1.The nutrition older people in the community is a critical element in their overall health and wellbeing, and possibly the most important preventive health measure to combat sickness, to prevent people returning to hospital and to reduce time in hospitals required when people have scheduled operations. This is common sense when we need to urgently consider how to make the best use of NHS resources

2.Because of the large numbers of malnourished people entering hospital the Vale CHC has focussed on issues to improve hospital food and ensure that dietary needs are met.

In our hospital monitoring visits we ask about the quality of food and have undertaken specifically to catering services and dietetic services. We identified that some wards had no weighing scales or that the scales were not working. This led the Trust to initiate a survey in its hospitals and to ensure that all wards had working scales and that they were used to monitor weight loss/gain.

Members of the CHC, noting the variability in catering services between wards and hospitals, have contributed to Trust working monitoring and developing improved catering services. We have urged increases in dietician staffing and recently the Trust has implemented an assistant dietician role and is gradually recruiting staff to strengthen the impact at ward level.

We have regularly drawn attention to the need for older people who need assistance to eat and drink and supported the Trust with the red tray scheme and focus on Fundamentals of Care, but note that this aspect is advisory.

3. The Community Health Council is pressing the need for a significant shift to enhancing community services with a strong emphasis on health and wellbeing and joint working with the local authority and voluntary organisations, with nutrition very much a part of this strategy. We also see the need to strengthen pre and post registration education and training of all health and social care professionals and the importance of public and patient engagement in ensuring future revalidation processes are fit for purpose. This clearly a wider workforce issues and starts with the implementation of an effective national curriculum, which would be inclusive of the wider workforce and population. None of these issues requires rocket science and we commend cost effective low-level interventions such as the Food Train in Dumfries, which address issues revealed by the WFA Older People's Food Charter.