1. GP Refresher Week 2015 Dietetics
Isabel Hooley, Chief Dietitian for Adult Services
Dorset County Hospital, North Dorset, West Dorset, Weymouth & Portland

2. Introduction to/Update on Dietetic Services
DCH Dietetics serves GPs/patients in North Dorset, West Dorset, Weymouth & Portland.
Patient care: Clinics (primary and secondary care), home visits, patient and staff group education, home enteral nutrition, inpatients (DCH and community hospitals).
Streamlining of the clinic pathway underway.
Consultation, policy development, service development, support & advice to healthcare professionals.
Good working relationships with paediatric dietetics and with the East Dorset (Dorset Healthcare), Poole Hospital and Bournemouth Hospital Dietetic Teams.

3. Irritable Bowel Syndrome
FODMAPs
Group sessions planned
Dietetics is a more cost effective first line referral than Gastroenterology (unless red-flag symptoms).
Coeliac Disease
Patients reviewed annually
Group sessions being considered

4. Obesity How successful is this traditional approach?
Tier 1 – Primary care with community advice
Tier 2 – LiveWell Dorset (Primary care with community interventions)
Tier 3 – Spire (Community/primary care based MDT to provide an intensive level of input/weight management programme)
Tier 4 – Specialist obesity services including surgery
How successful is this traditional approach?
Dietetics keen to explore different options.

5. Diabetes Group sessions Clinic 1:1 consultations
DES
FREEDOM
3-hour Carb Counting
3-hour Carb Awareness
Cook & Eat practical evening events
Clinic 1:1 consultations
Primary care
Intermediate care
Secondary care; MDT working within Consultant clinics
Consider referral before change of treatment
Could dietary adjustment prevent the need for increased treatment?
Does the new treatment need adjustment to diet/lifestyle?

6. Renal
Support to all patients receiving care from the renal service: part of the renal MDT
Potassium dietary modification
Phosphate binder advice/management
Fluid management
Weight management

7. Home Enteral Nutrition
Our HEN service includes adults and paediatrics.
Patients reviewed at least every 6 months.
New contract started April 2015; awarded to Nutricia, who held the contract previously.
Patient numbers and complexity increasing.

8. Malnutrition MUST screening – early identification important.
BMI
Weight loss
Presence/absence of acute illness
Oral nutritional supplements market lively at the moment
New products
Prices dropping on some products
2kcal/ml and 2.4kcal/ml products now widely available yet 1kcal/ml products still the most prescribed!
Over the counter products: Meritene (new name for Build Up), Complan, Aymes
Prescription requests from us sent via

9. We like collaborative, MDT working and welcome suggestions or requests.
The previous slides give examples of some of the main areas we can offer support to you and your patients. It is not an exhaustive list.
Please contact the department if you ever have nutrition/dietary questions:
Tel: