18 Mar 2021

The Care Provider Alliance has been working with NHS England and NHS Improvement, with support and advice from the BDA’s Older People Specialist Group (OPSG), to produce a new guide to the Enhanced Health in Care Homes (EHCH) framework.  The guide is intended for Registered Managers of care homes and care home staff in England but many health care professionals, including dietitians, may find it of interest.

EHCH aims to ensure that people living in care homes receive the same level of healthcare and support as those living in their own homes. Implementation of the framework relies on collaborative and relational working across multiple agencies including; primary care, community services, acute services, social care and the voluntary sector. People living in care homes should expect comprehensive personalised care plans, reduced risk of unplanned hospital admissions and quality palliative and end of life care planning.

All registered care homes should expect to be aligned to a Primary Care Network (PCN) and have a named clinical lead. They should also receive weekly “home rounds” or check ins from a multidisciplinary team (MDT). The guide highlights dietitians as an integral member of the MDT that can be co-opted to provide input and support when needed. This does not mean that dietitians are expected to attend on a weekly basis. Instead, OPSG would encourage dietetic service managers and dietitians who provide services to care homes to contact and support their local PCN Clinical Directors and/or care home clinical leads. It will be important to help them understand when to draw on your dietetic expertise.

The focus should be on the provision of proactive and preventative care that supports people to maintain their independence, functional status and quality of life. This should include rehabilitation, appropriate prescribing of nutritional products and palliative and end of life care planning. As well as providing direct resident reviews to those requiring specialist dietetic input, OPSG is calling on dietetic services to work with their care homes in a leadership capacity.

You should consider a whole care home approach that educates and supports the wider workforce, including care home catering staff, to be able to confidently and appropriately meet their resident’s individual nutritional needs. This approach has the potential to benefit many more residents than the traditional patient referral route, whilst safeguarding dietetic capacity to those who would most benefit.

For more information and advice please do not hesitate to contact OPSG  OlderPeople@bda.uk.com and if you are a BDA member please consider joining our specialist group.   

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Vittoria Romano

Chair, Older People Specialist Group