Oral nutritional supplements in care homes and the community: Nutrition review and staff education.

The University of Derby’s Health and Social Care Research Centre has been commissioned to support the delivery of Southern Derbyshire CCG’s review of oral nutritional supplements (ONS) and education of care home staff. Southern Derbyshire currently spends £1,409,099 on ONS prescribing (SH3-OT26 PID, 2016). While the efficacy of the use of ONS in malnourished patients is well understood (Agarwal, Miller, Yaxley, & Isenring, 2013), their use may not always be appropriate and other methods such as food fortification may result in either equal or better outcomes for considerably lower cost (Baldwin & Weekes, 2012). A successful pilot in five care homes by Southern Derbyshire CCG achieved cost savings of £183,203.33, along with the associated benefits of increased dietetic support to those residents who required input. On this basis, building on the pilot work, the present programme of work was conceived. Broadly, the project aimed to: (a) improve the nutritional state of residents in 112 care homes and at home; and (b) reduce spend on ONS prescribing. This was divided into two work streams: (1) evaluating the efficacy of a training programme on the identification, prevention and treatment of malnutrition, through a “Food First” approach including MUST training; and (2) the assessment, review and support of GP practices with patients prescribed ONS within their own home. This report provides an overview of the work done by the dietetics team up until the end of February 2018. The analysis of the dataset provides context for the recommendations presented.

The University of Derby’s Health and Social Care Research Centre has been commissioned to support the delivery of Southern Derbyshire CCG’s review of oral nutritional supplements (ONS) and education of care home staff. Southern Derbyshire currently spends £1,409,099 on ONS prescribing (SH3-OT26 PID, 2016). While the efficacy of the use of ONS in malnourished patients is well understood (Agarwal, Miller, Yaxley, & Isenring, 2013), their use may not always be appropriate and other methods such as food fortification may result in either equal or better outcomes for considerably lower cost (Baldwin & Weekes, 2012).

A successful pilot in five care homes by Southern Derbyshire CCG achieved cost savings of £183,203.33, along with the associated benefits of increased dietetic support to those residents who required input. On this basis, building on the pilot work, the present programme of work was conceived. Broadly, the project aimed to: (a) improve the nutritional state of residents in 112 care homes and at home; and (b) reduce spend on ONS prescribing. This was divided into two work streams: (1) evaluating the efficacy of a training programme on the identification, prevention and treatment of malnutrition, through a “Food First” approach including MUST training; and (2) the assessment, review and support of GP practices with patients prescribed ONS within their own home.

This report provides an overview of the work done by the dietetics team up until the end of February 2018. The analysis of the dataset provides context for the recommendations presented.