{"id":16583,"date":"2023-09-15T09:50:31","date_gmt":"2023-09-15T08:50:31","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=16583"},"modified":"2024-06-04T11:23:16","modified_gmt":"2024-06-04T10:23:16","slug":"community-dietetics","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dietetics\/community-dietetics\/","title":{"rendered":"Community Dietetics"},"content":{"rendered":"\n<p><strong>C.W &amp; A.K. 16-10-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p>Individuals aged 16 or over who have any of the following may be referred to the Community Dietetic Service:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients who have been screened using <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Community-Malnutrition-Referrer-Pathway-Update-June-21.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">MUST <\/a>(Malnutrition Universal Screening tool) who score 2 or more with unintentional weight loss<\/li>\n\n\n\n<li>Pre-assessment for enteral feeding<\/li>\n\n\n\n<li>Weight loss during pregnancy<\/li>\n\n\n\n<li>Hyperemesis gravidarum<\/li>\n\n\n\n<li>Complex ileostomy\/colostomy advice<\/li>\n\n\n\n<li>Pancreatic enzyme replacement therapy (PERT)<\/li>\n\n\n\n<li>Newly diagnosed Type 2 diabetes within 12 months of diagnosis who are not suitable for <a href=\"https:\/\/www.desmond.nhs.uk\/\" data-type=\"link\" data-id=\"https:\/\/www.desmond.nhs.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">DESMOND<\/a> <\/li>\n\n\n\n<li>Type 2 diabetic patients with poorly controlled blood sugars<\/li>\n\n\n\n<li>Care home residents can now be referred to us directly by care home staff by following the information on our public-facing Intranet page&nbsp;<a href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fservices.nhslothian.scot%2Fcarehomes%2Finfo__trashed%2Fservices%2Fservices-dietetics-and-nutrition%2F&amp;data=05%7C01%7CHeather.Levy%40nhslothian.scot.nhs.uk%7C86de9b7a6d504daacb1508dbb467d5ee%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638302130419494705%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=mGVdsRSGZ%2BpULEpjiMVndUgiG7AJ9JQZoXFEIflij8E%3D&amp;reserved=0\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/services.nhslothian.scot\/carehomes\/info__trashed\/services\/services-dietetics-and-nutrition\/<\/a><\/li>\n<\/ul>\n\n\n\n<p>Weight, height, BMI and weight loss history over the past 3-6 months should be recorded wherever possible on the referral.<\/p>\n\n\n\n<p>Please consider the risk of re-feeding syndrome which can be potentially dangerous. Further guidance can be found here <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dietetics-Adults-Re-Feeding-Syndrome-NHS-Grampian-21-Jun-19.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Dietetics-Adults-Re-Feeding-Syndrome-NHS-Grampian-21-Jun-19.pdf (nhslothian.scot)<\/a><\/p>\n\n\n\n<p>Please note that Oral Nutritional Supplements (ONS) should NOT be prescribed without a dietetic referral.&nbsp; ONS will only be recommended if ACBS criteria are met, such as disease-related malnutrition.&nbsp; Weight loss related to social or non-disease factors are not eligible for prescribed ONS.&nbsp;For more information please see Scottish Government Report \u2013 <a rel=\"noreferrer noopener\" href=\"https:\/\/www.therapeutics.scot.nhs.uk\/wp-content\/uploads\/2018\/08\/Gudelines-for-appropriate-prescribing-of-Oral-Nutritional-Supplements-in-adults.pdf\" data-type=\"link\" data-id=\"https:\/\/www.therapeutics.scot.nhs.uk\/wp-content\/uploads\/2018\/08\/Gudelines-for-appropriate-prescribing-of-Oral-Nutritional-Supplements-in-adults.pdf\" target=\"_blank\">Scottish Oral Nutritional Supplements ShortLife Working Group <\/a>(ONS SWLG) \u2013 April 2018 or the <a href=\"https:\/\/formulary.nhs.scot\/east\" data-type=\"link\" data-id=\"https:\/\/formulary.nhs.scot\/east\" target=\"_blank\" rel=\"noreferrer noopener\">Lothian Formulary<\/a>.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Those screened using<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Community-Malnutrition-Referrer-Pathway-Update-June-21.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"> MUST<\/a> who have a score of 1 or 2 with stable low BMI &#8211; see <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dietetics-Food-First-Nourishing-ideas.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nourishing Ideas<\/a> and <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nourishing-Drinks-version-2-2023.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nourishing Drinks<\/a>.<\/li>\n\n\n\n<li>Late stage palliative care \u2013 please follow the link for guidance<strong> <\/strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nutrition-in-Palliative-Care.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nutrition-in-Palliative-Care.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nutrition-in-Palliative-Care.pdf<\/a><\/li>\n\n\n\n<li>late palliative <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Eating-and-drinking-at-the-end-of-someones-life-1-1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Eating-and-drinking-at-the-end-of-someones-life-1-1.pdf<\/a><\/li>\n\n\n\n<li>Individuals aged 15 and under. Please refer to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatric\/paediatricdietetics\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatric\/paediatricdietetics\/\" target=\"_blank\" rel=\"noreferrer noopener\">Paediatric Dietetics<\/a><\/li>\n\n\n\n<li>Patients with low albumin. This may indicate inflammation or infection is present, therefore should not be used to determine nutritional status.<\/li>\n<\/ul>\n\n\n\n<p>For condition-specific information please see Resources and Links tab.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Please make an electronic referral via SCI Gateway. &nbsp;Select &#8220;AHP &#8211; Dietetics&#8221; then select site based on patient location:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>City of Edinburgh Dietetics&nbsp;&gt; LI Dietetics<\/li>\n\n\n\n<li><span style=\"color: initial\">West Lothian \u2013 St John\u2019s Hospital &gt; LI Dietetics<\/span><\/li>\n\n\n\n<li><span style=\"color: initial\">East Lothian \u2013 East Lothian Community Hospital &gt; LI Dietetics<\/span><\/li>\n\n\n\n<li>Midlothian \u2013 Bonnyrigg Health Centre &gt; LI Dietetics<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>See Resources and Links for patient advice about individual conditions<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Enteral Feeding: <a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/dietetics\/TubeFeeding\/Pages\/Enteral%20TubeFeeding.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/dietetics\/TubeFeeding\/Pages\/Enteral%20TubeFeeding.aspx<\/a>&nbsp; &nbsp;<\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nourishing-Drinks-version-2-2023.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nourishing-Drinks-version-2-2023.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nourishing Drinks<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nourishing-Drinks-larger-text-v1.0.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nourishing-Drinks-larger-text-v1.0.pdf<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/dietetics\/MUST\/Documents\/Food%20First%20-%20Nourishing%20Ideas%20LOT116.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Nourishing Ideas<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Food-First-Nourishing-Ideas-larger-text-v1.0.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Food-First-Nourishing-Ideas-larger-text-v1.0.pdf<\/a><\/li>\n\n\n\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/formulary.nhs.scot\/east\" data-type=\"link\" data-id=\"https:\/\/formulary.nhs.scot\/east\" target=\"_blank\">Lothian Joint Formulary<\/a><\/li>\n\n\n\n<li>Scottish Government Report \u2013 Scottish Oral Nutritional Supplements Short Life Working Group (ONS SWLG) \u2013 April 2018&nbsp; <a href=\"https:\/\/www.therapeutics.scot.nhs.uk\/wp-content\/uploads\/2018\/08\/Gudelines-for-appropriate-prescribing-of-Oral-Nutritional-Supplements-in-adults.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.therapeutics.scot.nhs.uk\/wp-content\/uploads\/2018\/08\/Gudelines-for-appropriate-prescribing-of-Oral-Nutritional-Supplements-in-adults.pdf<\/a><\/li>\n\n\n\n<li>Diverticular Disease <a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/stomach-liver-and-gastrointestinal-tract\/diverticular-disease-and-diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/stomach-liver-and-gastrointestinal-tract\/diverticular-disease-and-diverticulitis<\/a><\/li>\n\n\n\n<li>Iron Deficiency Anaemia <a href=\"https:\/\/www.bda.uk.com\/resource\/iron-rich-foods-iron-deficiency.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/iron<\/a><\/li>\n\n\n\n<li>General Healthy Eating Advice <a href=\"https:\/\/www.bda.uk.com\/resource\/healthy-eating.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/healthy-eating.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/HealthyEating.pdf<\/a><\/li>\n\n\n\n<li>Sports Nutrition Advice <a href=\"https:\/\/www.bda.uk.com\/foodfacts\/sport_exercise\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/sport_exercise<\/a><\/li>\n\n\n\n<li>Fad\/Detox Diets <a href=\"https:\/\/www.bda.uk.com\/resource\/detox-diets.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/detox-diets.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/detoxdiets.pdf<\/a><\/li>\n\n\n\n<li>Constipation\/Fibre advice <a href=\"https:\/\/www.bda.uk.com\/resource\/fibre.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/fibre.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/fibrefoodfactsheet.pdf<\/a><\/li>\n\n\n\n<li>Calcium\/Osteoporosis <a href=\"https:\/\/www.bda.uk.com\/resource\/calcium.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/calcium.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/Calcium.pdf<\/a><\/li>\n\n\n\n<li>Cholesterol <a href=\"https:\/\/www.bda.uk.com\/resource\/cholesterol.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/cholesterol.pdf<\/a> <a href=\"https:\/\/www.bda.uk.com\/resource\/heart-health.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/resource\/heart-health.html<\/a><\/li>\n\n\n\n<li>Hypertension&nbsp; <a href=\"https:\/\/www.bda.uk.com\/resource\/hypertension-diet.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/hypertension-diet.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/hypertension.pdf<\/a><\/li>\n\n\n\n<li>Routine Pregnancy advice <a href=\"https:\/\/www.nhsinform.scot\/ready-steady-baby\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nhsinform.scot\/ready-steady-baby<\/a> <a rel=\"noreferrer noopener\" href=\"https:\/\/www.bda.uk.com\/resource\/pregnancy-diet.html\" data-type=\"link\" data-id=\"https:\/\/www.bda.uk.com\/resource\/pregnancy-diet.html\" target=\"_blank\">https:\/\/www.bda.uk.com\/foodfacts\/Pregnancy.pdf<\/a><\/li>\n\n\n\n<li>Vegetarian\/Vegan advice <a href=\"https:\/\/www.bda.uk.com\/resource\/vegetarian-vegan-plant-based-diet.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bda.uk.com\/foodfacts\/plant-based_diet<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>C.W &amp; A.K. 16-10-23<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":3861,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1002],"class_list":["post-16583","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-community-dietetics"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dietetics\/https-apps-nhslothian-scot-refhelp-community-dietetics\/\" rel=\"tag\">Community Dietetics<\/a>","rttpg_excerpt":"C.W &amp; A.K. 16-10-23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16583","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=16583"}],"version-history":[{"count":38,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16583\/revisions"}],"predecessor-version":[{"id":19755,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/16583\/revisions\/19755"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3861"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=16583"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=16583"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}