The Impact of Changes in Health and Social Care on Enteral Feeding in the Community

Abstract

This paper examines the impact of the changes to health and social care on enteral feeding in the community, outlines implications for practice and offers recommendations to ameliorate the challenges. It is now clear that there have been significant changes especially in the last 10 years in health and social care provisions in the UK with an overarching effect on enteral nutrition in the community. Advances in technology, increasing demand and treatment costs, the need for improvement in quality, economic challenges, market forces, political influences and more choices for patients are some of the factors driving the change. Government’s vision of a modern system of health and social care is based on initiatives such as clinically led commissioning, establishment of Monitor, shifting care from acute hospitals to community settings, integrating health and social care provisions, Quality, Innovation, Productivity and Prevention (QIPP) program and the concept of “Big Society”. These strategies which are encapsulated in various guidelines, policies and legislation, including the health and social care Act, 2012 are clarified. The future challenges and opportunities brought on by these changes for healthcare professionals and patients who access enteral nutrition in the community are discussed and recommendations to improve practice are outlined.

Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses

“…It allows patients to receive nutritional therapy at home, in a familiar environment and with their family (Cawsey, Soo, & Gramlich, 2010). The number of patients on HEN is on the increase due to advancement in technology, development of percutaneous endoscopic gastrostomy (PEG) techniques and shift in focus of providing care from acute to community care settings (De Luis et al, 2013;Ojo, 2012). HEN was found to improve clinical outcomes such as reducing infectious complications and reducing healthcare costs with less hospital readmissions and shorter length of stay (Klek et al, 2014;Wong, Goh, Banks, & Bauer, 2017).…”

The Challenges of Home Enteral Tube Feeding: A Global Perspective

“…The use of HETF has become more common globally due to advances in technology, development of percutaneous endoscopic gastrostomy (PEG) technique and governments’ policy of shifting healthcare provisions from costly acute hospitals to community settings [ 8 , 9 , 10 , 11 ]. These have also ensured that more individuals on enteral feeds now live in the community.…”

“…One of the primary features of the HEN service is that patients’ feeds are managed “off script” and therefore do not require the use of FP10 [ 20 ]. The HEN service is the model of choice and requires a clear pathway between acute and community care and other partners including companies in order to ensure an effective delivery system [ 8 , 21 , 22 ]. In a study that compared hospital enteral nutrition and home enteral nutrition in China, Wang et al [ 23 ] reported that patients with intestinal fistulae in the HEN group had shorter hospital stay than patients in the hospital group.…”

Evaluation of the Role of Enteral Nutrition in Managing Patients with Diabetes: A Systematic Review

“…The prevalence of diabetes and the cost to the National Health Service (NHS) have been on the increase in the UK [ 1 , 2 ]. Various factors including the failure to maintain a healthy lifestyle such as regular physical activity and healthy dietary regimes, and genetic susceptibility have been ascribed as possible reasons for the high incidence of the condition [ 3 , 4 ].…”