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In order to prevent, anticipate and treat malnutrition we must first understand what we mean by malnutrition.

'a state of nutrition in which a deficiency, excess or imbalance of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function, and clinical outcome'².

It is the result of nutritional intake that does not meet nutritional requirements.

This strategy relates to adults in all health and social care settings including individuals in their own home. For the purpose of this strategy malnutrition will be considered as under-nutrition and does not cover obesity or eating disorders.

It is not intended to cover the nutritional needs of children given the very specialist needs of children and young people. However it will acknowledge the transitional care of young people into adult services as outlined in Strand 3 of the Integrated Care Pathway for Children and Young People with Complex Physical Health Needs, 2008³.

The strategy which has been developed within the existing legal framework recognises that people must be considered and cared for as individuals with reasonable adjustments made accordingly. This requires responsive care and support that is designed to meet their specific needs coordinated across all care settings.

Health and social care staff have an ethical duty to recognise and treat malnutrition usually by attention to drinking and eating as part of optimal care for patients⁴. They should also take appropriate steps to help those participating in the decision making⁵ to understand the assessment of the patients' requirements for nutrition or hydration⁶.

It recognises that people are considered and cared for as individuals, and acknowledges that nutritional care should be provided with an equitable, person centred approach respecting the diversity of people, including their beliefs and cultures, patients, their family and carers.

In addition, the strategy recognises the significant contribution of people, families, volunteers, independent, and the community and voluntary sectors. It promotes their role in the inter-disciplinary and inter-agency teamwork that is essential for good nutritional care.