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Patients meeting the following criteria who are motivated to make dietary and lifestyle changes should be referred to the adult outpatient dietetic service by their GP or consultant.

• Patients requiring nutrition support with an NST >4 or MUST>2
• Texture modified diet after SALT assessment
• Coeliac disease or dermatitis herpetiformis
• Inflammatory bowel disease
• High output stoma
• Irritable bowel syndrome
• Chronic pancreatitis
• Type 1 diabetes
• Type 2 diabetes referrals from consultants
• Impaired glucose tolerance
• Reactive hypoglycaemia
• Gestational diabetes
• BMI >30kg/m2 or BMI >27.5kg/m² for Asian populations
• Pregnant women with a BMI >30kg/m2 or BMI >27.5kg/m² for Asian populations
• Liver disease
• CKD stage 3b-5, not having input from a specialist renal dietitian

At present, all dietetic clinics are delivered via the telephone. More details will be in your appointment letter.

In addition to the outpatient clinics the dietetic service also provides group education for patients with Type 1 diabetes and monthly group education sessions for patients with the following conditions. If you have been referred to one of these groups you will be sent information via email, whilst we are in the process of setting up virtual groups:

• Gestational diabetes
• Coeliac disease

Structured education for patients with type 1 diabetes

The UK’s National Institute of Clinical Excellence recommends that ‘structured patient education’ is offered to everyone with Type 1 diabetes to enable them to manage their condition. The dietetic team delivers the DAFNE and SET1 programmes with the diabetes team.

DAFNE and SET 1 are delivered to groups of six to eight participants by trained educators. The course covers topics such as estimating the carbohydrate content in foods, blood glucose and ketone monitoring, insulin adjustment, hypos, illness and exercise. Participants are encouraged to learn new skills in carbohydrate estimation and insulin adjustment through practical experience. Learning involves sharing and comparing experience with other people with type 1diabetes, however there are opportunities for participants to speak to a health professional individually.

DAFNE- Dose Adjustment for Normal Eating                     
The DAFNE course is delivered at Mount Vernon Hospital over five consecutive days. We are currently exploring options for remote delivery of DAFNE.

Paediatric dietetic outpatient service
Children meeting the following criteria should be referred to the paediatric outpatient dietetic service by their GP or consultant.

• Failure to thrive
• Poor eaters
• Newly diagnosed type 1 diabetes / uncontrolled diabetes
• Cystic Fibrosis/PCD
• Coeliac disease
• Obesity
• Food allergies
• Constipation
• Iron deficiency

The paediatric dietetic service provides a number of general and specialist paediatric clinics, which are all delivered via the telephone or attend anywhere- further details will be in your appointment letter.

Frequently asked questions

Why is my appointment over the telephone?

The hospital would like to reduce the number of people attending the hospital for their appointment. In line with this, all of the dietetic outpatient appointments are being delivered via the telephone. If you do not have a telephone or are unable to be contacted by the telephone, please inform the person who referred you, so we can make the necessary arrangements.

How can I get referred to the dietitian?
If you require a specialist dietary assessment and advice you can be referred to the dietetic service by your GP or consultant. For general advice please access our dietary leaflets or useful links on the main Nutrition and Dietetic page.

What should I expect when I speak to a dietitian?
The Dietitian will provide a professional, non-judgemental consultation regarding your diet. They will assess your current diet, your weight and height and make practical recommendations to you about your diet in order to improve your health.

How quickly will I be seen by the dietitian after my GP or consultant has referred me?

You should receive a letter from the dietetic service within two weeks of your referral from your GP or consultant. If you have not heard from the dietetic service within this time frame we would recommend contacting the referring health professional.

The length of time you will have to wait to see the dietitian will vary depending on the urgency of the referral. This can range from two weeks to three months; however the dietetic team are working hard to reduce the waiting times. You can help by ensuring you let the dietitians know if you don’t plan on attending your appointment as soon as possible so this slot can be allocated to someone else.

Unfortunately 20 per cent of people referred to the dietitian don’t attend their appointment, resulting in 888 minutes of dietetic time being wasted each month. To ensure everyone is seen as quickly as possible please cancel your appointment at least 24 hours in advance if you are not planning on attending. This would enable an additional 16 new and 26 follow up appointments to be provided each month.

What is the specialist weight management telephone clinic?
If you have been referred to the dietitian for weight loss and have a BMI >35kg/m² you will be offered an appointment in the specialist weight management clinic.

Within the specialist weight management clinic you will have an initial 20-minute telephone appointment, followed by a 40-minute, telephone appointment and a maximum of three 20-minute review appointments. During this appointment you will speak to a specialist weight management dietitian, who is trained in cognitive behavioural therapy and will support you in making positive dietary and lifestyle changes to support weight loss.

When should I let the dietitian know if I am unable to attend my appointment?

You should call the dietetic office on 01895 279416 as soon as you know you are unable to attend your appointment. You must call a minimum of 24 hours before the appointment; otherwise you will be discharged from the dietetic service. If you cancel on more than two occasions you will also be discharged from the dietetic service.

How should I prepare for my telephone appointment?
It might be worthwhile to keep a 3 day food diary of foods that you have eaten and to weigh yourself prior to the telephone appointment. Please also have your up to date medication list ready.

The three-day food diary will help the dietitian to assess your dietary intake, patterns of intake and lifestyle; enabling them to give individualised goals.