Dietetic Service Provision in Paediatric Intestinal Failure: A National Survey

OBJECTIVE: To date, no guidance exists for the whole time equivalent (WTE) that should be allocated for each member of paediatric intestinal failure (IF) team. This study aims to identify current service provision for paediatric dietitians in IF across England and if this is adequate to allow dietitians to meet all aspects of their job plans. METHOD: Two prospective online surveys were sent to paediatric IF services in England. Survey one focused on measuring the number of home parental nutrition (HPN) patients and current dietetic service provision. Survey two focused on workload demands sustainability. RESULTS: Three hundred twenty-six children received HPN with a prevalence rate of 29/million children. Regionally, prevalence rates ranged from 11.7/million to 65.8/million children. Total dietitian provision was 12.2 WTE, with the median per Trust 1.2 WTE. Higher WTE rates did not equate to higher HPN prevalence rates. Survey two had 10 participants, 8/10 (80%) felt they did not have enough time to perform their job fully. 5/10 (50%) of participants reported caseloads to be unsafe. 10/10 (100%) of participants work above their contracted hours. CONCLUSION: This study indicates a regional inequality of dietetic service provision, especially when compared with the prevalence of HPN within each area. Participants are unable to complete all aspects of their job plan with the current dietetic service provision. Further national guidance and research are required to develop standards detailing the requirements of adequate service provision for paediatric IF dietitians to provide a safe and sustainable service.