1. 1 Billion (WHO 2003) 1 Billion (WHO 2003)

2. Functional nutrition? Health Disease Health Nutrition in the process of care

3. The patient’s journey CLINIC PRE- OP POST-OP WARD HOME RECOVERY SURGERY / ANESTHESIA Interactive Team audit of outcomes & compliance PRE ADMISSIONPRE ADMISSION FOLLOW UP30DAYFOLLOW UP30DAY Integrated perioperative protocol (ERAS) From Ljungqvist JPEN 2014

4. The patient’s journey CLINIC PRE- OP POST-OP WARD HOME RECOVERY SURGERY / ANESTHESIA Interactive Team audit of outcomes & compliance PRE ADMISSIONPRE ADMISSION FOLLOW UP30DAYFOLLOW UP30DAY Integrated perioperativer protocol (ERAS) From Ljungqvist JPEN 2014 Multi professional Multi stakeholder

5. New vision

6. Politics & Ressources Patients Research & Education Clinicalpractice Global strategy

7. Fight Against Malnutrition

9. What did we achieve?

10. Progress & Support EP Nutrition Day Conference 2010 European Parliament - EU Presidency - ENHA - ESPEN Chair EP Public Health Committee Alojz Peterle : “Malnutrition requires a cross-cutting solution; a good first step would be mandatory nutrition risk screening across Europe,…..” EP plenary votes September 25 + October 9, 2008,‘Together for Health’ 2008 – 2013 and 2010 European Partnership Action Against Cancer: Urges the Commission.. to make malnutrition, alongside obesity, a key priority in the field of health …

11. Strategic Alliance European Patient Organisations Memorandum of Understanding Signed April 2012 Shared agenda Conference EPF/EGAN – ENHA – MNI 4 July Brussels Support ENHA mission and objectives Support implementation activities in countries Drive awareness nutrition among European patient groups Next step: EU Irish Presidency European patients workshop undernutrition, Dublin 2013

12. Strategic Alliance World Health Organisation - Europe Alignment work programmes & collaboration June 2012

13. Structure Under nutrition Functional decline Frailty Seven General Objectives: 1.Management of Functional decline and frailty 2. Empowerment 3. Screening 4. Integrated Pathways of Care 5. Research & Methods 6. Sustainability 7. Co-operation (cross sector) European Innovation Partnership on Active and Healthy Ageing

14. Fight Against Malnutrition

15. Optimal Nutritional Care for All National Nutritional Care Plans: a Europe- wide implementation Campaign

16. Optimal Nutritional Care for All

17. Fight against malnutrition/ undernutrition Optimal Nutritional Care for All Multi-stakeholder initiative To facilitate greater screening for risk of disease-related malnutrition and nutritional care implementation across Europe ‘ Boost implementation of nutritional screening and follow up care across Europe > 2014 2014 >

18. Key Objective & Strategy ‘Optimal Nutritional Care for All’ European Union EIP Active & Healthy Ageing Country based nutritional screening campaign Partnership with European Patient Orgs WHO EURO Food & Nutrition Plan 2015 - 2020 Key drivers for implementation

19. Key steps in the ONCA campaign Engagement with national stakeholders Implementation conference, Brussels, 4-5 November Action plan and follow up Focus countries: Croatia, Germany, Spain, Turkey Observer countries: France, Israel, Poland, Slovenia

20. Nutritional Screening Implementation Conference 2014 - “Optimal Nutritional Care for All” Steering Committee Conference strategy, engagement national members and co-branding Olle Ljungqvist, Chair Jean Pierre Baeyens, EUGMS Pierre Singer, ESPEN John Chave, PGEU Pascal Garel, HOPE Anne de Looy, EFAD Ceri Green, MNI Cees Smit, EGA/EPF Frank de Man, ENHA

21. Nutritional Screening Implementation Conference 2014 “Optimal Nutritional Care for All” - Draft programme November 4 & 5, Brussels - Participants /stakeholders National delegates from patient groups, professional societies, national associations, Ministries of Health focus countries (40) observer countries (20) ENHA members (15) EU EIP AHA, WHO EURO (3) Key experts (3) Objectives To inspire and facilitate countries to form/strengthen national multi- stakeholder alliances and to focus on implementation of “optimal nutritional care for all” To benchmark current state of play of nutritional care in focus countries To align and implement the ENHA strategy with key stakeholder platforms per country To define and deploy measures of progress and impact per year

22. Optimal nutritional care for all Education Public health Implementation Nutrition Day National Regional/local None Stakeholder groups Policy and standards Guidelines Mandatory Optional/regional None Economic data Presence Prevalence DRM Reimbursement Provide % DRM risk per healthcare setting if available Sound legal basis with implementing measures Soft policy/standards None Screening + care pathways Partial guidelines None >80% reimbursement Regional reimbursement, insurance company specific, or co-pay No reimbursement (100% self-pay) Structural, > 80% Local, 20-80% Limited, < 20% National data Local data Limited/no data > 1000 patients + very effective Small/moderate + moderate None + limited Established national group Regional group Limited/no group Engagement Focus on DRM/ nutritional care Peripheral interest Limited/no interest