Improving the Transfer of Care process for nutrition in London

Led by NHS London Procurement Partnership (NHS LPP) and in collaboration with dietitians from across London, a set of digital dataset recommendations have been developed to help improve efficiency and quality when transferring dietetic patients across care settings in London.

In June 2023, the North Central London (NCL) Nutrition Group raised with the NHS LPP Nutrition and Hydration Prescribing Group, the challenges and areas of improvement needed in terms of quality, efficiency and experience when transferring dietetic patients across care settings, including requests for Oral Nutrition Supplements (ONS).

Establishing the picture in London

To ensure as many voices were heard to feed into this work, a survey was sent to 70 dietetic managers across the London Dietetic Managers forum and to Integrated Care System (ICS) colleagues in Primary Care prescribing roles. Responses confirmed that referring dietitians were frustrated by the need to copy large volumes of data from the patient record to populate referral forms, which was different in each borough.

It also showed how triaging dietetic teams saw incomplete referral details and missing information necessary for efficient triage. Requests to GPs for ONS did not always include an appropriate rationale for their initiation, nor a plan to measure the efficacy of the intervention.

The group found that having a structured transfer document would enable accurate reporting on who is being discharged on ONS with appropriate review, which is integral to support improvements in efficiency, quality and prescribing practice. 

Further to the concerns noted by clinicians, the national context and ambitions were clear. With a majority of NHS trusts now using electronic patient records (EPR), the focus is on the use of structured data and the provision of a single source of truth within a patient record, and in the sharing of information between care settings using Application Programming Interfaces (API). 

NHS LPP established a task and finish group of dietitians working across ICS care settings in London. The group sought to review and interpret how national ambitions to improve communication across care settings, such as the National Transfer of Care Initiative and the Professional Records Standards Body (PRSB) Core Information Standard, could be applied to Nutrition Transfer of Care documents.

Key recommendations and resources

The NHS LPP Nutrition and Hydration Prescribing Group have supported this process via a short life working group focusing on taking a Quality Improvement (QI) approach and delivery of project outcomes. We are thrilled to now be able to share the below collaboratively-developed resources:

Webinar recording

We recently held a webinar to present on this area of work. If you would like to watch this, you can view the recording here

19/11/2024