Supporting Organisation: Hertfordshire Community NHS Trust ( in collaboration with East and North Hertfordshire NHS Trust)
About Vikki's fellowship project
Title: The embedding of a Multidisciplinary Tool to be used for patients with Neurological Complex Feeding and Nutritional Issues in an Acute setting
Many patients with an acquired neurological diagnosis have a difficulty with swallowing (dysphagia). When admitted to an acute hospital and presenting with dysphagia, careful and considered input is required to achieve positive outcomes for these patients. The current acute pathway within ENHT does not support a multidisciplinary approach to manage feeding and nutritional issues. This can lead to confusion in plans, missing information and a lack of co-ordinated approach.
Appropriate timing and co-ordination of decision making is crucial with this patient cohort. Delays can mean opportunities to intervene are lost taking choice from patients. Whether a patient will eat and drink orally or whether to consider an alternative method of nutrition and hydration is an emotive and challenging decision - patients should have all the options and information presented to them in such a way that they can make this decision understanding all the risks and benefits.
The CHOICES Framework (designed and implemented elsewhere within the East of England), is a tool to guide professionals through the principles of decision making and aid documentation of decisions related to this issue. This IMPACT project will aim to pilot this framework in ENHT, making changes to pathways and working approaches. The aim in the long term being to deliver a co-ordinated, timely and patient centred way to address this complex issue.
Contact Vikki: v.meredith@nhs.net