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Nutrition Services

Introduction

We know that the current situation with Covid-19 will be difficult for our nutrition patients. We have written to you all individually and have placed information for both TPN and R Homecare patients below. We have also placed contact details at the bottom of this page for if you need clinical advice.

 

With Very Best Wishes

Dr Martyn Dibb, Dr Philip Smith, Dr Ashley Bond and Alison Young, Nurse Consultant.

Information

As you are aware we are having to put plans in place and manage any issues in relation to nursing problems, visit windows, delivery schedules and supplies given the unprecedented coronavirus crisis

In order to support you as safely and fully as possible during this international crisis we need to we need to implement either all or some of the following measures as follows:

  • Prior to every nurse visit or delivery the R Homecare coordinator will conduct a risk assessment
  • You MUST alert us if you have any signs of symptoms relating to the Coronavirus as per the government and NHS websites (gov.uk and www.nhs.uk)
  • You MUST alert us if you have potentially come into contact with anyone with the virus and self-isolate as per government guidance (gov.uk and www.nhs.uk)
  • Based on the current government’s recommendations for high risk patient groups, as you are a home parenteral nutrition patient you are being advised to self-isolate for 12 weeks in order to prevent you getting the virus. Be aware this is an ever changing situation so this may change over time.
  • We are asking all our HPN patients to register for extra government support at: https://www.gov.uk/coronavirus-extremely-vulnerable as you have been categorised in the highest risk patient group if you were to be infected with the coronavirus. If you need any help with this then contact our helpline or email address.
  • Due to potential staff shortages (staff my become unwell or be relocated to other parts of the NHS) we may need to changing the duration of your infusion potentially to 24 hours so we can reduce visits (or some change in feed regime).
  • If you miss or refuse a visit on a particular day we may not be able to accommodate another visit that day due to the stresses on the system
  • We may have to reduce services to two weekly deliveries
  • We may need to reschedule deliveries
  • We will need support from yourself/family in relation to unpacking your PN and ancillaries
  • We may need support from yourself/family in relation to connection and disconnection of PN
  • You may find that you will be asked to wear additional protective equipment such as a face mask to protect yourself during the connection/disconnection process
  • You will find homecare staff wear additional protective equipment such as a face mask, gloves and gowns to protect you and themselves from any cross contamination
  • In extreme circumstances, you may need to attend the hospital to have your parenteral nutrition connected/disconnected. We hope it will not come to this but unfortunately there may be no other solution to this
  • You may get visited by nutrition nurses who you are not familiar with. All visitors will be trained to administer your nutrition and show their NHS identification.  Please be welcoming and understanding if they are not familiar with your usual routine.
  • We are not able to accommodate holiday travel PN prescriptions until further notice

Thank you very much for your help and support at this time.

We write to you as your consultants and nurses, but also fellow citizens, at this time of unprecedented crisis and pressure in the NHS.  We understand how this will be causing huge stress and anxiety for many of you and so wanted you to know we are going to do our absolute best to support you.  However, it is without question we will need your help now, more than ever, to keep you safe and some essential changes may be needed in order to do this.

Below we have listed a number of changes that you will need to be aware of that will have to be immediately instigated in order to maintain a safe service for you:

  • In the event of an urgent appointment being required this may be facilitated by one of the Nutrition nurses 0151 706 3650 (during working hours) or out of hours 08003285437. Alternatively you can Email nutritionsupport@rlbuht.nhs.uk.  

For those who require nutrition nurses to connect/disconnect their PN (and are looked after by R Homecare) please refer to the attached letter from R Homecare company.

If you do not get your PN or fluids via R Homecare, you should be aware that your company may need to make changes to the timing, duration and delivery of our PN in order to run a safe service for all during this time of crisis.  Those companies will let you know of any changes and we ask for your co-operation.

Finally, as general advice regarding Coronavirus:

  • Please keep up to date with the news and recommendations on the NHS (nhs.uk) and government website (www.gov.uk)
  • Given many of you have multiple severe comorbidities the government’s latest recommendations (in agreement with a working party of nutrition specialists) have agreed that all patients on home parenteral nutrition (HPN) should be ‘shielded’ from the virus and self-isolate for 12 weeks. This is a preventative strategy (i.e. avoiding you getting the virus), as this is much better than dealing with the consequences of getting the virus.   The same applies additionally if you are on enteral nutrition and have ‘short bowel syndrome’ and if you are on strong immunosuppression.  Please be aware this is an ever changing situation and so recommendations may be altered over time.
  • As a HPN patient you are categorized in the ‘Highest Risk’ category of patient and can self-register for extra government support at: https://www.gov.uk/coronavirus-extremely-vulnerable. For example, you’ll be able to ask for help getting deliveries of essential supplies.  We are advising all our HPN patients to register themselves as soon as possible via this link.  If you have any issues doing this, please contact us via the details above. 
  • Please remember being in hospital at this time is not recommended unless it is absolutely necessary as exposure to the virus is highest here.

We want to thank you in advance for your cooperation at this very difficult time and can assure you we will do the very best we can for you given the situation the NHS is in.

Finally, please all take very good care of yourselves and your families at this difficult time.  We hope we can all get through this together.

Urgent Contact Details

R Homecare: 0151 706 3650

Out of Hours: 08003285437

Email: nutritionsupport@rlbuht.nhs.uk