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Adult Oral Nutritional Supplements

Two project reports have been written regarding the management of Oral Nutritional Supplements (ONS) and malnutrition in London, the 'LPP Clinical Oral Nutrition Support Project Report 2009' and the 'LPP Clinical Oral Nutrition Support Project Report 2010'.

The LPP Clinical Oral Nutrition Support Project Report 2009 evaluated the management of ONS and dietetic capacity in London. The follow up LPP Clinical Oral Nutrition Support Project Report 2010 assessed the various prescribing initiatives implemented in London enabling a number of measures to be identified which can improve prescribing practice and the management of malnutrition.

LPP carried out a pilot audit to understand what information is currently included on a prescription request from acute care to primary care for adult ONS, Paediatric ONS, modular supplements and specialist infant formulae. This report, the Report on Audit of Information Transferred from Acute Care to Primary Care for Nutrition Prescription Requests, presents the findings of the audit and prescription requests to GPs.

All the reports may be downloaded from the Supporting Information box to the right of this page, along with our Principles of Good Practice for HCPs when communicating Nutrition Requests to GPs.

The latest Adult Nutrition Product Pricing schedule is also available for download from the Supporting Information section.

Resources to improve ONS prescribing practices

To support London NHS organisations in the implementation of initiatives and services to improve ONS prescribing practices, a number of resources have been developed. All of the templates are designed to be adapted to suit local practice.

The documents listed below can be downloaded from the Supporting Information box.

ONS Demand Management - A Guide to Getting Started

The aim of this document is to provide CCGs and dietetic services with information and resources to facilitate service development within the areas of ONS demand management and nutrition support.

ONS Guidelines (Adults)

These guidelines are designed to help London NHS organisations standardise practice with regard to the management of malnutrition and ONS.

6 Steps to Appropriate Prescribing of Oral Nutritional Supplements (Adults)

These simple guidelines are designed for GPs to support good prescribing practice. The pathway on the back allows specific products to be stipulated according to local formulary or contractual agreements.

ONS Training Package

Designed to support the "6 steps" guidelines, this training package can be implemented by both dietetic services and medicines management.

Appropriate Prescribing for Dietitians

These presentation slides outline the appropriate recommendation of ONS and gluten free products.

A Guide to Prescribing ONS in Nursing and Care Homes

These guidelines are designed to help CCGs to improve the identification and treatment of malnutrition in nursing and care homes and facilitate good practice with regard to the NHS.

A Guide to Prescribing ONS in the Community (Adults)

These guidelines aim to help CCGs. They are designed to be used by pharmacists, general practitioners (GPs), qualified district nurses, practice nurses and other appropriate community health professionals where access to local dietetic services is limited.

Best Practice Example of Food First Diet Sheets for Adults

The Nutrition Support Dietetic Service at Central London Community Healthcare developed a series of four diet sheets to support patients in implementing a "Food First" approach ("Poor Appetite," "Snack Suggestions," "300 Calorie Alternatives," and "Why Should I Have Nourishing Drinks"). The service also developed a diet sheet that explains the role of ONS. Central London Community Healthcare NHS Trust is happy for this resource to be used if their work is acknowledged.