Nutrition and Hydration

PrescQIPP have produced a resource to support food fortification for those caring for people who have been identified as being at risk of malnutrition, or who are malnourished. It is likely to be particularly useful for those working in, or supporting care homes for older adults, but could also be used to support people living in their own homes.

A simplified version of the recipe book that can be shared with care home caterers and is also endorsed by the National Association of Care Catering.

Please follow Speech and Language Therapy treatment plan. See the Somerset Prescribing Formulary for formulary choices.

Handouts to support a food first approach can be found below and on Patient Webinars.

• British Dietetics Association – Malnutrition Factsheet
• Nourishing Drinks
• 100 Calorie Boosters
• Making Every Mouthful Count
• Keeping Healthy on a High Calorie Diet
• Basic Store Cupboard Ideas
• British Dietetic Association – Carer Information: eating and drinking at end of life
• Nourishing Recipes (Somerset Resource)
• Plant Based Nourishing Recipes (Somerset Resource)

From the 1^st of December 2016, NHS Somerset has made all Gluten Free products non-formulary (the Somerset formulary advises GPs on safe, evidence-based cost-effective prescribing).

Therefore, the GPs will no longer prescribe all Gluten Free products on prescription.

Gluten free products are now more widely available from shops and supermarkets for you to purchase instead, either in person or via online delivery and the price of these products continues to decrease.

You may also decide to replace some gluten free products previously provided on prescription such as GF pasta with alternative naturally gluten free products such as rice and potatoes.

Gluten free resources and advice on cooking and baking can be found at the Coeliac UK support website:

Home of Gluten Free Recipes – Inspiration and tips for gluten free cooking – Coeliac UK

Living gluten free FAQs – Coeliac UK

Your local community pharmacy can order gluten free products for you to purchase if there are particular brands you wish to keep as part of your diet. However, these may well be more expensive than equivalent products available from supermarkets and other shops.

Information for people who maybe at risk of dehydration

NHS Somerset Keeping Hydrated leaflet for preventing urinary tract infections

Staying hydrated is important for our health and wellbeing leaflet.

For information on Cow’s Milk Protein Allery (CMPA) and infant nutrition please see the Infant Feeding page.

Ferric maltol for the treatment of iron deficiency anaemia in adults

ONS Guidance for Renal Patients

Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk MHRA June 2020

RUH- B12 advice on investigation management

BSH- Guidance for B12 replacement

NICE CKS Management of anaemia – vitamin B12 and folate deficiency

IM Hydroxocobalamin 1mg/1ml every 2-3 months is recommended as first line where treatment is required.

If I.M not possible then we would recommend the higher dose of oral cyanobalamin 1mg.

Please see the NHS Somerset formulary 9.1 – Anaemias for formulary options available.