Nutritional Support
Oral Nutritional Supplements (ONS) in Primary Care
Follow link for Medicines Optimisation Gateway Page and further advice on supplements
Also see links right for leaflets
Adult Services
Specialist Dietetic Services: Adult Dietetics
Inclusion criteria:
Urgent (to be seen within 8-12 weeks)
- Patients who are malnourished / at risk of malnutrition
- Eating disorder BMI <25kg/m2
- Post-operative dysphagia (e.g. liquid diet only)
- Newly diagnosed type 1 diabetes
- Liver disease with ascites and/or malnutrition /weight loss
- NASH (with cirrhosis)
- Pancreatic enzyme insufficiency, malabsorption
Routine (to be seen within 18 weeks)
- PCOS
- Obesity where first line treatment has been unsuccessful – BMI > 30 to 40 with co-morbidities (Patients with severe / complex obesity, refer to Specialist Weight Management Service at UHCW)
- Known food allergy / intolerance to ensure adequate nutritional intake
- Chronic Fatigue Syndrome
- NASH (nil Cirrhosis)
- Hyperthyroidism / Hypothyroidism
- Low Salicylate diet
- GORD
- Hyperlipidaemia if needing more dietary information, if underweight or obese (for first line dietary advice see BDA foodfacts hearthealth
- Dietary related nutritional deficiencies & malnutrition
- Diverticular disease
- Dysphagia for texture modification advice
- Type 2 diabetes not wishing / not appropriate to attend DESMOND. This includes under 18, not able to understand enough English for group education, deaf but unable to lip read
- Diabetes poorly controlled (HbA1c >58mmol/l) and related to diet
- Type 1 diabetic for carbohydrate counting review / change to basal bolus regimen or declined attendance at CARBS-4-1 programme
- Patients starting on GLP-1 for dietary review
- Inflammatory bowel disease for advice on dietary management of symptoms or nutritional support (Irritable Bowel Syndrome where one to one counselling is required. Offer first line advice from BDA foodfacts IBS before referral)
- Bile Acid Malabsorption/Diarrhoea
- Pancreatitis
- Dietary advice for patients with ileostomies and colostomies
- (Patients with intestinal failure should be referred to Dr Nicola Burch)
- Confirmed coeliac disease on diagnosis and for annual reviews (Gluten free diet should not be commenced until diagnosis confirmed by biopsy)
Procedures & Treatments
Nutritional Assessment
Nutritional and dietetic advice
Eating behaviour modification
Dietary counselling
Exclusion criteria:
- Children under 16 years old
- Patients not requiring dietary advice
- Patients newly diagnosed with Type 2 Diabetes will be invited to the DESMOND programme for dietetic advice.
- Referrals for IBS where coeliac disease has not been excluded will be rejected (NICE CG61)
- Referrals for altered bowel habit should be referred to the medical gastroenterology department first.
Pre-referral Requirements:
Weight
BMI
Weight History
Past Medical History
Presenting Complaint
Full list of medication
Relevant scans/investigations performed
Relevant blood results
Any safeguarding issues
Can the patient attend clinics
Transport required
Interpreter (and which language)
Any other special requirements?
If the patient would like a text reminder please remember to update the patient contact details with their mobile number.
Consider further advice using the advice and guidance facility.
When considering referral, priority should be given to patients with a new diagnosis, previous dietetic advice, motivation to make lifestyle changes.
This referral service is predominantly virtual via telephone/video with face to face appointments considered on a clinical need basis.
Alternative referral services:
- Paediatric Dietetics service for under 16 year olds
- Adult Specialist Weight Management
About Specialist Adult Dietetic Service
Adult Gastroenterology Services
Adult Dietetics (Gastroenterology)
Inclusion criteria:
Urgent (to be seen with 8 weeks)
- Liver disease with ascites and/or malnutrition /weight loss
- NASH (with cirrhosis)
- Pancreatic enzyme insufficiency, malabsorption
Routine (to be seen within 18 weeks)
- Inflammatory bowel disease (e.g. Crohn’s disease, Ulcerative Colitis) requiring advice on dietary management of symptoms or nutritional advice to achieve ideal weight
- Irritable Bowel Syndrome where one to one counselling is required (majority of IBS patients can be seen through group sessions – refer to the Dietitians at UH for FODMAP clinic). Consider first line advice from BDA foodfacts IBS prior to dietetic referral.
- Bile Acid Malabsorption/Diarrhoea
- Pancreatitis disease
- Dietary advice for patients with ileostomies and colostomies (Please note: patients with intestinal failure should be referred to specialist MDT clinic with Dr Burch)
Procedures & treatments:
Nutritional Assessment
Nutritional and dietetic advice
Dietary counselling
Exclusion criteria:
- Children under 16 years old
- Patients not requiring dietary advice
- Diabetes as the main reason for referral – refer to Dietitians working within the Community Diabetes Service based at Newfield House.
- Patients newly diagnosed with Type 2 Diabetes will be invited to the DESMOND programme for dietary advice.
- Patients with fatty liver disease requiring advice for weight loss should be referred to the Adult General Dietetics clinics
- Confirmed coeliac disease on diagnosis and for annual reviews (Gluten free diet should not be commenced until diagnosis confirmed by biopsy). These patients should be referred to the Dietitians at UH for the coeliac clinic.
- Referrals for IBS where coeliac disease has not been excluded will be rejected (NICE CG61)
- Patients who can be seen within Adult General Dietetics clinics and do not meet the above criteria.
- Referrals for altered bowel habit
Pre-referral requirements:
Weight
BMI
Weight History
Past Medical History
Presenting Complaint
Full list of medication
Relevant scans/investigations performed
Relevant blood results
Any safeguarding issues
Can the patient attend clinics at UHCW?
Transport required
Interpreter (and which language)
Any other special requirements?
If the patient would like a text reminder please remember to update the patient contact details with their mobile number.
Alternative referral services:
- Paediatric Dietetics service for under 16 year olds
- Adult General Dietetics for non-gastroenterology specific patients.
- Adult Specialist Dietetics for more complex patients
- Adult Diabetes for diabetes patients
- Specialist Weight Management
Bariatric Services
Bariatric Surgery: Adult Specialist Weight Management Dietetics
Inclusion criteria:
General adult patients with a BMI >35 with co-morbidities or >40 without.
South Asian patients can be referred with a BMI > 35 without co-morbidities.
Infertility and PCOS that fits in with the above two criteria.
Urgent (to be seen by dietician within 4 weeks) following bariatric surgery:
- Acid Reflux
- Night time cough
- Recurrent Chest Infections
- Regurgitation
Routine: (to be seen within 18 weeks) – referred to Dr Barber’s clinic Diabetes and Endocrinology)
General adult patients with a BMI >35 with co-morbidities or >40 without.
- South Asian patients can be referred with a BMI equal to or greater than 35 without co-morbidities.
Routine Dietetic referral only (Patients who have previously had bariatric surgery):
- Nutritional deficiencies
- Poor weight loss
- Symptomatic – dumping syndrome
Procedures & Treatments
Nutritional Assessment
Nutritional and dietetic advice
Eating behaviour modification
Dietary counselling
Exclusion criteria:
- Children under 16
- Patients with a BMI <35
Pre-referral Requirements
HbA1c
Fasting Glucose
U&E’s
Lipid Profile, TFT’s, LFT’s within last 2 months
Weight
BMI
Weight History
Past Medical History
Presenting Complaint
Full list of medication including any insulin doses
Relevant scans/investigations performed
Relevant blood results
Any safeguarding issues
Can the patient attend clinics?
Transport needed
Interpreter (and which language)
Any other special requirements?
If the patient would like a text reminder please remember to update the patient contact details with their mobile number
Consider further advice using the advice and guidance facility.
When considering referral, priority should be given to patients with a new diagnosis, previous dietetic advice, motivation to make lifestyle changes
This referral service is predominantly virtual via telephone/video with face to face appointments considered on a clinical need basis.
Alternative Referral Services:
- Paediatric Dietetics service for under 16 year olds
- Adult Dietetics Service.
Specialist Weight Management Service before surgery
Information for people thinking of having laparoscopic weight loss surgery
Diabetes
Adult Dietetics Clinic (Diabetes)
Inclusion criteria:
- Newly diagnosed type 1 diabetes (Urgent to be seen within 4 weeks)
- Type 2 diabetes not wishing to attend/not appropriate to attend DESMOND. This includes under 18, not able to understand enough English for group education, deaf but unable to lip read (Routine to be seen within 18 weeks)
- Diabetes not adequately controlled (HbA1c >58mmol/l) and related to diet
- Type 1 diabetic requiring carbohydrate counting review or change to basal bolus regimen or declined attendance at carbs for 1.
- Individuals’ commencing on GLP-1 and requiring dietary review.
Procedures & Treatments:
Nutritional Assessment
Nutritional and dietetic advice
Eating behaviour modification
Dietary counselling
Exclusion criteria:
- Children under 16 years old
- Patients not requiring diabetes dietary advice
- Patients newly diagnosed with Type II Diabetes will be invited to the DESMOND programme, where they will receive dietetic advice.
Pre-referral Requirements
- Weight
- BMI
- Weight History
- Past Medical History
- Presenting Complaint
- Full list of medication
- Relevant scans/investigations performed
- Relevant blood results
- Safeguarding issues
- Can the patient attend clinics?
- Transport needed?
- Interpreter (and which language)
- Any other special requirements?
If the patient would like a text reminder please remember to update the patient contact details with their mobile number.
Consider further advice using the advice and guidance facility.
When referring to dietician, priority should be given to patients with a new diagnosis, considering previous dietetic advice, and motivation to make lifestyle changes.
Alternative referral services:
- Paediatric Dietetics service for under 16 year olds
- Adult Gastroenterology clinic
- Adult Specialist Dietetics for more complex patients
- Adult General Dietetics Service
- Specialist Weight Management
Carbs-4-1 Type 1 Diabetes Education
Diabetes: how to take control UHCW leaflet
Healthy Eating With Diabetes (Type 1&2) UHCW leaflet
Type 1 Referral For Dietetic Advice
Newly diagnosed patients (within a year of diagnosis) will be invited to attend Step by Step.
To be eligible for the CARBS 4-1 course, patients must manage their Type 1 diabetes using a basal-bolus regime (2 different insulins, at least 4 injections a day).
The team will need to assess patients with learning difficulties and mental health issues before accepting them on the course.
Renal Service
Renal Dietician
MacMillan Support
Coventry MacMillan Dietician
Paediatric Dietetic Service
Paediatric Dietician
Urgent Referral
- Child under 1 year old with faltering growth (2 centile drop in weight/ 2 centile discrepancy between weight and height/<0.4th centile or weight)
- Swallowing difficulties (consider referral to Speech and Language therapy too)
- Child under 1 year old with suspected food allergy/intolerance for determining possible dietary factors and advice on adequate nutrition
- Child under 1 year old with known food allergy/intolerance to ensure that adequate nutritional intake, especially important in children
- Nutritional deficiencies requiring dietary assessment
- Children requiring enteral tube feeding
- Coeliac disease on diagnosis and for annual reviews (Gluten free diet should not be commenced until diagnosis confirmed by biopsy)
- Irritable bowel syndrome and confirmed functional bowel disorders.
Restricted eating patterns and faltering growth
Routine Referral
- Child over 1 year old with faltering growth (2 centile drop in weight/ 2 centile discrepancy between weight and height/<0.4th centile or weight)
- Child over 1 year old with suspected food allergy/intolerance for determining possible dietary factors and advice on adequate nutrition
- Child over 1 year old with known food allergy/intolerance to ensure that adequate nutritional intake, especially important in children
- Coeliac disease on diagnosis and for annual reviews (Gluten free diet should not be commenced until diagnosis confirmed by biopsy
- Irritable bowel syndrome and confirmed functional bowel disorders.
- Restricted eating patterns
Children with Diabetes, hyperlipidaemia and Inflammatory Bowel disease are seen following a referral from a Paediatrician
Procedures/Treatments Performed:
Nutritional and dietetic advice
Eating behaviour modification
Dietary counselling
Exclusions:
Patients over 16 years old – please refer to adult service
Obesity – Please refer to community lifestyle programmes in Coventry – One Body One Life
Suggested Investigations
None
Administrative Requirement
Weight/ growth chart information
Weight History
Past Medical History
Presenting Complaint
Relevant medication
Relevant scans/investigations performed
Relevant blood results
Any safeguarding issues
Can the patient attend clinics?
Do they need transport?
Do they need an interpreter (and which language)
Any other special requirements?
If the patient would like a text reminder please remember to update the patient contact details with their mobile number.
Service notes:
There may be other less common indications for referral to a dietician: please contact dietician for further advice using the advice and guidance facility.
When considering need to refer to dietician, priority should be given to patients with a new diagnosis, considering previous dietetic advice, motivation to make lifestyle changes.
This referral service is predominantly virtual via telephone/video with face to face appointments considered on a clinical need basis.
Alternative service:
Adult General Dietetics
Adult Specialist Weight Management service
Useful Dietary Library of Resources
A guide to avoiding unnecessary food additives (pdf)
Weight Management action plan (pdf)
Advice for children with a significantly limited diet (pdf)
Alcohol and type 1 diabetes in adolescents (pdf)
Allergy – Introducing milk free solids to your baby (pdf)
Allergy – Milk free and Egg free diet (pdf)
Allergy – Milk free diet (pdf)
Allergy – Soya free diet (pdf)
Bile Acid Diarrhoea (BAD) Dietary Advice (pdf)
Care of your MIC Jejunostomy feeding tube (pdf)
Constipation and your childs diet (pdf)
Dementia Care – A practical guide to eating and drinking (pdf)
Dementia Care Swallowing Problems (pdf)
Diabetes – Glycaemic index (pdf)
Diabetes – How to take control (pdf)
Diabetes – Hypoglycaemia diet sheet (pdf)
Diabetes – Physical activity and insulin for people with Type 1 Diabetes (pdf)
Diabetes – Physical activity and insulin Type 2 Diabetes (pdf)
Diabetes – Reducing Carbohydrates (pdf)
Diabetes Healthy eating with diabetes (pdf)
Diet advice for heart disease and stroke (pdf)
Diet and cancer care – Constipation (pdf)
Diet and cancer care – Diarrhoea (pdf)
Diet and cancer care – Dietary advice for patients receiving radiotherapy to the pelvis area (pdf)
Diet and cancer care – Dry mouth (pdf)
Diet and cancer care – Nausea and vomiting (pdf)
Diet and Cancer care – Sore mouth or throat (pdf)
Diet and Cancer Care – Taste changes (pdf)
Diet and Cancer Care – Tube feeding (pdf)
Diet and cancer care – Vitamin and mineral supplements (pdf)
Dietary advice following gastrectomy (pdf)
Dietary advice following oesophagectomy (inc jej feeding) (pdf)
Dietary advice following pancreaticoduodenectomy (Whipple Procedure) (pdf)
Dietary advice for people taking warfarin tablets (pdf)
Dietary advice for people with a high output stoma (pdf)
Dietary advice for people with an Ileostomy (pdf)
Dietary advice for people with severe neutropenia in protective isolation (pdf)
Dietary advice to gain weight and protect your heart (pdf)
Dietary advice to Lower Blood Cholesterol Levels (pdf)
Dietary and lifestyle advice for the management of heartburn (pdf)
Dietary treatment of weight loss on a low sugar diet (pdf)
Eating problems in school aged children (pdf)
Eating well on a low fat diet (pdf)
Eating well when breathing is difficult (pdf)
Eating well when starting haemodialysis (pdf)
Feeding advice for children with autism who have restricted eating (pdf)
Gluten Challenge for children (pdf)
Having a Percutaneous Endoscopic Gastrostomy (PEG) Tube inserted (pdf)
Healthy Eating for children with Hyperlipidaemia (pdf)
Healthy eating for diabetes in pregnancy (pdf)
How to increase your iron intake (pdf)
Kidney Disease: A guide to diet (pdf)
LEAP Info for Parents for introduction of peanut at home (pdf)
Low iodine diet – a one week diet (pdf)
Naso–Jejunal (NJ) Tube Fitted at the Bedside Using Magnetic Imaging. (CORTRAK) (pdf)
Nutritional supplements in hospital and what to try at home (pdf)
Paediatric Diabetes – A step-by-step guide to carb-counting with accuracy (pdf)
Paediatric Diabetes – Baking ideas for diabetes (pdf)
Paediatric diabetes – Exercise (pdf)
Paediatric Diabetes – Hypoglycaemia (pdf)
Paediatric Diabetes – Snacks (pdf)
Paediatric Diabetes – Healthy Eating for Children with Diabetes (pdf)
Paediatrics – How to gain weight in children (pdf)
Paediatrics- How to gain weight in babies (pdf)
Prevention or treatment of weight loss High protein high calorie information (pdf)
Reintroduction of cow’s milk (pdf)
Renal Disease – Eating out on a renal diet (pdf)
Renal Disease – Healthy eating with kidney problems (pdf)
Renal Disease – Blood Results (pdf)
Renal Disease – Blood results pre-dialysis (pdf)
Renal Disease – Christmas on a renal diet (pdf)
Renal Disease – Controlling your blood sugar levels after a kidney transplant (pdf)
Renal Disease – Diet action plan (pdf)
Renal Disease – Diet and controlling blood results on NX stage dialysis (pdf)
Renal Disease – Eating well after a kidney transplant (pdf)
Renal Disease – Eating well on dialysis (pdf)
Renal Disease – Eating well with kidney problems (calories for people with diabetes) (pdf)
Renal Disease – Eating well with kidney problems (calories) (pdf)
Renal Disease – fluid allowance (pdf)
Renal Disease – Getting started on a low phosphate diet (pdf)
Renal Disease – Getting started on a low potassium diet (pdf)
Renal Disease – Haemodialysis and Diet (pdf)
Renal Disease – How to increase the potassium in your diet (pdf)
Renal Disease – Low Phosphate Diet (pdf)
Renal Disease – Low Potassium Diet (pdf)
Renal Disease – Low potassium diet for people with diabetes (pdf)
Renal Disease – Low potassium snack and drinks for people who have diabetes (pdf)
Renal Disease – Low potassium snacks and drinks (pdf)
Renal disease – Managing your fluid balance (pdf)
Renal Disease – Meal and snack suggestions for a small appetite (pdf)
Renal Disease – Peritoneal Dialysis and diet (pdf)
Renal Disease – PD Peritonitis and diet (pdf)
Renal Disease – Protein Portions with CKD (pdf)
Renal Disease low potassium diet the basics (pdf)
Swallowing Difficulties: How to Eat Well on a Soft and Bite-sized Diet (pdf)
Start right – Eating for the one to five year olds (pdf)
Starting your baby on solid food (pdf)
Swallowing difficulties – No oral fluids (pdf)
Vitamin D Food Fact Sheet (pdf)
Weight loss – food facts and tips (pdf)
Weight management – Action plan (pdf)
Weight management – Advice for Asian People (pdf)
Weight management – Change for the better (pdf)
Weight Management – Glycaemic Index (pdf)
Weight management – Making changes work for you (pdf)
Weight management – Meal ideas (pdf)
Weight management – Resources (pdf)
Weight management – Food Portions (pdf)
What can I eat now I have an oesophageal stent (pdf)
Wound healing Diet sheet (pdf)
Rugby & South Warwickshire Guidance
SWFT Dieticians Services Patient information leaflets and related links
Cancer
MacMillan.org.uk healthy diet and lifestyle
Diabetes
Encouraging your child to gain weight
General information
Ensuring Good Nutrition and Hydration
Getting the Balance Right as a Vegan
Infant and child nutrition
Special diets: Gastrointestinal disorders
A Guide to Healthy Eating – Gall stones, constipation, high bp, raised cholesterol
BDA Irritable Bowel Syndrome Diet
Management of Toddler Diarrhoea
Special diets: Learning Disabilities Accessible Information
Type 2 Diabetes Diet Information
Healthy Menus Healthy Shopping
Preventing Overeating in Autistic Spectrum Disorder
Leave feedback
You must be logged in to post a comment.