospital, care and communitysettings to address malnutrition most effectively.

Media Matters

RHONDA SMITHBAPEN MARKETING &COMMUNICATIONS

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Simple arithmetic illustrates the data handlingchallenges presented in providing nutritionalcare. Take a typical 30 bed ward or 30 residentcare home for example. Assuming the simplestscenario where everyone is eating and drinkingnormally. Thirty people eat at least three timesper day, making choices about each componentof each meal. Those thirty people also consumeat least seven beverages each day, another sevenchoices each. That is (30 people x 3meals x 3courses) + (30 people x 7 beverages) or 480choices or data elements. Add in the complexitiesof snacks, modified diets, portion sizes, oralnutritional supplements and artificial nutritionand the data elements that need to be managedeach day run into the thousands. The furthercomplexity of, meeting cultural and religiousneeds and the permutations available whenserving each drink or meal (i.e. with sugar orwithout, with gravy or without, etc.), mean thatthe data elements run into tens of thousands injust one small area. Provision of nutritional care

is one of the most challenging and complexservices delivered in any care setting. It is hardlysurprising that it frequently fails.The National Patient Survey carried out for theHealthcare Commission in England each yeargives us a snapshot of what patients, recentlydischarged from hospital think of the service.There are three questions related to food in thesurvey and Table 1 illustrates the responses ofthe sample of c80,000 people.Data for the 2008 survey was collected duringJuly. It is clear from the three years data we havealready analysed that something new needs tohappen to radically improve patient satisfaction.The quality of service we provide, its safety andthe impact it has on clinical outcome has neverbeen more important. On the 60th anniversaryof the inception of the NHS, Lord Darzi launchedhis long awaited report 'High Quality Care for All- NHS next stage review'. This report is verydifferent to other recent reviews - it contains noradical restructuring or reorganisation

The Need forNutrition InformaticsRICK WILSONDIRECTOR OF NUTRITION AND DIETETICS, KINGS COLLEGE HOSPITALLONDON, BAPEN SOUTH THAMES REPRESENTATIVE AND MEMBER OFBAPEN COMMUNICATIONS COMMITTEE

The Need for Nutrition Informatics

Nutritional care has become more sophisticated, complex andchallenging over the years. In fast moving, high turnover healthcareenvironments the determination of nutritional need, accurate deliveryof care, continuous monitoring and quality improvement, demandexcellence in information management and performance monitoring.Our knowledge of the benefits of good nutritional care grows by thehour. Its impact on outcomes - good or bad - is increasingly apparentas is its influence on the patients’ experience of their care.

Table 1: Results of the Healthcare Commission National Patient Survey

2005 2006 2007

How would you rate the 54% 53% 55%food? (% of people ranking it 'good or very good')

Were you offered sufficient Not available 79% 77%choice of food? (% yes)

Did you get enough help 62% 58% 60%and assistance with eating? (% yes)

Provision ofnutritional care isone of the mostchallenging andcomplex servicesdelivered in anycare setting. It ishardly surprisingthat it frequentlyfails.

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recommendations and no new national targets.Instead, it is all about the engagement ofclinical staff in the delivery of improvements tothe patient experience, quality of care, safetyand clinical outcomes.Nutrition, nurture, nursing; all these words havethe same latin root nutrire to nourish or tosuckle. The provision of nutrition is a clearoutward demonstration of caring, converselywithholding food or water is readily and easilyinterpreted as a lack of care or even as a hostileact. A failure of nutritional care will beinterpreted as a total lack of caring and willcolour public opinion of an institutionaccordingly. Hospital, hospitality and hospitableare also words which give us a clue about thecaring and secure environment required forrecovery and recuperation from illness. The latinroot hospitale, guest house or inn, illustratesonce again the importance of shelter and theprovision of food and drink to the sick andneedy. The very first hospitals were places ofsanctuary in monasteries and convents; food,drink, shelter and security were just about allthat could be done for the sick. This was truethroughout history and until the late 19th andearly 20th centuries. The development ofmodern medicine, anaesthesia, antibiotics andsurgery has radically changed the nature ofhospitals, but the fundamentals of care remain.Shelter, security, food and water are vital iftreatment is to succeed and recovery andrecuperation are to be optimised.The Governments of all four countries in the UKare actively seeking quality and outcomeimprovement from their respective health andsocial care services. Taxpayers and voters wanthigh quality and effective care in return for theirsupport and their money. In England, theregulatory bodies the Healthcare Commissionand the Commission for Social Care Inspection,are merging to become a new regulator the‘Care Quality Commission’. The Care QualityCommission will exist in shadow form from theautumn of 2008 and legislation will be put inplace to provide its powers by April 2009. TheDepartment of Health has already consulted onthe registration standards that will be requiredof all health and social care providers(www.dh.gov.uk/en/Consultations/Closedconsultations/DH_083625). The emphasis of theseregistration requirements is on patient/publicsafety and quality of care and service. There isincreased recognition of the importance of goodnutritional care in ensuring that clinicaloutcomes and the patient experience areoptimised. There is also a clear recognition thatpoor nutritional care is a safety issue. If peopledo not get enough food or fluid then starvation,dehydration and eventually, death will ensue. Itis increasingly apparent however, that the wrongmeal or a missed meal is harmful and presents areal risk to patient safety. A coeliac patientgetting a meal containing gluten, a dysphagicpatient getting food of the wrong consistency, apatient with diabetes missing a meal or beingfasted inappropriately; all of these situations are

harmful. Furthermore, this harm is avoidableharm; staff and institutions will be held toaccount for exposing people in their care tothese avoidable risks.So how will we manage these risks in the fastmoving environment of modern hospitals? Onetool that is emerging as a key part of the dieteticoffice is Nutrition informatics - an application ofinformation technology to nutritional caremanagement processes. Nutrition informatics isthe term coined to describe this type ofsoftware. As part of the hospital informationsystem and the patient record, Nutritioninformatics software enables staff to document,monitor and review all aspects of nutritionalcare. The clinical record can include informationabout food allergies or dietary requirements aswell as ‘softer’ nutritional care issues such asfood preferences and cultural and religiousdietary needs. Nutrition informatics softwarecan provide knowledge and decision supportsystems for the clinician in developing individualnutritional care plans. They can also providesolutions for the documentation of the deliveryof nutrition and hydration, integrating thisinformation with other parameters of theprogress of recovery. Once the informationabout nutritional care is captured then theopportunities for the continuous audit andevaluation of care can be realised. This must beour vision for the future.

ReferencesHoggle L B, Michael M A, Houston S M, Ayres El J. Nutrition informatics.J Am Diet Assoc. 2006 Jan ;106 (1):134-9.

The Need for Nutrition Informatics

Once theinformation aboutnutritional care iscaptured then theopportunities forthe continuousaudit andevaluation of carecan be realised.

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Core Group Updates

PINNT stands for Patients on Intravenous and Naso-gastricNutrition Therapy and this year is our 21st birthday.Our aims are: to encourage contact and mutual support between members; to provide information; to develop publicawareness of the therapies; and encourage and assist with research. We work closely with healthcare professionals andindustry to ensure that patients have the best possible quality of life whilst on artificial nutrition.If you think your patients or indeed yourself would benefit from PINNT, we can be contacted via:Email: [email protected] Website: www.pinnt.com Post: PO Box 3126, Christchurch, Dorset BH23 2XS

Professor Philip Calder kicked off proceedingswith an overview of fatty acid metabolism. Onpaper a rather dry subject, but in Philip’s skilledhands an excellent start to the day, allowingmost of us to ‘revise’ this important area andgive us a starting point to the subsequent talks.The second session was a bit of a gamble. AdinaMichael-Titus, a Reader in neurosciences at theRoyal London, was recommended by Jeremyand gave a talk on the use of omega-3 fattyacids in spinal cord injury, based mainly onlaboratory work on rats. I don’t mind confessingthat I was concerned that this would not reallyfit in with the rest of the day and be rather too‘basic science’. As it turned out, for me and formany others, this was the most stimulatingsession of the whole day. Adina describedremarkable neurological recovery in the ratsgiven the omega-3’s, and the potential clinicalapplications of this approach are immense. So,this may not have been a liver-orientated talk,but it was loosely related to nutrition, andcertainly got everyone thinking. Thereafter, weturned wholesale to the liver. Alastair Forbespresented on the particular challenges of theobese patient, both in terms of the impact ofobesity on liver physiology and how this mayinfluence how we nutritionally support suchindividuals, and also the risks, complicationsand sequelae of bariatric surgery.

After lunch in Jeremy’s pet local curryhouse, we returned for three overtly clinicalsessions. Jeremy Woodward, from Cambridge,talked us through how we interpreted,investigated and managed abnormal liverfunction during parenteral feeding. David Lloyd,our trainee representative on the BAPENMedical committee, discussed the differentlipid emulsions available and how they affectliver function. To finish, Jill Johnson, the

dietetic lead at the Queen Elizabeth liver unit inBirmingham, told us how to nutritionallysupport patients with established liver disease,e.g. the cirrhotics.

The delegates were a mix ofgastroenterologists and hepatologists at bothConsultant and trainee grade, and dietitians. Thefeedback we received indicated that everyonefelt this was a very enjoyable and excellent day.Although it is becoming increasingly difficult topersuade colleagues to utilise their sparse studyleave and rapidly dwindling (non-existent!) studyleave budgets to attend these one-off days, wedo believe that there is sufficient interest forthem, and fully intend to continue them in thefuture – look out for 2009 dates (notification inthis publication and on the website will appearin due course).

While we put a lot of store on this smallerand more intimate mid-year meeting, our mainannual event is the postgraduate teaching day,which we hold on the day before the mainBAPEN conference (this year to be held onMonday 3rd November in Harrogate). Last year136 delegates attended – roughly 20% of thetotal conference attendance. The 2008 theme is‘Nutrition and Inflammatory Bowel Disease –everything you need to know’. While the maintarget audience is clinicians (as we are BAPENMedical), the content will appeal and berelevant to anyone and everyone with aninterest in nutritional support. Please see theprogramme on the website. It will be anexcellent day, with very high calibre speakers –and you even get a free evening meal thrown inif you are staying on for the conference. All foronly £47 (or £23.50 if you are a BAPEN Medicalmember) – unbeatable value!

I look forward to seeing you at futureBAPEN Medical events.

‘Nutrition and the Liver’BAPEN Medical Summer Meeting July 3rd

Tim Bowling, Chair BAPEN Medical (on behalf of the BAPEN Medical committee)

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SBAPEN Medical held its third mid-year meeting. The purpose of these meetings is to have agreater mix of science and clinical practice than we would have at the main BAPENconference meetings. This year our focus was on the liver. As it was our last opportunity toutilise Jeremy Powell Tuck’s hospitality before his retirement, he organised the WingateInstitute at the Royal London Hospital as our venue. There we welcomed 53 delegates andspeakers, including representatives from Baxter, who kindly sponsored the day.


Our membership goes from strength to strength,we topped 250 last year, the most members wehave had since 1998. Re-registration this yearcurrently stands at over 120 members, with morejoining each month. We are, as always, lookingfor more! So nurses, dietitians, pharmacists,doctors, please visit our website www.nnng.organd take a look at what we are up to. Withoutdoubt, our members agree that the Yahoo! chatgroup is a resounding success, and without KatePickering, who set up the group and acts asmoderator, this would not have been achievable. Our 2008 conference, held on 23rd and 24th Juneat Knebworth Barns, was a resounding success.Over 80 delegates attended and it was withoutdoubt our most successful and largest to date.Talks included: a lively debate on whether nasalbridles are ethically justified; dysphagia andvideofluroscopy; EPIC II guidelines, metabolic andbiochemical complications of PN. This year wealso welcomed our first international speaker.Professor Albert Westergren, a nursing academic,with an interest in stoke care and dysphagia, flewin from Sweden to give a well-received talk onMalnutrition and Eating Difficulties in the ElderlyCare Setting; and he has vowed to return nextyear. We had three mini communications too,where newer members presented their work tothe membership. This gave the opportunity forpeople to present to an audience in a safeenvironment – it proved to be a great success. Theevening social event was also very successful.Entitled ‘The School Disco’, most members threwthemselves into the spirit of things.

Other NNNG news…Winnie Magambo has been leading a group ofnutrition nurses in our quest to develop someevidence based guidance for the managementand treatment of gastrostomy granulomas (orskin tags to the unenlightened!). She presentedthe results of the questionnaire at the NNNGconference, and it looks like it will lead to evenmore work, perhaps in the way of a multi-centreresearch project. Liz Evans has been heavily involved with theDepartment of Health Core Learning Unit to

produce the e-learning module for practitionersaround better ways of organising oral nutritiondelivery. Andrea Cartwright and LynneColagiovanni are both involved in thedevelopment of the NCEPOD PN audit report,which will find out what is currently happening inhospitals providing PN, then as a result makerecommendations and set some standards forinstitutions that are involved in PN provision. Allour works cannot be mentioned her, but this justgives you a flavour of a very busy year. We hope2009 is as successful!

The NNNG Committee re-live their school days at the Conference Dinner

NNNG UpdateTracy Earley, Communications Officer, NNNG

Core Group Updates

2008 has proved to be one of some change, and some stability for the NNNG committee. Neil Wilson, Nutrition Nurse Specialist, left the committee totake up a new post as a lecturer - we wish him every success. As a result of Neil’s departure, I joined the committee as joint Communications Officeralong side Kate Pickering. The remainder of the committee continue, with Andrea Cartwright keeping everyone of us in order – difficult as it is at times!

We were grateful to have themajority of our past chairs present to celebratethe night with us. Our guests also includedJeremy Powell-Tuck who helped organise thefirst meeting.This year was election year at our AGM. BeckyWhite, our chair for the last three yearsdecided to step down in order to pursue otheravenues. We are fortunate that she is notgoing too far and will continue to be part ofthe BPNG Exec, as her enthusiasm for nutritionis boundless. The names of the currentexecutive committee are available on the

BPNG website: www.bpng.co.ukOver the last year we have been involved in anumber of projects including producing acompetency framework for pharmacistsworking within nutrition. We are hoping thatthis will be used as a tool for pharmacists toprogress to Consultant Pharmacists. We are also in the process of providingguidance for healthcare professionals workingwith patients on long term and homeparenteral nutrition. As part of this we arehoping to standardise the processes aroundthe home parenteral nutrition prescriptions in

order to reduce the possibility of errors. What are the plans for the next year? We will beholding our annual Fundamentals Day forParenteral Nutrition at the beginning of 2009.This is open to all professions that are starting outin parenteral nutrition. Later in the year we will beholding a study day for advanced practioners. Thedetails of these courses will be available on theBPNG website (www.bpng.co.uk) from the end of 2008.Once the information about nutritional care iscaptured then the opportunities for the continuousaudit and evaluation of care can be realised.

BPNG

The BPNG celebrated it’s 20th birthday this year with a gala dinner at our summer course. After a hard day in theclassroom, we put on our glad rags and danced the night away.

BAPEN In Touch No.50 August 2008

BPNG UpdateJackie Eastwood, Chair BPNG

Committee Group Updates

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Education Committee UpdateRuth Newton, Chair : Education & Training

This is an exciting time for the education committee, covering new territory – well new territory for me as the new Chair! We have a numberof challenging projects to address over the next 12 month.

Firstly, our symposium in November atHarrogate, looks at controversial issues such asnasal bridles and competencies essential to carefor patients. The latter we are hoping toprogress further with the development ofteaching tools, which will help train allprofessionals involved in nutrition and enablethem to show they are ‘competent to care’. This

is an important area which is already beingaddressed by several specialist groups. We areall now required to provide evidence that we aresuitably trained, using best practice, to carry outour daily jobs.

We are also looking to develop a MUSTtraining package, examining the existing packagesof training in order to provide a user-friendly tool.

AND we are in the final stages of preparing thenew nutrition teams training package – so if youknow of a new team that requires some trainingplease let us know.

I must, as a final task, say a big vote ofthanks to Ian Fellows, the retiring Chair, forall his help and hard work over the pastseveral years – Thanks from all of us!

BANS UpdateDr Barry Jones, Chairman, BANS

Many of you will be wondering when e-BANS is to be launched. The answer is that we are rolling it out now to those who wish to transfer to anelectronic version (contact Geoff Cooke at Streets Heaver Ltd - [email protected] or Ann Micklewright - [email protected]).By the New Year, we hope all reporters will have converted. We expect there to be some ‘glitches,’ which we will do our best to deal with as quickly aspossible. The advantages to reporters and reporting units will be considerable. You will be able to access your own data at any time electronically andthe dreaded six-monthly follow ups are to become much easier. e-BANS will automatically remind reporters which patients need updating and ifnothing has changed, a simple tick in a box will suffice.

The downside of BANS in the future is theimposition of the need for consent beforedivulgence of the semi identifiable data wecollect. This is a legal requirement under theHealth and Social Security Act 2001. We haveapplied for and been awarded Section 60 supportfor continuing with data collection (see PIAGwebsite: www.advisorybodies.doh.gov.uk/PIAG).You can reassure your Caldicott Guardians using thisinformation. This process will be repeated inDecember 2008 for a further year’s extension. Wewill have to demonstrate that we have movedtowards obtaining consent for those who canconsent, or assent for those who can not. We willprovide the necessary information sheets andexamples of consent/assent forms on the e-BANSwebsite and also on BAPEN’s website shortly. Weappreciate that obtaining consent will beproblematical for some reporters. On registering anew patient on BANS, reporters will be asked toindicate whether consent has been obtained. If ithas not, you will not be permitted to transfer theinitials, date of birth, gender or first half of postcodeto e-BANS. However, you can still let us have thecompletely anonymised data for that patient. Wewill no longer be able to be sure that we have avoided

double registrations but we will still get a pretty goodidea of how many patients are out there.

If any one is in doubt as to the value of BANSdata, we have just achieved a notable victory. In1999, the attention of BAPEN Council was drawnto the inequity of access to HPN. A position paperwas then produced using BANS data. This was thebasis for ongoing interactions with governmentover the lack of commissioning of HPN and theinequity of access. These initial approaches wereineffective. However, data collected since then hasfurther enhanced our case such that the NutritionCommittee of the Royal College of Physicians ofLondon, was able to persuade the then President,Dame Carol Black to take up the matter with theChief Medical Officer, Sir Liam Donaldson. This inturn led to the formation of an important grouprepresenting the Department of Health, NSCAG(National Specialised Commissioning AdvisoryGroup), BAPEN and HPN and intestinal failurerelated professionals. Lead by Professor JeremyPowell-Tuck, this group is now known as HIFNET(Home Parenteral Nutrition and Intestinal FailureNetwork) and will become the relevant group forHPN and intestinal failure in England.

This culminated in the production and

publication of a definitive document, entitled: ‘AStrategic Framework for Intestinal Failure andHome Parenteral Nutrition Services for Adultsin England’. This can be accessed atwww.nscteam.org.uk/ifstrategy.htm. Within thisdocument is reference to the importance of BANSdata and also a statement that all commissionedHPN/IF providers will be required to notify BANSof their data. This is already part of the standardsapplying to HPN patients within the Scottish andWelsh network. These achievements have onlybeen possible because of the tireless efforts ofHPN reporters.This year’s report is shaping-up well and will beavailable on the BAPEN website before the AnnualConference in Harrogate. It can be downloadedfree of charge and used as you see fit, subject tocopyright laws. The BANS committee has beenpleasantly surprised by the numbers of reportersstill actively participating despite the difficultiescaused by PIAG and consent based data togetherwith the switch to e-BANS .

The future of BANS and its electronic offspringdepends as ever on the continuing input fromreporters whom the BANS committee would like tothank once again.

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My task in this communication is to feedback some of the activities from theExecutive and Council that may not becommunicated by others. • At last we are up and running with the

membership database, which shouldhopefully make life easier for both theOffice and you in terms of membershiprenewal and a much more robust way ofkeeping tabs on the membership in generaland its demographics.

• A contract has been agreed with CompleteMedia & Marketing to publish thiscommunication, which will free up theCommunications Committee (whopreviously were responsible for In Touch) todevote more time to the website. We allrecognise that the website is our window tothe outside world, and to a certain extentwe will be judged by the quality of it. Atpresent, most of the membership is notreally in the habit of logging on and using itvery much to access information, in part forgood reason as it has not previously been ascomprehensive and up-to-date as we wouldlike. We want habits to change. VeraTodorovic and others have and are spendinga huge amount of time on the website,including starting up the members section(now functioning) which will includeconference presentations (2007 ones arethere); announcements of BAPEN-relatedmeetings at both local, regional andnational level; and links to other relatedorganisations. Please get into the habit ofusing the website more. Any suggestions forimprovement would be greatly valued.

• One of the perennial constraints of thisAssociation is finance, and one of theperennial problems for the membership is

how to negotiate time off from your hospitalbase to attend BAPEN meetings and how toraise the necessary funds to come along. Weare very aware of these difficulties. So if youdespair at the registration costs of theNovember conference, please rememberthat EVERY effort is made to keep this to aminimum. Council, and especially theTreasurer, have the impossible task ofstriking the right balance between incomegeneration (the annual conference being themajor source of income for the year) andcosts to the individual delegate. This yearthe rates are the same as 2007, and actuallycompare very favourably to many nationalmeetings.

• Finally, and very importantly, a number ofindividuals are stepping down from theirroles of responsibility from both theExecutive and Council. While the perceptionamongst the membership may be that theseare ‘jobs for the boys/girls’, I can assure youthat we really want to hear from anyonewho feels they have something to offer theAssociation. Not previously being on Councilor playing a ‘significant’ role within BAPENis entirely irrelevant – it is your enthusiasmthat is paramount. Please feel free to sendme in confidence any expressions ofinterest, either for specific roles or justwanting to put your hand up as an interestedindividual (email: [email protected] or tel:0115 919 4427).

I think that is enough mumbling for now!Hopefully I will see you in Harrogate.

TIM BOWLING, HONORARY SECRETARY BAPEN

Mumblings from the Secretary

This is my first missive as Honorary Secretary of BAPEN, and I have a hard act tofollow. My predecessor Penny Neild did a superb job to which many of us owegreat thanks. Probably the most significant impact of this role for me has beenthe realisation of the immense amount of work that goes on behind the scenesby the Council and Executive, and especially the Chairman, Marinos Elia, and theTreasurer, Christine Russell – all in addition to their day jobs! This effort goeslargely unrecognised by the majority of the BAPEN membership, but withoutwhich this Association would collapse.

Council Matters

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BAPEN In Touch No.50 August 2008

Diary Dates

National Adult Small Intestinal Transplant ForumA forum for clinicians wishing to discuss patients who may besuitable for intestinal transplantationDate: 1st September & 1st December 2008 (2-5pm) Venue: St Mark's Hospital, HarrowFor further information:Dr Simon Gabe - Tel: 020 8235 4089Email: [email protected] Stephen Middleton - Tel: 01223 217467Email: [email protected]

30th ESPEN Congress Nutrition Renaissance from Care to CureDate: 13th – 16th September 2008 Venue: FLORENCEFor further information:Website: www.espen.org

Nutrition NoW The North West and North Wales Branch of the BDA (NWNW)4th Nutritional Exhibition has over 50 Departments andCompanies taking part. We have secured speakers onCardiovascular Disease and BAPEN to provide the educationalelement of the day.Date: 17th September 2008Venue: JJB Stadium, WiganFor further information email: [email protected]\

South West Regional BAPEN Meeting Date: 24th September 2008Venue: Lyngford House Conference Centre, TauntonThemes: Nutrition in pancreatitis/ critical illness and difficultenteral feedingCase discussions included ALL WELCOME – whether members of BAPEN or not: Dietitians; Nurses; Nutrition nurses; Doctors – Physicians andsurgeons; Pharmacists; Any clinician with an interest in Nutritionalsupport; Trainees of all disciplines are particularly welcomeRegistration (to include coffee, tea and lunch): £47.00 (inclusive ofVAT) for BAPEN members and £52.50 (inclusive of VAT) for all others. For further information contact:Email: [email protected]: 01823 342126Fax: 01823 344612

NW Regional Nutrition Teaching DayOrganised by the NW Regional BAPEN CommitteeSponsored by Fresenius Kabi LtdDate: 2nd October 2008Venue: The Post Graduate Centre, University Hospital AintreeThe teaching day has Royal College of Physicians CPD Approval 6 pointsFor further information contact Louise Matlock:Email: [email protected] Tel: 07970 084080

Wales Regional Intestinal Failure Workshop Date: 3rd October 2008Venue: All Nations Centre, CardiffFor further information contact Winnie Magambo:Tel: 02920746393Email: [email protected]

AuSPEN Annual Scientific Meeting for 2008 Held as part of the Asia Pacific Critical Care 2008 Congress Date: 30th October – 2nd November 2008Venue: Sydney For further information visit: www.auspen.org.au

BAPEN Medical Teaching Day - Nutrition and inflammatorybowel disease – everything you need to knowIn conjunction with ESPEN Life-long learningDate: 3rd November 2008 (10am start)Venue: Harrogate It will be possible to complete the Life-long learningcompromised gut module and secure 3 credits for the ESPENEuropean Diploma in Clinical Nutrition if the quiz is completedsuccessfully and an evaluation form is filled in.ALL WELCOME: Members of BAPEN Medical; Members ofBAPEN; Any clinician or healthcare professional with an interestin nutritional support; Surgeons; Trainees of all disciplines inparticular are welcomeRegistration (including coffee, tea and lunch): £23.50 (inclusiveof VAT) for BAPEN Medical/BAPEN members and £47 (inclusiveof VAT) for all others.For further information contact Dr Emma Greig (HonorarySecretary BAPEN Medical):Email: [email protected]: 01823 342126Fax: 01823 344612

Annual BAPEN Conference

Date: 4th – 5th November 2008

Venue: Harrogate International Centre, Harrogate

Website www.bapen.org.uk

ASPEN - Clinical Nutrition Week 2009Date: 1st – 4th February 2009Venue: New OrleansFor further information visit: www.nutritioncare.org

FIRST ANNOUNCEMENT – Midlands BAPEN Meeting Date: 10th February 2009Venue: Holywell Park Conference CentreCost: Day delegate fee £50For further information:Melanie Baker – [email protected] Fairhurst – [email protected] Merrick – [email protected] will be available via www.bapen.org.uk (fromAugust 2008)

FIRST ANNOUNCEMENT - BAPEN North East Regional Meeting Date: 30th April 2009 Venue: Northern Skills Centre, Hexham General Hospital,NorthumberlandFor further information email: [email protected]

GASTRO 2009: Combined World Congress / UEGW GlobalCollaboration for GastroenterologyDate: 20th – 25th November 2009Venue: London Excel Centre Website: www.gastro2009.org


Regional Representatives

BAPEN Contacts

Chairmen of Standing CommitteesExecutive Committee

Honorary ChairmanProfessor Marinos EliaTel: 0238 079 4277Fax: 0238 079 4277or: 0208 342 8308Email: [email protected]

Honorary TreasurerMrs Christine RussellTel: 01327 830 012Fax: 01327 831 055Email: [email protected]

Honorary SecretaryDr Tim BowlingTel: 0115 919 4427Fax: 0115 919 4427Email: [email protected]

Honorary Senior OfficerDr Simon GabeTel: 020 8235 4089Fax: 020 8235 4001Email: [email protected]

Chair: Communications & LiaisonVera Todorovic Tel: 01909 500 990 Ext. 2773Fax: 01909 502 809Email: [email protected]

Chair: Education & TrainingRuth Newton Tel: 01782 552290Fax: 01782 552916Email: [email protected]

Chairman: Programmes CommitteeDr Mike StroudTel: 0238 079 6761Fax: 0238 079 4945Email: [email protected]

Chairman: Regional Representatives Dr Jeremy NightingaleTel: 0208 235 4196/4038Fax: 0208 235 4001Email: [email protected]

Chairman: Research & Science Committee VACANT

Chairman: BANS Dr Barry Jones Tel: 01384 244 074Fax: 01384 244 262Email: [email protected]

ScotlandJanet Baxter Tel: 01382 496 558 Fax: 01382 632317 Email: [email protected]

Northern Ireland Dr Sharon Madigan - Community Dietitian Tel: 02890 944 500 Email: [email protected]

WalesWinnie Magambo - Nutrition Nurse Tel: 029 2074 6393 Email: [email protected]

North West Dr Simon Lal - ConsultantTel: 0151 529 8387Email: [email protected]

North East Barbara Davidson - Senior DietitianTel: 0191 244 8358 Email: [email protected]

TrentMelanie Baker - Senior Specialist DietitianTel: 0116 258 6988 Mob: 07913 976 082 Email: [email protected]

West Midlands Alison Fairhurst (joint rep) - Nutrition Support DietitianTel: 01384 244 017 Fax: 01384 244 017 Email: [email protected] Sue Merrick (joint rep) - Dietitian & Team Leader forNutrition Support Tel: 01902 695 335 Fax: 01902 695 630 Email: [email protected]

Thames Valley Marion O’Connor - Nutrition Support Dietitian Tel: 01865 221 702/3 Fax: 01865 741 408 Email: marion.o’[email protected]

Eastern AngliaDr Ian Fellows - Consultant Gastroenterologist Tel: 01603 288 356 Fax: 01603 288 368 Email: [email protected]

North Thames Dr Jeremy Nightingale MD FRCPConsultant Gastroenterologist and General PhysicianTel: 0208 235 4196/4038 Fax: 0208 235 4001 Email: [email protected]

South Thames Mr Rick Wilson - Director Dietetics & Nutrition Tel: 020 3299 9000 x2811 Email: [email protected]

South WestDr Emma Greig - Consultant Gastroenterologist Tel: 01823 342 126 Email: [email protected]

South Peter Austin - Senior Pharmacist Tel: 02380 796 090 Fax: 02380 794 344 Email: [email protected]

South East Dr Paul Kitchen - Consultant Gastroenterologist Tel: 01634 833 838 Fax: 01634 833 838 Email: [email protected]

Industry Representative Carole Glencorse - Head of Nutritional Services Tel: 01628 644 163 Fax: 01628 644 510 Email: [email protected]

Chairmen/ Representativesof Core Groups

Chairman: BAPEN MedicalDr Tim BowlingTel: 0115 919 4427Fax: 0115 919 4427Email: [email protected]

Chair: BPNGJackie EastwoodTel: 0208 235 4094Fax: 0208 235 4101Email: [email protected]

Chair: NNNGAndrea CartwrightTel: 01268 593 112Fax: 01268 593 317Email: [email protected]

Chairman: PENGPete TurnerTel: 0151 706 2121Fax: 0151 706 4638Email: [email protected]

Chair: PINNTCarolyn WheatleyTel: 01202 481 625Fax: 01202 481 625Email: [email protected]

Liaison Officer: The Nutrition SocietyProfessor Gary FrostTel: 020 8383 8037Email: [email protected]

Other Representatives

Liaison Officer: ESPENDr Jon ShafferTel: 0161 787 4521Fax: 0161 787 4690Email: [email protected]

Liaison Officer: BSPGHAN Dr Susan HillTel: 0207 405 9200 Ext 0114Fax: 0207 813 8258Email: [email protected]

BAPEN Office

Chair: Communications & LiaisonVera Todorovic Tel: 01909 500 990 Ext. 2773Fax: 01909 502 809Email: [email protected]

In-Touch PublisherFaye EagleTel: 01992 538 001Email: [email protected]

BAPEN, Secure Hold Business Centre, StudleyRoad, Redditch, Worcs, B98 7LGTel: 01527 457 850Fax: 01527 458 718Website: www.bapen.org.uk

To contribute to In Touch, contact:

For media enquiries, contact:

BAPEN Marketing & Communications ManagerRhonda SmithTel: 01264 710 428 Mobile: 07887 714 957 Fax: 01264 710 768Email: [email protected]


MALNUTRITION MATTERS

BAPEN Conference is the Networking & Learning Event for all professionals involvedin and committed to improving nutritional policy, care & treatment in community, care& hospital settings.

Programme includes:

• Updates on: Nutrition Screening Week 2008; Combating Malnutrition in Sheltered Housing (GNASH); Parliament toPatient Activity; BANS; Nutrition Action Plan; Changing Regulations & Standards in Nutritional Care

• Key symposia include:o Coeliac Disease: Basics and controversies (with the British Society of Gastroenterology)o Nutrition at the End of Life: Feeding the dying patiento Lost in Transit: Can nutritional care survive the primary/secondary care journey?o Hot Topics in Parenteral Nutritiono Feeding Size 0:The science of starvationo Young people, artificial nutrition and transitional care o It ‘MUST’ Happen – or risk the consequences o Feeding Size 0:The challenges of anorexia nervosa o Competent to Careo Gutless – You are the Weakest Link: Goodbye

• Original Communications• New for 2008 - A Poster Reception will be held at 5:30pm on Tuesday 4th November where you will have an

opportunity to discuss any issues with the author whilst enjoying a glass of wine!• Visit the Resource Centre as well as the Exhibition for information from NHS agencies, charities and commercial

companies• See the new e-BANS system demonstrated live on-line!

This meeting is approved for credits under the Continuing Medical Education (CME) Scheme by all Medical Royal Colleges

The BAPEN Annual Dinner will be held at The Majestic Hotel,Harrogate at 8:00pm on Tuesday 4th November.

Download the registration form, or register and pay on-linevia the BAPEN website:

www.bapen.org.ukThe BAPEN Annual Conference is organised by:Sovereign Conference, Secure Hold Business Centre,Studley Road, Redditch,Worcestershire, B98 7LGTel: +44 (0)1527 518777 Fax: +44 (0)1527 518718Email: [email protected]

Media & Marketing enquiries to Minerva PRC LtdEmail: [email protected] • Tel: +44 (0)1264 710428

ofThe British Association for

Parenteral and Enteral Nutritionto be held at

Harrogate International CentreTuesday 4th & Wednesday 5th November 2008

2008 Annual Conference

Advancing Clinical NutritionRegistered Charity 1023927

touch 4 in in touch touch 4 e Issue No. 50 August 2008

Documents

Transcript of touch 4 in in touch touch 4 e Issue No. 50 August 2008