Oral Nutritional Supplements

Sunderland CCG, in collaboration with City Hospitals Sunderland NHS Foundation Trust are reviewing how they manage patients who need Oral Nutritional Supplements (ONS).

They have produced some updated guidelines for primary care to use when assessing whether a patient actually needs ONS and if they do, what to actually prescribe. The guidelines can be dowloaded by clicking here.

Key points include:

Key Points
 Prescribing ONS is expensive for the NHS, costing Sunderland CCG over £950,000 in 2015/16.
 The MUST tool should be used to identify patients who are at risk of malnutrition (more information here).
 All patients who are prescribed ONS should be under the care of a dietitian.
 Following discharge from hospital ONS should only continue to be prescribed if the GP practice receives a care plan from the patient’s dietician.
 Give acute prescriptions on a short term basis (1 b.d.), starting with a variety of flavours and refer the patient to the dietitian for review.
 If the patient or carer can prepare drinks (including patients in care homes) start a powdered ONS. This can potentially save over £300 per patient, per year.
 If a patient is at risk of malnutrition:
o First line – Food fortification, eating ‘little and often’, homemade milkshakes, etc.
(more information here** including leaflets available to print for patients).
o Second line – over the counter ONS – products such as Meritene® and Complan®
should be considered in the short term.

Jenny Harries is the Medicines Management Dietitian who will be leading on this piece of work and will:
– Audit the ONS prescriptions of patients at GP Practices with high ONS prescribing costs.
– Identify where appropriate but more cost-effective ONS can be used
– Review patients and recommend ONS prescription changes where appropriate
– Ensure patients have a nutritional care plan in place
– Produce resources to aid appropriate prescribing of ONS in the primary care setting e.g. GP ONS prescribing guidelines.
Contact details:
Email: jenniferharries@nhs.net
Address: Dietetic Department, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP
Tel: 0191 5699013