InTouch Newsletter

Core Groups Updates

BPNG

Ruth Newton, BPNG Chair

We are currently in the process of planning our next study days, the first of which will be our Fundamentals Course, which will be run at the Royal Pharmaceutical Society (RPS) in London on 16th May. As accredited education foundation trainers of the RPS, we are able to access the excellent training facilities at headquarters and this will be the first study day at this location, so it is very exciting. This will be advertised with cost reduction for BPNG members on our new website to be launched on 1st March. Click here to see further details.

We also have exciting plans to celebrate BPNG’s 30th year, with a conference dinner in Harrogate on 19th November 2018. Our study day, aimed at advanced pharmacists practicing in nutrition, will also be held that day giving delegates the option to stay over to attend the opening day of the BAPEN Annual Conference.

The BPNG are affiliated trainers of the RPS, and we are currently working on the nutrition modules of the national training program (NTP), which will be launched later in the summer. It will be in the form of an online module with learning material and case-based discussion, which will then be submitted for assessment by experts from the BPNG. It is thought that this will be rolled out to those wishing to apply for reaccreditation first but watch this space (www.rpharms.com)!

As affiliate trainers of the RPS, we are required to expand our educational remit to include community pharmacy colleagues. The UK Primary Care Pharmacy Association is a not for profit national network, supporting all members working in the primary care setting. The organisation has recently launched Clinical Specialist Groups and, thanks to her links with the group, Sarah Zeraschi has been elected as Chair of the Nutrition and Hydration Group. This will strengthen our links with community and give opportunities for developing our role across healthcare boundaries. The website is in development, but current link here: https://pcpa.org.uk/index.php

The BPNG exhibition stand at the BAPEN Conference in November 2017 attracted a lot of interest, as did the very well attended BPNG symposium, which was chaired by Tony Murphy, Production Pharmacist at UCL hospital. The session addressed important questions which included: “Are organisational changes in the NHS moving us towards a greater use of standardised approaches to PN?” And “Will cost pressures signal the decline of ‘bespoke’ nutrition and a renaissance of the humble ‘off the shelf’ multi chamber bag for both adult and neonatal nutrition?” These topics were then discussed by Khal Khan, a Pharmacist with the NHS Hospital Pharmacy & Medicines Optimisation Team, who gave an overview of the national pharmacy aseptic services review. This talk was followed by Louise Whitticase, Lead Pharmacist at Birmingham Women’s and Children’s NHS Trust who described her experiences of implementing standardised neonatal PN across a network and managing the provision of PN without ‘on-site’ pharmacy aseptic services.

BPNG’s Vice-Chair and Consultant Pharmacist Nutrition in Leeds, Sarah Zeraschi, asked: “Is the squeeze on NHS resources and commercial capacity pushing us towards greater use of standard PN for adult inpatients?”. It was clear from the debate that all areas are feeling the pressure at the moment and we need to follow this up by asking if this is the best for patient care. All areas are very political at the moment and also contribute to the work we are doing with the Carter review working party.

As ever BPNG is open to questions and suggestions for topics to teach and take forward with our professional bodies so please get in touch.

PINNT

Carolyn Wheatley, PINNT Chair

Email: comms@pinnt.com

Website: http://pinnt.com

Facebook: PINNTcharity

Twitter: @pinntcharity

SAVE THE DATE – HAN Week 2018 – 6th-12th August 2018

What could you do to raise awareness during HAN week 2018?
Why not share with colleagues what you do to make a difference for those on home artificial nutrition?
Share the valuable work you do to support patients and carers on home artificial nutrition!

Contact PINNT via comms@pinnt.com if you have an event you’d like them to know about to support awareness.

NNNG

Liz Anderson, Chair of the NNNG

Email: nationalnursesnutritiongroup@gmail.com

Website: www.nnng.org.uk

Twitter: @NNNGUK

In this issues update, Liz Anderson, Chair of the NNNG reviews the Southampton
Practical Nutrition Support course.

This is a very intense course run over three days. Initially developed for doctors, its aim was to educate them about the importance of nutrition support and how nutrition plays such a huge part in patient pathways. However, in recent years, it has expanded its audience and this year’s delegates included dietitians, pharmacists, nutrition nurses and even a consultant geriatrician.

So why did I go? Well I saw the programme and was excited about it. Subjects ranged from the pathology of malnutrition to the importance of micronutrients. I am passionate about micronutrients and feel that certainly as far as oral nutrition is concerned, they are the forgotten heroes. We worry about getting calories in, but we also need to worry about getting nutrients in that are so vital for tissue repair and cell growth.

There was plenty of practical stuff too, including how to work out nutritional requirements, nutritional assessment and anthropometry. You haven’t really seen anything until you see doctors very solemnly trying to work out their heights using the ‘Malnutrition Universal Screening Tool’ (‘MUST’)!

Because we had such a mix of professionals in the room, there were a lot of opinions – particularly when case studies were discussed. With six nutrition nurses in the room the conversation was never dull.

The course is run by the Centre for Nutrition Education in Southampton. There are very esteemed and experienced speakers, such as Professor Mike Stroud and Professor Alan Jackson. However, it really is multidisciplinary, with presentations from dietitians, pharmacists, nurses and radiologists. I would recommend any healthcare professional to attend – whatever their experience. I learnt things I did not know, consolidated knowledge and have got lots of new ideas to take back to practice.

The NNNG Committee continues to be busy and, as we start 2018, projects are well underway. With the release of Best Practice Guidelines and the launch of our new improved website and membership access, there are many reasons to join. Good Nutrition Needs Nurses!

NIFWG of BSPGHAN

Jutta Köglmeier, NIFWG Chair of BSPGHAN

Email: Jutta.Koeglmeier@gosh.nhs.uk

Website: www.bspghan.org.uk

Meetings

During 2017, NIFWG met on 26th January at the BSPGHAN Annual meeting in Glasgow; 24th May prior to the RCPCH Gastroenterology Symposium in Birmingham; and on 16th November in London.

The fourth paediatric intestinal failure and rehabilitation meeting was held jointly with BAPEN on 20th November in Birmingham. The programme was well received and included exciting topics relevant to both paediatric and adult intestinal rehabilitation teams:

e-BANS

Chair: Akshay Batra; Regional Deputy Lead: Tony Wiskin; Secretary: Julian Thomas A major focus of the group is to ensure that the paediatric section of e-BANS (Paediatric electronic-British Artificial Nutrition Survey) will continue to be accessed by the intestinal failure units and all relevant patients are captured. The NIFWG has managed to secure a BSPGHAN innovation grant to fund the much required admin support.

Jonathan Hind presented on the epidemiology of intestinal failure in children in the UK, and the evolution of the paediatric e-BANS registry on behalf of the group at the CIRTA meeting in New York on 30th June 2017.

BAPEN

Tony Wiskin has taken up the role as paediatric e-BANS regional deputy lead. His term as BAPEN Education and Training rep has come to an end. A call has gone out to all BSGPHAN members to find a replacement
The bond with BAPEN is continuing to grow stronger
The joint paediatric/adult intestinal failure rehabilitation symposium on 20th November had a paediatric and adult speaker for each presentation. Topics relevant both to adult and paediatric practice sparked interesting discussions.
As a Core Group, members of BSPGHAN are now entitled to free BAPEN membership.

Allied Health Groups

Pharmacy

BPNG (British Pharmacy Nutrition Group): Revised National Framework for home PN has been published. Venetia Simchowitz continues to represent paediatric pharmacists on the Framework. Blueteq forms have now been in use for some time. Home parenteral nutrition cannot be requested without a completed Blueteq form (NHS England – Initial Funding Application for HPN for children (under 18s) needing parenteral nutrition.

Angela Cole continues in her role as the paediatric nursing representative and Susan Hill as the paediatric Gastroenterologist.

The paediatric chief pharmacist group has developed three regimes for standard bags in neonates and children. An industry manufactured standard bag has been developed and should be commercially available soon.

The new ESPGHAN guidelines on parenteral nutrition in children are still not published. The delay is due to an ongoing debate about the use of parenteral nutrition in the paediatric intensive care setting. Data supports that certain amino acids contribute to the occurrence of infections in children. There is hence controversy about the appropriate timing of the start of PN on PICU.

The guidelines are however expected to become publicly available early 2018.

Members of the NIFWG have taken part in the European wide CVC survey. The outcomes of the survey is have been analysed and will be included in the ESGPHAN PN guidelines and will also be published separately.

Dietitians

Blenderised diets continue to attract great attention at present. The BSPGHAN Allied health professionals group dietitians are writing a position paper which will be published on the BSPGHAN website. The associates committee has met with the British Dietetic group and they are now working together to develop guidelines about decision making.

A further aim of the group is to put together a consensus document on weaning from artificial/tube weaning. The work is ongoing.

Nutrition nurses

The nutrition nurses continue to work on:

Standardisation of nursing practices in PN and nurse/patient ratio for home PN children
Equipment and methods used for connecting and disconnecting PN at home. A wide variety of equipment has been requested under the National home PN Framework.

Research, Training and current/future projects

Guidelines for the diagnosis and management of intestinal failure in childhood
The development of a Decision Tree for feeding neuro-disabled children with deteriorating intestinal function in conjunction with the Royal College of Paediatrics. A Delphi process is planned and the NIFWG members will take part. A systematic review (current treatments, therapeutic strategies before consideration of parenteral nutrition) has been carried out by one of the Scottish trainees. The group has successfully secured a second BSPGHAN innovation grant to fund this project.
To obtain funding for a randomised controlled trial investigating the use of Taurolock prophylaxis for the prevention of central venous catheter associated sepsis
Develop a practical ethical framework for decision making in severe neonatal intestinal failure
Guidelines for the use of blenderised diets in children
Recommendations for the best method to wean children from intravenous to enteral nutrition
National survey on jejunal feeding practices in children across the UK.

Following completion, the group would like to publish the documents both on the BSGPHAN and BAPEN websites.

PENG

Kate Hall, PENG Chair

Email: communications.peng@bda.uk.com

Website: www.peng.org.uk

Twitter: @PENGDT

We are looking forward to a new membership year 2018/19 and being able to offer, thanks to BAPEN, free membership to BAPEN for PENG members from March 2018. In addition, Spring 2018 marks an exciting time for the PENG Pocket Guide to Clinical Nutrition. The Pocket Guide editorial team and authors are working hard to complete the final pages in order to be able to launch this Spring, and to promote (prior to formal launch) the new Guide at the BDA Live on 15th March 2018 (day 2 of BDA Live). The Pocket Guide will also be available to order in the Spring and all PENG members during the 2017/18 membership year are entitled to receive a complimentary copy once available.

The PENG Clinical Update Course team are busy organising this year’s Masters course, which will be held in June. Registration is still open but places are filling up fast. An article about the Clinical Update Course will be in the next edition of Complete Nutrition (Vol 18, No.1 Feb/Mar 18) – guess how many years it has been running? The answer is in CN!

Details for this year’s PENG Award have now been finalised and full details can be found by clicking here.

PENG are trying to set up a UK Parenteral Nutrition (PN) forum and there has been interest from other parts of the UK for this, including Northern Ireland, so this will be a focus for 2018. Alison Culkin (PN Lead for PENG) is calling for members to get in touch to get the forum started. The forum will be a brilliant way to share ideas and best practice.

The focus for the PENG Study Day this year is PN, so watch this space and all dietitians to look out for a survey monkey coming your way in March.

The PENG membership year is March through to February and we look forward to welcoming back current and new members (incl. student dietitians) to PENG this March. Of course, as highlighted above, the additional benefit this year is that all PENG members will receive free membership to BAPEN.

For further information about PENG, visit: www.peng.org.uk

P.S. Video footage from the pre-BAPEN Conference PENG Study Day will soon be available on the PENG website so keep an eye on it!