Enteral nutrition cut to ease PCT budget

GP practices across Shropshire have been told to limit the use of enteral nutrition after spending over £500,000 in under a year.

In a letter to all GP practices in the area, Telford and Wrekin PCT announced that £579,325 had been spent on enteral nutrition between May 2006 and April 2007.

In terms of the amount of money spent on drugs in Shropshire, enteral nutrition is ranked third behind atorvastatin and fluticasone.

In the letter, Jacqui Duffy, head of medicines management at Telford and Wrekin PCT, advised GPs that 'sip feeds should not be used as general supplements for poor appetite'.

'They should only be prescribed in accordance with national guidance and they should not be a first line option', the letter says.

'If a patient is identified using a malnutrition screening tool to be in need of nutritional support, first line treatment should be to encourage an increase in calorie intake by dietary measures.'

However, Shropshire GP Dr Christopher Lisk said that it was dieticians and nursing home nurses rather than GPs who were pushing the use of enteral nutrition.

The patient will be discharged on enteral nutrition from hospital for the GP to continue in the community, said Dr Lisk.

'We are spending £500,000 a year on laziness. We should be encouraging nursing home staff and carers to make a cheap and nourishing broth, which is just as effective as enteral nutrition'

Enteral nutrition is, however, important for those patients that live on their own without any support, stressed Dr Lisk.

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