Community Services

Inpatients

We provide an in-patient service to the following community hospitals:
o Benjamin Court
o Colman Hospital (Caroline House, Pine Cottage & Priscilla Bacon Lodge)
o Cranmer House
o Dereham Hospital
o Kelling Hospital
o North Walsham
o Norwich Community Hospital (including Community Stroke Rehabilitation Unit)
o Ogden Court
o Julian Hospital
o Hellesdon Hospital

Patients are nutritionally screened upon admission using ‘MUST’ and referred to the dietitian if they are at high risk of malnutrition.

Patients at Priscilla Bacon Lodge are screened using a specifically designed nutrition pathway for palliative care patients.

Ward housekeepers and nutrition link nurses work closely with the dietitians and catering company to ensure patients receive the right diet.

Outpatients

The Nutrition & Dietetic department aim to see outpatients as close to their home as possible.

Outpatients (including children), are seen at 22 community locations including community hospitals, health centres and GP surgeries.

Dietitians educate and support patients (and their families/carers) on therapeutic diets for conditions such as:
o Food Allergies
o Diabetes
o Cancer
o Malnutrition (or those at risk of)
o Obesity
o Irritable Bowel Syndrome (IBS)
o Coeliac Disease
o Difficulty swallowing which requires a soft or puree diet
o Faddy eating
o Diverticular Disease
o Inflammatory Bowel Disease


Patients may be seen for an individual consultation or in a group education session e.g. for people with newly diagnosed type 2 diabetes. These groups are run jointly with specialist diabetes nurses. The 8 current locations for these groups that run throughout the year are:
o Adelaide Street, Norwich
o Attleborough
o Cromer
o Diss
o Kelling
o Lawson Road, Norwich
o Thorpe
o Wroxham

Home visits are offered to immobile/housebound patients who are unable to attend an outpatient appointment or patients who are resident in care homes.

Assistant Practitioners and Dietetic Assistants assess and monitor patients in their own home with malnutrition who require advice and support to improve their nutrition and wellbeing.

Home Enteral Feeding

Some patients require artificial feeding through a tube into the stomach or small bowel for conditions such as Stroke, Motor Neurone Disease (MND) and Head & Neck Cancer.

Approximately 250 adult patients are looked after by the specialist team comprising of Dietitians, Dietetic Assistants, Nutrition Nurses and Homecare Company Nurses. These patients are reviewed in their own homes, clinics and care homes.

The team is involved in pre-tube placement education and training, so patients and/or relatives are able to make informed decision as to whether they would like to have a feeding tube. This occurs when the patient is no longer able to meet their nutritional needs.

The team works closely with ward staff to ensure the safe discharge of patients, which involves training on the care of the tube, training on the use of the equipment and how to obtain relevant supplies.

Ongoing dietetic review of these patients includes the assessment of nutritional requirements, detecting and monitoring feeding problems and liaising with other healthcare professionals.

Learning Disabilities

People with a learning disability are at increased risk of developing nutritionally related health problems. More people with a learning disability are underweight than the general population; putting them at increased risk of malnutrition. More are obese; increasing the risk of developing obesity related complications. Swallowing problems (dysphagia), bowel disorders, reflux, diabetes and poorly balanced diets are all commonly seen. These nutritionally related health problems are less likely to be noticed and/ or addressed.

The Specialist Learning Disabilities Dietitian provides a clinical dietetic service to people with dysphagia and who meet the service eligibility criteria for other nutritional problems. Referrals are seen with other members of the multidisciplinary team when appropriate.

Referrals are also seen by Dietitians working in other speciality areas or in community clinics.

Allocation for all referrals is determined on an individual basis.