Nutrition is the healthy food that we need.
Dietetics is the study of the best food for different health conditions.
This page gives information about:
Dietitians are the only qualified health professionals that assess, diagnose and treat dietary and nutritional problems at an individual and wider public-health level. They work with both healthy and sick people. Uniquely, dietitians use the most up-to-date public health and scientific research on food, health and disease which they translate into practical guidance to enable people to make appropriate lifestyle and food choices. Dietitians are the only nutrition professionals to be regulated by law, and are governed by and ethical code (registered with the Health Care and Professions Council) to ensure that they always work to the highest standard (Quote from British Dietetic Association).
The Royal Liverpool and Broadgreen team cover inpatient care and outpatient clinics. The Stroke service provides early supported discharge therefore see patients in their own home.
The department has a variety of specialist Dietitians covering a wide range of clinical areas and conditions. The team also benefits from Dietetic assistants and clerical support staff. We are part of the Therapies Directorate.
We work very closely with the Dietitians at the Liverpool Heart and Chest Hospital, the team at Liverpool Community Health
Some of the areas covered by the department are:
There are two critical care dietitians who specialise in the nutritional assessment and delivery of nutrition to patients with acute life threatening disorders on designated intensive care and High dependency Units.
The provision of nutritional support is part of routine care in both critical care units. These patients are at very high risk of becoming malnourished due to the stress placed on the body whilst critically ill. The body’s priority is to use body tissue for defence and repair in an attempt to survive. This is associated with muscle loss.
Many patients on critical care units are on a ventilator, a machine to assist with a patients breathing and likely to be sedated. This prevents a patient from eating a normal diet and therefore a temporary artificial route of feeding is required until woken up, weaned off the ventilator and oral diet can be resumed.
In line with the NICE Guidelines for Nutritional Support in Adults the Trust has a multidisciplinary nutritional support team (NST).
This comprises of a nutritional support Dietitian, a pharmacist, gastroenterologist, nutrition nurse consultant, three nutrition nurse specialists and a clinical biochemist.
The team is predominantly involved with Total Parenteral Nutrition (TPN – intravenous feeding) but they do have some input into oral and enteral tube feeding.
The team reviews patients on TPN daily and assesses new referrals. Generally speaking, TPN is only given to patients who do not have a functioning gut and cannot be fed orally or enterally. This is because TPN has many complications and it may not be as beneficial as other forms of nutritional support.
The nutritional support Dietitian estimates the nitrogen, energy and electrolyte requirements for TPN, while the TPN pharmacist arranges compounding of the bag and adjusts the volume and electrolytes in conjunction with the clinical biochemist.
The team also has surgical, gastro, speech therapy and microbiology members who can be contacted if necessary.
Details of typical nutritional support teams can be found on the OfNoSH (organisation of nutritional support in hospitals) section of the BAPEN website.
There is a multidisciplinary clinic at the Royal where patients on home parenteral nutrition are reviewed. Patients with electrolyte abnormalities or those who need to be started on tube feeding can also be seen in this clinic.
Food and lifestyle choices play an important role in diabetes care. Diabetes dietitians provide education and support to help people with diabetes make informed choices about food and lifestyle. We provide personalised advice based on a person’s current lifestyle, medications and other health conditions. We work closely with the diabetes nurses and diabetes consultants to help people to improve their diabetes control.
We see people as inpatients on the wards as well as outpatients in clinics. We also provide “carbohydrate counting” group education to people with type 1 diabetes which educates them on how to adjust their insulin based on their food intake.
In the short term, we can help people to improve their blood glucose levels by matching their current treatment with an appropriate meal pattern which can help to prevent hyperglycaemia (high blood glucose levels) and hypo’s (low blood glucose levels).
In the longer term we can help people to make changes in line with healthy eating guidelines and help with weight loss or protection against heart disease.
The Gastroenterology specialist dietitians cover areas including inflammatory bowel disease (IBD) i.e, Crohns disease and ulcerative colitis, alcohol liver disease and malignancy of the gastrointestinal tract.
Many patients with these conditions require nutritional support from the dietitian. This includes the usage of nutritional supplement drinks which provide additional calories, protein and vitamins and minerals. At times these patients require feeding via a tube or dietary changes to relieve symptoms such a low residue (low fibre diet).
There is a weekly gastroenterology clinic seeing patients with IBD and Coeliac Disease. The aim is to see all newly diagnosed patients with Coeliac Disease and follow up patients that need further support. Patients with Coeliac Disease are seen annually by the dietitian to ensure the patient is nutritionally stable.
More information can be found about Coeliac Disease on the Coeliac UK website.
Crohn's and Colitis UK provide information and support for people affected by inflammatory bowel disease.
Nutrition plays an important role in the care of patients with cancer and those who are immunocompromised. It is therefore especially important that these patients have access to specialist dietetic services as they are susceptible to declining nutritional status and infections as a result of disease and treatment intervention.
Maintaining an adequate intake and good level of nourishment is important for each patient both to improve their general health and to maintain their best possible state of health as they progress with their treatments and adapt to lifelong medication.
To achieve this, the dietitian assesses the nutritional status of the patient, gives advice, education and support throughout their period of care.
This education often entails food safety, ensuring optimum nutritional status and due to increasing numbers of malnutrition, some form of nutritional support is required.
The infectious diseases dietitian works with patients on the isolation ward 3x and 3y to reduce the risk of them becoming malnourished.
Nutrition is an essential part of treatment for the various illnesses, infections and conditions associated with infectious diseases.
A good nutritional status has been shown to improve immune function, reduce muscle wasting, improve mood, and reduce length of stay in hospital.
The Dietitians see patients with movement disorders whilst an inpatient and during Consultant led clinics at Broadgreen Hospital.
Movement Disorders include conditions such as Parkinson's Disease, MSA (Multiple System Atrophy) and PSP (Progressive Supranuclear Palsy) which are progressive neurological conditions. Parkinson's Disease symptoms include tremor, rigidity and slowness of movement.
Weight fluctuation dietary problems and difficulty chewing and swallowing can be common in Parkinson's Disease. People may gain weight due to inactivity and difficulty preparing meals. People may lose weight due to increase energy needs as a result of increased movement with tremors. Problems with constipation are common and dietary changes with medication may help resolve this.
Patients can discuss dietary problems with their Dietitian. Further information can be found on the Parkinson's UK website which provides advice and support.
We are a team of six specialist renal dietitians who assess nutritional requirements and food intake of renal (kidney) patients.
Diet is an important part of the management of kidney disease and we support patients with kidney disease pre-dialysis and on dialysis as well as those patients who have received a kidney and/or pancreas transplant.
The kidneys remove waste products from the body in the urine. These waste products can be affected by foods that are eaten.
Patients who have kidney failure may be required to avoid or limit certain foods and drinks. Individually tailored advice is provided based on blood results, nutritional status, medical condition and treatment.
The renal dietitians also support and facilitate education and continuing professional development within the hospital and satelitte units in the surronding areas of Halton, Warrington,Broadgreen and St Helens.
The areas we provide a service to:
The Stroke Dietetic Team consists of 5 dietitians who provide input to all stroke patients admitted to the trust.
Acute Stroke Unit (ASU) and Stroke Rehabilitation Unit (SRU)
Patients diagnosed with stroke on the ASU and SRU are screened for risk of malnutrition and are provided with dietetic input as required.
After a stroke some people have difficulty with eating and drinking and may require to be fed through a tube, the dietetics department are involved in safe initiation of tube feeding and support and advice on the most appropriate route of feeding.
We also provide support to people who are having difficulty eating and drinking, are malnourished or who require advice on the different food textures which may be required to ensure safe swallowing after a stroke.
We are also available to provide advice on management of diabetes, diet modifications to promote healthy cholesterol levels and diet and lifestyle advice for the prevention of stroke.
Early Supported Discharge (ESD Team)
The ESD Dietitians provide follow up for patients in their own environment for up to 6 months after they are discharged from hospital.
Evidence suggests that providing input and therapy in patients own home can improve their chances of survival and of independent living.
The dietitians link in weekly to the multidisciplinary team and provide joint therapy visits when needed to ensure the patient receives the most appropriate and efficient care.
Stroke Review Clinic (SRC)
Dietitians are available in SRC to provide follow up, support and advice to patients on any issues related to their diet or nutrition.
Life After Stroke
Life After Stroke is a 4 week education programme for stroke survivors and their carers that is coordinated by the dietitians.
It provides an insight into the causes of stroke, support in managing the symptoms of stroke and providing guidance on how to help reduce the risk of further strokes by managing your medication, diet and lifestyle.
It also provides information for stroke survivors on agencies, charities and support groups that can provide further support to them and their families.
The Stroke Association provide advice and support for people recovering from a stroke.
You need a referral from your GP, consultant or another health professional. The department will then send you an option letter with contact details for your to call and make an outpatient appointment.
During your first appointment the dietitian will ask you about your usual food intake and will ask you if you are happy to be weighed (if relevant). The dietitian will discuss your nutritional needs and work with you to set individual goals. At the end of your appointment the Dietitian will discuss arrangements for your future appointments when needed.
If you need to cancel your appointment please contact the therapies department on 0151 706 2760 Monday - Friday; 8:30am - 4:00pm.
Therapies department
0151 706 2760
Royal Liverpool Dietitians Department
0151 706 2120
Broadgreen Dietitians Department
0151 282 6473
Royal Liverpool Renal Dietitians
Our clinic locations are listed below
Royal Liverpool University NHS Hospital Trust,
Prescot Street,
Liverpool, L7 8XP
Clinics:
Ground Floor *follow signs for Therapies Department*
Broadgreen Hospital
New Main Entrance
Broadgreen Hospital
Thomas Drive,
Liverpool, L14 3LB