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Improvements in the completeness of coding (the number of diagnoses that are recorded) may also artificially increase the number of recorded cases of malnutrition on hospital discharge records as may improved detection of malnutrition due to increased screening. Note that the figures in these tables may not correspond exactly with figures released previously. This is because the same patient may now be counted in two separate hospitals whereas previously they would only have been counted once at NHS board level. Databases are also continually updated and corrected.

The definition of malnutrition employed in this analysis includes diagnoses of anorexia nervosa, nutritional deficiencies (e.g. vitamin A, thiamine and calcium deficiencies), nutritional anaemias and malnutrition related diabetes mellitus.

It should be noted that these patients may have been malnourished or at risk of malnourishment when they were admitted to hospital.

The tables 1 and 2 that follow present the number of patients of NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran discharged as a result of the patient''s death with a principle or contributory diagnosis of malnutrition. It is not possible to present a table with deaths directly attributable to malnutrition due to the potential risk of disclosure due to the small numbers involved.

Table 1: Number of NHS Greater Glasgow and Clyde Residents Who Died in Hospital and Had a Diagnosis of Malnutrition as Principle or Contributory Diagnosis by Hospital of Treatment; Year Ending 31 March 1998-2008

Source: ISD Scotland (SMR01).

Note: *Indicates values under three not shown due to the potential risk of disclosure.

Table 2: Number of NHS Ayrshire and Arran Residents Who Died in Hospital and Had a Diagnosis of Malnutrition as Principle or Contributory Diagnosis by Hospital of Treatment; Year Ending 31 March 1998-2008

Source: ISD Scotland (SMR01).

Note: *Indicates values under three not shown due to the potential risk of disclosure.

The information requested on how many residents were diagnosed with malnutrition is given in tables 3 to 4 that follow.

Table 3: Number of NHS Greater Glasgow and Clyde Residents Discharged From Hospital With a Diagnosis of Malnutrition by Hospital; Year Ending 31 March 1998-2008

Source: ISD Scotland (SMR01).

Note: *Indicates values under five not shown due to the potential risk of disclosure.

Table 4: Number of NHS Ayrshire and Arran Residents Discharged from Hospital with a Diagnosis of Malnutrition by Hospital; Year Ending 31 March 1998-2008

Source: ISD Scotland (SMR01).

Note: *Indicates values under five not shown due to the potential risk of disclosure.

The Scottish Government recognises the importance of nutrition to patients and we have taken steps to improve the whole experience of nutrition in hospitals including improving the standard of meals. In 2008, we introduced a national catering specification Food in Hospitals, which provides guidance to NHS boards on how to provide tasty, nutritious and healthy meals to the diverse population of patients who enter hospitals. The specification aims to ensure that hospital catering recognises the fundamental importance of appropriate food provision for every patient as part of his or her treatment. This in turn will influence health and recovery.

The figures published in answer to S3W-23008 show all deaths where malnutrition is the principle, or contributory, cause of death. The following table details the number of deaths directly attributable to malnutrition. The numbers of deaths in hospital directly attributable to malnutrition have remained relatively stable.

Number of Patients Who Died in Hospital and Had a Principle Diagnosis of Malnutrition Year Ending 31 March 1998-2008

The Scottish Government is taking forward a comprehensive programme to improve and enhance the nutritional care of patients in hospital backed by £1.5 million of new investment:

Screening all patients on admission to hospital for the risk of undernutrition and putting in place a care plan to meet the needs of those with, or at risk of, malnutrition.

Introducing Food in Hospitals, the National Catering and Nutrition Specification for Food and Fluid provision in Scotland, 2008, which assists NHS boards to deliver a healthy balanced diet to all patients.

Providing £1.08 million to support nutrition champions in NHS boards for a period of two years to support the NHS board in the delivery of the Food, Fluid and Nutrition agenda.

Senior charge nurses playing an important role in ensuring these patients are given care and support to improve and maintain their nutrition where appropriate.

Protected meal times also ensure that patients are not interrupted unnecessarily and also allows nursing staff more time to spend with patients who need assistance to eat and drink.

This work links directly with the development of Clinical Quality Indicators, one of which is for food, fluid and nutrition, currently being implemented across NHS Scotland.

http://www.isdscotland.org/isd/costs-book-detailed-tables.jsp?pContentID=3612&p_applic=CCC&p_service=Content.show&.

http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The number of deaths in hospital directly attributable to malnutrition between 1998 and 2008 have remained relatively stable, as set out in the answer to question S3W-24140 on 1 June 2009. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.