Community Dietetics

C.W & A.K. 16-10-23

Who to refer:

Individuals aged 16 or over who have any of the following may be referred to the Community Dietetic Service:

Patients who have been screened using MUST (Malnutrition Universal Screening tool) who score 2 or more with unintentional weight loss
Pre-assessment for enteral feeding
Weight loss during pregnancy
Hyperemesis gravidarum
Complex ileostomy/colostomy advice
Pancreatic enzyme replacement therapy (PERT)
Newly diagnosed Type 2 diabetes within 12 months of diagnosis who are not suitable for DESMOND
Type 2 diabetic patients with poorly controlled blood sugars
Care home residents can now be referred to us directly by care home staff by following the information on our public-facing Intranet page https://services.nhslothian.scot/carehomes/info__trashed/services/services-dietetics-and-nutrition/

Weight, height, BMI and weight loss history over the past 3-6 months should be recorded wherever possible on the referral.

Please consider the risk of re-feeding syndrome which can be potentially dangerous. Further guidance can be found here Dietetics-Adults-Re-Feeding-Syndrome-NHS-Grampian-21-Jun-19.pdf (nhslothian.scot)

Please note that Oral Nutritional Supplements (ONS) should NOT be prescribed without a dietetic referral. ONS will only be recommended if ACBS criteria are met, such as disease-related malnutrition. Weight loss related to social or non-disease factors are not eligible for prescribed ONS. For more information please see Scottish Government Report – Scottish Oral Nutritional Supplements ShortLife Working Group (ONS SWLG) – April 2018 or the Lothian Formulary.

Who not to refer:

Those screened using MUST who have a score of 1 or 2 with stable low BMI – see Nourishing Ideas and Nourishing Drinks.
Late stage palliative care – please follow the link for guidance Nutrition-in-Palliative-Care.pdf
late palliative Eating-and-drinking-at-the-end-of-someones-life-1-1.pdf
Individuals aged 15 and under. Please refer to Paediatric Dietetics
Patients with low albumin. This may indicate inflammation or infection is present, therefore should not be used to determine nutritional status.

For condition-specific information please see Resources and Links tab.