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NHS Eastern Cheshire CCG Governing Body Meeting held in public 30 November 2016. Nursing Home Dietetics Service update. Catherine Voyce & Eva Portillo Community Nutrition Support Service. The service. Aim of service Improve equity of access to dietetic services
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NHS Eastern Cheshire CCG Governing Body Meeting held in public 30 November 2016 Nursing Home Dietetics Service update Catherine Voyce & Eva Portillo Community Nutrition Support Service
The service Aim of service • Improve equity of access to dietetic services • Cost-effective prescribing of oral nutritional supplements • Education and support of staff in nutritional care • Admission avoidance • Aid recovery
Service timeline • Clinical service • GP referrals • Acute to community dietetic service • Nursing home rota • Domiciliary visits Service planning & set-up Audit of oral nutritional supplements with MMT • MMT meeting • CCG Care home workshop • NH GP meeting • Liaising with CQC • Dementia EOL team • SLTs • CCG Quality team • Dietetic assistant competency training • Service standards & processes May June August July Dec Sep Oct Nov 2016
Oral Nutritional Supplement audit Audit questions • Does indication for prescription meet • ACBS criteria • MMT prescribing policy for ONS? • Is patient on most appropriate ONS to treat nutritional diagnosis? Outcome of audit • Recommendations: • Stop prescription • Change prescription to new product • Continue with current prescription • Communicated by letter to GP & NH • Summary of outcomes sent to MMT
Results - overall • If ONS indicated and appropriate • Changed to a nutritionally dense product & 45% cheaper! • Cost savings from implementation of MMT ONS policy • Collaboration between MMT and prescribing support dietitians • Savings are being collated by MMT
Results – stage of ONS % of ONS prescriptions by stage 57% 95%
Year To Date Financial savings Between May and September 2016, the service has saved £144,000 (£345,000 Full Year Estimate) on the prescribing of nutritional supplements.
NH baseline audit - education Nutrition training Malnutrition risk training Nutrition & MUST training is needed!
Performance monitoring • Dietetic outcome measures • User experience - Service user feedback • Patient safety - Audit of nutrition care pathways in nursing homes • Service performance
The next 6 months Clinical service
Summary • Equitable access to dietetics for pts in NH or housebound • Dietetic pathway from acute to community • Cost savings for CCG • Plan for training • Networking with community teams for integrated working • Positive feedback from service users