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Dietetics Projects and Information

Malnutrition is estimated to affect at least three million adults in the UK and costs £13 billion annually. It may be caused by illness or a variety of physiological and social factors. People suffering from malnutrition may be admitted to hospital more often, stay in hospital for longer and visit their GP more frequently. The National Institute for Clinical Excellence suggests improving the treatment of malnutrition has the third highest potential to deliver cost savings to the NHS.

Adult Oral Nutritional Supplements

Adult Oral Nutritional Supplements (ONS) may be used to treat malnutrition. Research suggests ONS can reduce death rates and complications, as well as reduce length of stay and weight gain in a variety of clinical conditions. However London audit data indicates some ONS are prescribed to patients who do not need them.

LPP's Clinical Oral Nutritional Support Project has been evaluating the treatment of malnutrition and the management of ONS in London primary care trusts since 2008. A number of measures have been identified which improve the identification and treatment of malnutrition together with the management of ONS.

Paediatric Nutrition Products

Expenditure on paediatric nutrition products is rising year on year. The paediatric nutrition product project commenced in 2010 to identify whether this increase is as a result of improved detection and treatment or if it is due to inappropriate prescribing. LPP audit data has identified that although a high proportion of paediatric nutrition products are initiated appropriately, many patients continue on these longer than required.

To help London NHS organisations address this increasing spend and to help healthcare professionals improve patient outcomes, experience and safety, LPP has developed guidance documents for these product groups. These documents are available on the Paediatric Nutrition Products page and can be locally adapted.

Gluten Free Products

Gluten free foods have been available on prescription for many years. The increased availability of these foods in supermarkets, in addition to the huge variety and palatability of these products, has led to much debate as to whether these foods should continue to be available on prescription.

In 2011 Coeliac UK and LPP reviewed their recommendations regarding gluten free prescriptions. In line with healthy eating guidance, luxury foods such as sweet biscuits and cakes are no longer recommended on prescription. We continue to endorse the prescriptions of gluten free staple foods such as bread and pasta for patients with Coeliac Disease, Gluten-Sensitive Enteropathies and Dermatitis Herpetiformis.

To help London NHS organisations appropriately prescribe gluten free foods the LPP has recently developed summary recommendations for Gluten Free Prescribing which are available on the Gluten Free Products page.

Dietetic Best Practice Case Studies

Go through best practice advice and case studies from NHS dietitians, and contact us to submit your own.

Procurement Guidance

The Commercial Medicines Unit (CMU - formerly the Pharmaceutical Directorate of the NHS Purchasing and Supply Agency), Department of Health has developed procurement guidance on the provision of nutrition supply services including feeds, pumps, consumables, home delivery and associated support service. The National Enteral Feeds Advisory Group was convened in 2000 by the NHS Purchasing and Supply Agency to support its role in providing appropriate and effective guidance and strategic advice to the NHS in England on all matters relating to the purchasing and supply of enteral tube feeds, oral nutritional supplements and associated products and services. The Group is facilitated and chaired by the CMU.

The guidance document has been developed and approved by the National Enteral Feeds Advisory Group and is supported by the Medical Nutrition Executive. Tendering for nutrition supply services can be considered a complex and significant undertaking, involving collaboration from a wide range and diversity of stakeholders. This guidance is intended to support procurement groups / clinicians throughout the process. The aim of this document is to define best practice with regard to the procurement of nutrition supply services across the whole health economy and outlines the twelve key steps to be followed in order to drive forward a best practice agenda for successful procurement.

Contact Us

For further information on the nutrition project contact Rebecca Fisher at rebecca.fisher@lpp.nhs.uk