Contact us
0300 123 0861
kcht.CentralisedAppointmentTeam@nhs.net
Monday to Friday, 9am to 3pm
Medway and Swale
0300 123 3444
medch.cccadults@nhs.net
Who we are
The Community Dietetics Team (adults) includes dietitians, dietetic assistant practitioners and dietetic assistants.
What we do
We provide specialist nutrition advice for adults in group and one-to-one settings both virtually and face to face. This includes; malnutrition, weight management (Kent only), diabetes, gastrointestinal conditions, allergies and food intolerances. Referrals are subject to meeting service criteria.
How do you access the service?
You need to be referred by your GP or another qualified healthcare professional (subject to meeting referral criteria).
- Community Dietetics Service for adults referral form
- For Medway and Swale, use the Nutrition and Dietetics Medway and Swale referral form.
Care home staff should follow the guidance in the Kent Manual for Mealtimes before referring to dietetics. Many eating, drinking and swallowing issues can be safely and
Useful resources
The resources have been produced by specialist groups in the Community Dietetics Team.
- Dietary management of gastroparesis
- Cirrhosis of the liver: 50g carbohydrate snacks
- Low fibre diet
- Gluten free diet
- Coeliac Disease (NHS Patient Webinar)
- Bile acid diarrhoea
- Constipation (NHS Patient Webinar)
- Diverticular Disease (NHS Patient Webinar)
- Inflammatory Bowel Disease (NHS Patient Webinar)
- Irritable Bowel Syndrome (NHS Patient Webinar)
- Reflux disease (NHS Patient Webinar)
Step 1: Identify adults at risk of malnutrition
Weigh and screen the patient using the MUST tool or the online calculator:
Malnutrition Universal Screening Tool (MUST)
Assign a risk score:
- score 0 = low risk
- score 1 = medium risk
- score 2 or more = high risk.
If the patient is low risk (score 0)
Provide routine care:
- re-weigh monthly
- re-screen monthly.
If the patient is medium risk (score 1) or high risk (score 2 or more)
Proceed to Step 2.
Step 2: Assess underlying causes of malnutrition
Investigate and treat any underlying causes of weight loss.
Step 3: Set goals and treatment plan
Develop and update the nutritional care plan:
- clarify the patient's usual weight with the patient or next of kin
- set nutrition goals
- implement Food First treatment by fortifying foods and drinks and offering nourishing snacks and drinks two to three times daily
- complete accurate food and fluid charts for at least three days to assess intake.
Step 4: Monitor
Medium risk
- re-weigh and re-screen after one month
- assess progress
- update the care plan.
High risk
- re-weigh and re-screen after one week
- assess progress
- update the care plan.
Step 5: Evaluate progress
Has the patient improved?
Examples of improvement include increased food intake or weight gain.
If yes:
- continue with the nutritional care plan
- if previously high risk, manage as medium risk if there are no further concerns
- if previously medium risk, manage as low risk if there are no further concerns.
If no improvement is seen, such as ongoing poor intake or further weight loss, proceed to Step 6.
Step 6: Review and prescribe oral nutritional supplements
- refer to dietitians
- if Advisory Committee on Borderline Substances (ACBS) criteria are met, ask the GP to prescribe one month of a first-line powdered oral nutritional supplement, for example Aymes Shake
- update the nutritional care plan
- continue Food First strategies
- monitor supplement compliance
- GP and dietitian should review and adjust the prescription accordingly.
ACBS standard indications
Oral nutritional supplements may be appropriate for:
- disease-related malnutrition
- intractable malabsorption
- pre-operative preparation of malnourished patients
- dysphagia
- proven inflammatory bowel disease
- following total gastrectomy
- short-bowel syndrome
- bowel fistula.