Inpatient Services at Barnsley Hospital
The Acute Services Team comprises of Dietitians who work within Barnsley Hospital NHS Foundation Trust and Mount Vernon Hospital providing a dietetic service to all the wards. The service is available between 9.00am and 5pm Monday to Friday.
Referrals can be made directly to the Service by members of the medical team in writing. Alternatively, referral can be made via the nutritional screening tool or the red tray pathway.
Patients seen on the wards are both acutely and chronically ill, with various types of nutritional problems/requirements, e.g. critically ill patients who require alternative feeding, such as enteral and parenteral nutrition, or patients with long-term chronic conditions such as coeliac disease, diabetes, COPD and heart disease. Malnutrition is a common condition in hospital patients which needs identification and treatment in order to reduce recovery time and complications.
Assessment techniques such as weight history, anthropometrical measurements, food diaries and biochemistry are routinely used to devise and evaluate nutritional plans. Aims of treatment are to improve nutritional status, aide recovery, or control biochemistry, e.g. in diabetes or renal disease.
Nutritional Screening Tool
All patients are nutritionally screened on admission at ward level by the nursing staff. The scores for patients admitted the previous day are screened on a daily basis with those scoring 15 or above being automatically referred to a dietitian for nutritional assessment and advice.
Red Tray Pathway
This patient focussed system allows patients who have been identified to be nutritionally ‘at risk’ to be supported during their stay. It consists of a red tray replacing the usual brown meal tray used to serve the patient’s meals. This increases the nursing staff’s awareness of the patient’s food intake which is monitored for at least 3 days. If, after 3 days nursing staff have concerns or the patient’s food intake is consistently poor, the patient is referred to a dietitian for assessment. The Red Tray Pathway can be introduced at any point during a patient’s hospital stay.
Examples of patients who may benefit from the Red Tray Pathway:
- Patients with a nutritional screening score of between 11 and 14.
- New patients to wards (especially if undernourished)
- Concern by the family regarding patients nutritional intake, or for those who may have memory problems (Alzheimer’s / Dementia)
- Patients who are slow to finish their meals or need encouragement
- Nausea / Vomiting
- Swallowing problems
- Patients with physical / mental disabilities
- Those who need assistance with eating and drinking
If family members feel that their relative would benefit from the Red Tray system then they can request for the system to be implemented.
Patients who continue to need dietetic services following discharge from hospital will benefit from a full planned discharge programme which provides a seamless transition between hospital and home. These patients will include those who are being artificially fed, those who need continuing nutrition support and those who have been diagnosed with diabetes or coeliac disease.
An automatic referral to the appropriate dietitian will be made on discharge and appropriate action taken. This may include arrangements for delivery of feed or supplement drinks, or an outpatient appointment at a suitable location. The service is district-wide and so is operational throughout the whole of the Barnsley area. The patient’s GP will also be informed of the action taken.
Outpatient clinics are run at 30 different venues throughout the Barnsley area where patients can be treated for a range of conditions. These include diabetes, raised cholesterol levels, coeliac disease, gastrointestinal disease, food allergy or intolerance or nutritional deficiencies, e.g. anaemias, and others.
For GP’s who wish to refer a patient, the ‘General Practitioner Request for Dietetic Service’ card, or a letter sent to the Department of Dietetics and Nutrition at Barnsley Hospital NHS Foundation Trust are accepted, and for hospital consultants and their teams the ‘Request for Dietitian’ referral card is accepted.
All referrals must include the reason for referral, any relevant medical history, biochemical test results and other relevant information.
Please note that referrals to the Obesity Service must be on the Barnsley Obesity Referral Form.