Dietetics and Nutrition

If you have never seen a dietitian and think that you need to, you can be referred via your GP, practice nurse or hospital consultant depending on the nature of your condition.

What is a dietitian?

Dietitians are the only nutrition professionals to be regulated by law, and are governed by an ethical code to ensure that they always work to the highest standard.

Dietitians specialise in translating scientific information about nutrition and food into practical dietary advice. As well as providing impartial advice about nutrition and health, dietitians also advise about food related problems and treat disease and ill health.

The acute dietetic team see adult hospital inpatients who are referred via the Malnutrition Universal Screening Tool (MUST). Malnutrition is a common condition in hospital patients which needs identification and treatment in order to reduce recovery time and complications.

Patients seen on the wards are both acutely and chronically ill, with various types of nutritional issues. This includes  patients with long-term chronic conditions such as coeliac disease, diabetes and COPD and also patients who are more acutely unwell, offering dietetic support post surgery or assessing when alternative types of feeding are required, such as tube feeding.

Malnutrition Universal Screening Tool (MUST)

All patients are nutritionally screened on admission to hospital by the nursing staff using the MUST tool. This tool assesses the patients weight, nutritional intake, history of weight loss and clinical condition  Patients that score as at high risk of malnutrition or needing dietetic input are referred to a dietitian for nutritional assessment and advice.

Red Tray Pathway

This is a specialised system to allow patients who have been identified as nutritionally ‘at risk’ to be supported during their stay in hospital.  It consists of a red tray replacing the usual meal tray used to serve the patient’s meals. This identifies the patient to staff and highlights that they may need more support and encouragement at mealtimes.

Patients who may benefit from the red tray pathway include:

• patients with a high MUST score
• new patients to wards (especially if undernourished)
• patients who are slow to finish their meals or need encouragement
• patients with nausea or vomiting
• patients who have issues with their swallowing
• patients with disabilities
• those who need assistance with eating and drinking

If family members feel that their relative would benefit from the Red Tray system then they can request for the system to be implemented.

Discharge Services 

Patients who continue to need dietetic support following discharge from hospital will be supported. Such patients can be seen in outpatients clinics here at the hospital, or by the community dietetic team. There are several general outpatient clinic sessions at Barnsley Hospital for adult patients. 

The paediatric dietitians based at Barnsley Hospital see babies, children and adolescents up to the age of 15 years old. Those aged 16 years and over will be seen by the adult dietetic team.

We accept written referrals from Barnsley acute and community paediatricians. We accept electronic referrals from community GP practices via the Choose and Book system.

A paediatric dietitian can provide individualised nutritional information, advice and support for a wide range of conditions, including food allergies and intolerances, poor weight gain or growth, restricted diets, specialist weaning and feeding advice for those diagnosed with feeding difficulties, genetic metabolic disorders, coeliac disease, cystic fibrosis, renal disease, iron deficiency anaemia, and for management of a range of gastro-intestinal diseases.

The dietitians also manage a caseload of 0-15 years olds in the Barnsley area who need tube feeding, or have long term complex needs or disabilities that affect their nutrition.

There are 3 outpatient clinic sessions at Barnsley Hospital each week, but we will see individuals in home, school and other community settings when this is more appropriate. We also work closely with paediatricians, the children’s community nursing team, Barnsley speech and language therapists, and health visiting services.

The diabetes team see:

• children and adolescents who have been diagnosed with diabetes and are followed up from the date of diagnosis up to the age of 19

• transition clinics run to enable young adults with diabetes to move through into the adult services

• adult diabetes services are provided in the Robert Hague Centre for Diabetes & Endocrinology within Barnsley hospital

• antenatal services for women with Type 1 & 2 or Gestational Diabetes

Referrals:

• children up to the age of 19 come from the Paediatric Diabetes Team

• written adult referrals are accepted from Hospital Consultants and Diabetes Specialist Nurses, and electronic referrals from community GP practices via the Choose and Book system.

The diabetes dietitians can provide individualised nutritional information, advice and support for diabetes in conjunction with other medical conditions that require dietary advice. We provide education around carbohydrate counting for patients with a variety of insulin regimes (including insulin pumps).

There are several outpatient clinic sessions at Barnsley Hospital for paediatric and adults with diabetes each week. The Paediatric Diabetes Dietitians will also see individuals in home, school and college as appropriate. Telephone and email reviews are possible.

Related links

• British Dietetic Association 
• Health and Care Professionals Council
• Food Standards Agency
• Department of Health
• Diabetes UK
• Coeliac UK