{
  "abstract": "Management of parental nutrition (PN) is complex and multifactorial. The use of multi-disciplinary teams to manage intestinal failure (IF) patients is essential to ensure safe use of PN, promote enteral autonomy and improve outcomes. 1–4 Gold standards for key members of paediatric IF team are published, yet little guidance exists for the whole time equivalent (WTE) that should be allocated for each member. To date there is no guidance for dietitians working in paediatric IF. The increasing prevalence rates and complexity of paediatric IF patients requiring long term PN2–5 has wider implications for organisations and resources involved in the management of these patients. To help link resources and outcomes, job planning is essential to provide a means to understand workforce capacity and patient needs.6 7 This study aims to identify current service provision for paediatric dietitians in IF across England. It aims to explore if this provision is adequate to allow dietitians to meet all aspects of their job plans, set out by British Dietetic Association.Two online surveys were sent to organisations providing paediatric IF service in England. Survey one focused on current dietetic service provision. Survey two concentrated on IF dietitian’s workload demands, job plans and workload safety. To compare results to population, data was used from office National Statistics (ONS) mid 2022 dataset.14/17 centres responded to survey one (82% response rate). The total number of paediatric patients receiving Home PN (HPN) in England was 326, with a prevalence rate of 27/million children, regionally prevalence rates ranged from 11.7/million to 65.8/million children. 50% centre respondents were able to specify exact WTE funding for paediatric dietetic IF services, the remaining centres provision came from gastroenterology funding, of which 40% were unable to specify how much time was specifically allocated towards IF. The total WTE dietitian provision nationally for IF services is 1.1/million children. Regionally, the WTE per head of paediatric population ranged from 0.2/million children to 2/million children.Abstract OC20 Figure 1Survey 2 had 10 respondents. 40% respondents had job plans. 80% felt they didn’t have enough time to perform their job fully. 50% of participants, reported caseloads to be unsafe. 100% of participants work above their contracted hours with 60% working 1–5 hours extra, 30% working 6–10 hours and 10% working 11–15 hours over.This study indicates that current paediatric IF dietitian service provision across NHS trusts in England is not sufficient. There is an apparent regional inequality of dietetic service provision, especially when compared to the prevalence of HPN within each area. All paediatric IF dietitians are working additional hours and the majority report unsafe workloads due to not having enough time to complete their job. With increasing IF patient complexity and numbers, further national guidance and research is required to develop standards.References Cuerda C, Pironi L, Arends J, et al. ESPEN practical guideline: clinical nutrition in chronic intestinal failure. ClinNutr. 2021;40:5196–5220.Brown SK, Davies N, Smyth E, et al. Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition. Foundation Acta Pædiatrica. 2018;107:2207–2211.Barrocas A, Bistrian B, Mueller C, et al. Nutrition support teams: institution, evolution, and innovation. ClinNutr. Pract. 2023;38:10–26.Lakananurak N, Moccia L, Walls E, et al. Characteristics of adult intestinal failure centers: an international multicenter survey. ClinNutr. Pract. 2023;38:657–663.Wiskin A, Russell R, Barclay A, et al. Prevalence of home parenteral nutrition in children. ClinNutr. 2021;42:138–141.NHS England and NHS Improvement. Job planning the clinical workforce – allied health professionals: A best practice guide. 2019.British Dietetic Association. Safe Staffing Safe Workload Guidance. 2017.",
  "authors": [
    {
      "affiliations": [
        "Great North Childrens Hospital"
      ],
      "name": "Ruth Stanley"
    }
  ],
  "title": "OC20 Dietetic service provision in paediatric intestinal failure: a national survey",
  "uid": "64b0f760-e884-5f51-aedd-53be0c980df5"
}