Nutrition and Dietetics - Northern services

Our department consists of registered dietitians, dietetic support workers and administrators who support patients from across north Devon at our base at North Devon District Hospital. 

The team is split into several specialist teams:

The acute team 

We provide inpatient dietetic care to appropriately referred adults on all the main wards in the hospital and cover areas such as gastroenterology, surgery, intensive care, health for older people, cardiology, orthopaedics, neurology, oncology, haematology, maternity and intestinal failure. 

Our Nutrition team provide care for inpatients on parenteral nutrition (PN) and advises on the care of patients with complex enteral nutrition needs. 

We also ensure that the hospital meals meet nutritional standards. 

The outpatient team 

The team run general and specialist outpatient clinics. These are run as telephone, video or face-to-face clinics at NDDH, depending on the needs of the patient. Referrals are from hospital consultants, GPs, specialist nurses, or other therapists.

We help with nutrition support, weight management, diabetes, eating disorders, oncology, IBS, Crohn's disease, coeliac disease, liver disease, and IBS. 

The paediatric team 

We work with children 0-18 years of age. We work closely with health professionals within the hospital but also with other members of the wider healthcare community. These include community consultant paediatricians, GPs, health visitors, specialist nurses and child and adolescent mental health teams. We see children with a wide variety of different conditions. We provide advice to help manage their conditions through dietary changes.

Here are some examples of what we can help with: 

• Food Allergies 
• Diabetes 
• Cystic fibrosis 
• Cardiac conditions 
• Coeliac disease 
• Faltering growth 
• Inflammatory Bowel Disease 
• Eating disorders 
• Tube feeding at home 
• Inpatients at Caroline Thorpe ward 

The Community Home Enteral feeding team (adults) 

The community team offer home visits to enterally fed (tube-fed) patients in their own homes or care homes. Patients require tubes for a number of reasons such as neurological problems, cancer or other problems affecting their ability to eat, and the use of a tube could be short-term or long-term.  The dietitians in this team work closely with the company enteral feeding nurses, who also visit these patients at home. 

Staff and Student Training 

We provide training on different aspects of nutrition to all disciplines of staff, including doctors, nurses, support workers, catering staff, and housekeeping staff.  

We provide award-winning clinical placements for student dietitians from the University of Plymouth. We take students from the first year to their final year, and have students working with us at regular times throughout the year.  

Referrals are made via e-RS (electronic referral system) or via EPIC by placing an order. 

Leaflets for patients at risk of malnutrition

• Green leaflet: Eating well – Advice for patients and carers: for those at low risk of malnutrition
• Yellow leaflet: Your Guide to Making the Most of Your Food – Advice for patients and carers: for those at medium risk of malnutrition
• Red leaflet: Nutrition Drinks (known as Oral Nutritional Supplements) – Advice for patients and carers: for those at high risk of malnutrition
• Eating well with a small appetite
• Nourishing drinks
• Plant based food fortification
• Soft nourishing diet
• Managing Adult Malnutrition – Resources for Patients and Carers

Modified Texture Diet Leaflets

• Level 3 Liquidised
• Level 4 Puree
• Level 5 Minced and moist
• Level 6 Soft and bite-sized

Disease specific support

• Dietary information for acute pancreatitis
• Dietary information for chronic pancreatitis
• Dietary and lifestyle advice for reflux
• First line dietary advice for constipation
• Low fibre / low residue diet
• Low FODMAP diet – a guide for patients and GPs
• Preparation for surgery - liver-reducing diet
• How to slow your pace of eating
• Diet and your colostomy
• Dietary advice following your ileostomy

Specialist Weight Management Clinic

Diet and Nutrition food fact sheets

• British Dietetic Association Food Fact Sheets

Food Fact Sheets on a wide range of medical conditions, nutrients, and for all stages of life. They are written by dietitians to help you learn the best ways to eat and drink to keep your body fit and healthy.

PIFU - Patient initiated follow-up information

Reflux

NHS Start4life: Reflux and bottle feeding

https://www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/bottle-feeding-challenges/reflux-and-bottle-feeding/

NHS Start4Life: Reflux and breastfeeding

https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/reflux/

Constipation

NHS Start4Life: constipation when bottle feeding

https://www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/bottle-feeding-challenges/constipation-and-bottle-feeding/

NHS Start4Life: constipation when breast feeding

https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/constipation/

Infant and Toddler Forum: common nutritional problems

https://infantandtoddlerforum.org/toddlers-to-preschool/common-nutritional-problems-in-toddlers/constipation/

ERIC web site - Children's bladder and bowel charity:

https://eric.org.uk/childrens-bowels/constipation-in-children/

Weaning

NHS start 4 Life: For age appropriate meal and snack ideas: https://www.nhs.uk/start4life/weaning/recipes-and-meal-ideas/

The Infant and Toddler Forum: for weaning advice, finger foods etc

https://infantandtoddlerforum.org/babies-the-first-year/

Fussy Eating

The Child Feeding Guide: resources on tips and tools for parents on fussy feeding, online assessment tools and food refusal guides. You can create an account to track exposure, refusal and acceptance of foods.

https://www.childfeedingguide.co.uk/

Somerset Patient Webinars 6-14 mins long on Fussy feeding tips

https://patientwebinars.co.uk/condition/fussy-eating-in-children/

The Infant and Toddler forum: parents section

https://infantandtoddlerforum.org/toddlers-to-preschool/fussy-eating/

NHS Weaning and fussy eating : resources on weaning, fussy eating and meal/snack ideas.

https://www.nhs.uk/conditions/baby/weaning-and-feeding/fussy-eaters/

Iron Deficiency Anaemia

The Infant and Toddler Forum: parents section

https://infantandtoddlerforum.org/toddlers-to-preschool/common-nutritional-problems-in-toddlers/iron-deficiency-anaemia/

Weight Management

NHS healthy families:  Advice on snacking, food swaps and reducing fat, salt and sugar. Healthy recipes and activity ideas.

https://www.nhs.uk/healthier-families/

NHS - Eat well guide

https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/

First steps nutrition: Eating well resources page has picture guides on portion sizes for age groups and healthy recipe ideas.

https://firststepsnutrition.org/

Infant and Toddler Forum: Portion size guidance for under 5’s.

https://infantandtoddlerforum.org/toddlers-to-preschool/portion-sizes-for-toddlers/toddler-portion-sizes-table/

British Dietetic Association: Mindful Eating

https://www.bda.uk.com/resourceDetail/printPdf/?resource=mindful-eating

Food Allergy

Infant and Toddler Forum: Guidance and tips about food allergy

https://infantandtoddlerforum.org/toddlers-to-preschool/common-nutritional-problems-in-toddlers/food-hypersensitivity-introduction/

https://infantandtoddlerforum.org/toddlers-to-preschool/common-nutritional-problems-in-toddlers/food-hypersensivity-advice/

Allergy UK: A British medical charity who support patients with allergies

https://www.allergyuk.org/

British Dietetic Association: Food Fact sheets about allergy

https://www.bda.uk.com/resource/food-allergy-food-intolerance.html

https://www.bda.uk.com/resource/food-allergy-intolerance-testing.html

Coeliac Disease

Coeliac UK: A British medical charity who support people with Coeliac Disease

https://www.coeliac.org.uk/home/

British Dietetic Association: Food Fact sheet about Coeliac Disease

https://www.bda.uk.com/resource/coeliac-disease-and-gluten-free-diet.html

Diabetes

Diabetes UK: A British medical charity who support people with Diabetes

https://www.diabetes.org.uk/

British Dietetic Association: Food Fact Sheets about diabetes

https://www.bda.uk.com/resource/diabetes-type-1.html

https://www.bda.uk.com/resource/diabetes-type-2.html

JDRF: Type 1 Diabetes Charity

https://jdrf.org.uk/

Digibete: Online support and resources for children and parents/carers.

https://www.digibete.org/

Autism

British Dietetic Association: Food Fact sheet about Autism and the potential impact on eating

https://www.bda.uk.com/resource/autism-diet.html

Children and family health Devon: Resources for families on sensory processing https://childrenandfamilyhealthdevon.nhs.uk/autistic-spectrum-disorder/resources/