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Screening for malnutrition

When and how to screen

Screening for at risk patients

As nutritional status can change across different life stages and with the onset or progression of chronic illness, screening can be a useful tool to help you identify those at increased risk of malnutrition at any given time point.

Malnutrition screening can be conducted using simple, quick-to-use tools, and is often the first line of action.1

When to screen for malnutrition

Screening can be used in many settings and regular repeat screening may be required, as a patient’s clinical condition and nutritional requirements can alter.1-4 It is especially important to re-assess identified at risk patients as they move through different care settings.1-4

In primary care5

Within primary care, NICE Clinical Knowledge Summaries recommend screening for malnutrition opportunistically or if there is clinical concern.

  • Initial registration at a general practice and then annually if the person is at low risk of malnutrition.
  • Routine health checks or immunisation appointments.
  • During medication reviews.
  • Contact with a community or district nurse.
  • On admission to a new care setting, and then monthly if the person is at low risk of malnutrition.
  • Unintentional or unplanned weight loss.
  • Apathy or fatigue.
  • Poor appetite or early satiety.
  • Altered taste sensation.
  • Difficulty swallowing.
  • Altered bowel habits or gut function.
  • Prolonged intercurrent illness or recurrent infections.
  • Reduced physical function or frequent falls.
  • Loose-fitting clothes, jewellery, or dentures.
  • Muscle wasting (sarcopenia).
  • Fragile skin or poor wound healing or pressure ulcers.

In hospitals6

Within hospitals, NICE Clinical Guideline 32, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, states:

‘All hospital inpatients on admission and all outpatients at their first clinic appointment should be screened. Screening should be repeated weekly for inpatients and when there is clinical concern for outpatients. People in care homes should be screened on admission and when there is clinical concern.’

MUST

The most commonly used validated screening tool in all UK care settings is the MUST ’Malnutrition Universal Screening Tool’ (‘MUST’) developed by BAPEN.4

For further information on screening and the MUST toolkit, please click here.

How to manage malnutrition

Learn more about ‘Food First’ and other strategies to manage malnutrition.

Find out more
  1. Serón-Arbeloa, C. Malnutrition Screening and Assessment. Nutrients 2022, 14, 2392. https://doi.org/10.3390/nu14122392
  2. Nutrition support in adults. NICE Quality Standard 24. Published 30 November 2012.
  3. Managing Adult Malnutrition in the Community. BAPEN. 3rd Edition 2021. Available at: https://www.malnutritionpathway.co.uk​/library/managing_malnutrition.pdf
  4. Nutritional Screening, BAPEN https://www.bapen.org.uk/must-and-self-screening/nutritional-screening/
  5. When and how should I screen a person for malnutrition or risk of malnutrition? NICE CKS. Available at: https://cks.nice.org.uk/topics/adult-malnutrition/diagnosis/screening/
  6. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. NICE Clinical guideline 32. Published 22 February 2006.

References accessed February 2026.

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