The service provides easily accessible expert paediatric dietetic input to paediatric patients from birth up to 16 years of age, and up to 19 years of age if under the Diana Service, and their families resident within the London borough of Newham requiring home enteral feeds or who have additional needs or disabilities.
 
Referral
  • Referral form (Appendix 2)
  • The referrals are prioritised by the clinical Band 7 Dietitian and seen according to priority and need.
  • Verbal referrals require a backed up in writing so there is an auditable trail of referral patterns.
  • The Dietitian referral form can be found on the Trust Intranet and external website
  • Referral may be via GP, Paediatric Consultants or a qualified nurse or Allied Health Professional. Self-referrals are not accepted.

Referral Criteria

Referrals will be accepted for children (birth up to 16 years) with:

  • Palliative care/ end of life
  • Requiring community dietetic follow up
  • Enteral Feeding
  • All referrals accepted (short & long term)
  • Neurodevelopmental Delay or Neurological Condition or Syndrome
    • Examples include but are not restricted to:
      • Global Developmental Delay
      • Cerebral Palsy
      • Brain tumour or injury
      • Micro/ Macrocephaly
      • Encephalopathy
      • Spina bifida
      • Hydrocephalus
      • Epilepsy
      • Trisomy 21 (Down’s Syndrome)
  • Severe & Profound Learning Difficulties
  • Education Statement
  • Ongoing issues that compromise nutrition
  • Children with Autism will initially be seen for a one-off nutritional assessment

 

Autism Referrals

  • Children with autism will initially be offered a one-off nutritional assessment with the Dietitian. They will only be offered a follow up appointment if their growth is faltering or they have an extremely limited diet requiring nutritional supplementation.

Weight Loss Referrals

  • Children referred for weight loss advice will initially be offered a block of six sessions. A decision will be made at the end of the six sessions to determine whether further input would be beneficial. The referrer and GP will be informed of the decision.
Triaging

Prioritisation for accepted referrals (see section 9: referral criteria) will occur as follows:

Priority 1: To be seen within 1 - 2 weeks

  • New Enterally fed patient upon discharge from hospital
  • Rapidly deteriorating condition which may require enteral feeding

Priority 2: To be seen within 3 weeks

  • Severe Dysphagia
  • End stage terminal illness with complex nutritional needs
  • Children with a child protection plan or where there are child protection concerns (please contact the dietician to discuss these concerns)

Priority 3: To be seen within 4 weeks

  • Faltering Growth
  • Ex-premature
  • Other severe medical issues: cardiac, respiratory, oxygen dependent, tracheotomy
  • Metabolic diseases
  • Conditions compromising nutrition/ fluid intake

Priority 4: To be seen within 6 weeks

  • General nutrition advice

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