Denmark

ONCA-Denmark aims to reduce the incidence of disease-related malnutrition in Denmark, thereby reducing nutrition-related risk of complications, prolonged treatment, re-admissions, disease incidence and mortality. Clinical nutrition focusing on citizen and patient are essential to fight disease- age and physical condition related to malnutrition.

Mandate for ONCA-Denmark

Background

The Optimal Nutrition Care for All (ONCA) campaign is a multi-stakeholder initiative across Europe aimed at supporting professional communities, associations and patient groups to conduct screening for risk of disease-related malnutrition and optimal nutritional care and therapy.

The ONCA campaign supports national professional associations, associations and patient groups in implementing nutritional risk screening and optimal nutritional care in their respective countries. The campaign is facilitated by the European Nutrition for Health Alliance (ENHA).

ENHA has appointed a steering committee to lead the initiative through strategic guidance and engagement with partners at a national level. The Steering Committee consists of representatives from ESPEN, EUGMS, HOPE, EFAD, EGAN and MNI.

ONCA-Denmark is the national formalized ONCA co-operation in Denmark consisting of relevant professional companies, associations and patient groups in Denmark.

Purpose

The overall purpose of ONCA-Denmark is that all patients and citizens in Denmark have the right and access to assessment of nutritional status and nutritional therapy, regardless of age, diagnosis and clinical problem, thus ensuring patient rights and equality in health care for all.

ONCA-Denmark aims to reduce the incidence of disease-related malnutrition in Denmark, thereby reducing nutrition-related risk of complications, prolonged treatment, re-admissions, disease incidence and mortality. Clinical nutrition focusing on citizen and patient are essential to fight disease- age and physical condition related to malnutrition.

Target group

ONCA-Denmark’s primary target group for the collaboration is citizens and patients in all treatment, nursing and rehabilitation programs in hospitals, general practice and the municipality, health centres, nursing homes, home care and daycare institutions. The cooperation must ensure active involvement of citizens and patients, as well as dialogue between the actors in the collaboration.

ONCA-Denmark’s secondary target group is Danish politicians at all levels, officials, planners and employees in municipal and regional services, medical companies as well as private home care and public and private food delivery companies.

Assignments

ONCA-Denmark will work for political awareness and prioritization, which is crucial for achieving measurable success and constantly developing the quality of nutritional efforts.

ONCA-Denmark will also work for a national strategy to create coherent services for all citizens and patients in Denmark at risk of malnutrition. This will be achieved through the development and implementation of new and evidence-based national quality goals for malnutrition and nutrition.

The strategy must also contain updated recommendations and guidelines demanding identification of nutritional risk and coverage of energy and protein needs through citizen/patient care in hospitals, in the health and care sector and in transitions between sectors. Finally, efforts must be taken to develop and introduce that professional standards in the municipalities contain user rights in relation to nutrition.

Finally, ONCA-Denmark will be a platform where professional associations, organizations and patient groups can meet and discuss issues related to disease-related malnutrition.

Aims and results

1. All citizens and patients in Denmark have the right and access to an assessment of nutritional risk and nutrition therapy.

Sub-objective 1
Citizens/patients in the primary sector must have nutritional risk identified, according to municipal professional standards. For example, home care and nursing homes must screen systematically, and it is desirable to define a strategy for when general practitioners should screen for nutritional risk, for example when referring patients to cancer package care programs, elderly health examinations, annual chronic disease examinations i.e.. For those found to be at nutritional risk, a nutrition plan and follow-up are initiated.

Sub-objective 2
All patients are screened for nutritional risk at the time of admission and in outpatient care.

For all citizens and patients at risk of malnutrition, a specific nutrition plan and monitoring of energy and protein intake must be implemented.
Special efforts should be made for patient groups with frequent occurrence of malnutrition.

2. Nutrition plan and follow-up between sectors

A nutrition plan must be prepared for all citizens and patients at nutritional risk with agreement on specific goals and follow-up, as well as who is responsible for follow-up in the transition between sectors.

For citizens who receive public care as well as citizens in nursing homes and in residential institutions, a nutritional assessment must be done semi-annually, so that it can be handled in due time.

3. Involvement of authorities

ONCA-Denmark aims to become a public-private partnership in collaboration between Danish relevant authorities and organizations. The partnership must initiate awareness-raising initiatives among decision-makers and authorities, including increasing focus on health-economic benefits in the treatment of malnutrition.

ONCA-Denmark must also be a platform where patients can meet and interact with policymakers, authorities and other relevant stakeholders.

Politicians, authorities and municipalities and regions must have awareness of ONCA

4. Recommendations and guidance, implementation and training

Updated evidence-based national guidelines on the risk of malnutrition must exist for citizens and patients in treatment, nursing and rehabilitation programs in hospitals, general practice and the municipality, health centres, care centres, home care and residential institutions

The guidelines must be updated by qualified professionals and with the influence of citizens/patients. ONCA-Denmark is at disposal with updated evidence-based expert knowledge and knowledge of international ONCA initiatives for the preparation of these guidelines.

Recommendations and guidelines should include a plan for implementation.

Recommendations and guidelines should include plans for the education and training of relevant staff as well as for citizen and patient education.

5. Data, documentation and quality objectives

Documentation must be available for all the above factors (1-3) as well as monitoring of the development and effect over time, including patient-reported outcomes (PROMS) as well as clinical outcome measures(i.e. readmissions, infection complications) and health care costs.

Organization

So far, ONCA-Denmark consists of representatives from DSKE/DAPEN (Danish Society for Clinical Nutrition), the Diet and Nutrition Association, FMF (Industry Network for Food for Medical Purposes/Medical Nutrition Industry(MNI)) and the Lung Association.

In addition, the National Board of Health has observer status in ONCA-Denmark. Participation is only professional and not of political nature.

Meetings in ONCA-Denmark are held 2-3 times annually, excluding meetings in the international ONCA collaboration.

Professor, Chief Physician of Clinical Nutrition, Henrik Højgaard Rasmussen is chairman in Denmark, elected for the period 2018-2020 (e-mail).

Jeppe Rønnebæk Kongsbak, the secretariat for the branch network FMF (Dansk Erhverv), is secretary (e-mail).

Mette Holst, Head of Clinical Nutrition Research, Aalborg University Hospital, is the editor for this homepage and spokesperson for the collaboration between DSKE, ONCA-Denmark and ONCA 2019-2021.

The role of the parties

Danish Society for Clinical Nutrition

The Danish Society for Clinical Nutrition, DSKE is a multidisciplinary company (doctors, nurses, and scientists in clinical nutrition and clinical dietitians) whose purpose is to:

• Prevent and treat malnutrition and disease-related malnutrition.
• Promote awareness of the consequences of malnutrition and malnutrition, as well as the possibilities of utilizing nutrition into the treatment of diseases.
• Promote research regarding malnutrition and disease-related malnutrition.

DSKE is a professional partner in ensuring the above professional sparring in ONCA-Denmark.

The Diet and Nutrition Association

The Diet and Nutrition Association is a trade union and interest organization for nutrition professionals. Members of the Diet and Nutrition Association are, among others, clinical dietitians, nutrition assistants, nutrition technologists, professional bachelors in nutrition and health and Master of Clinical Nutrition, in the regional as well as the municipal area.

The Diet and Nutrition Association is a professional partner in ONCA-Denmark.

Industry Network FMF – Food for Medical Purposes

The FMF industry network is an industry association for manufacturers of food for special medical purposes in Denmark under the Danish Industry. FMF is a professional partner in relation to product range, product innovation and scientific sparring. At the same time, the involvement of FMF ensures that nutrition programs meet patients, authorities and professional companies.

The National Board of Health

The National Board of Health has observer status in ONCA-Denmark. Participation is only professional and not of political nature.