Nutrition & Dietetics - For Clinicians

If your patient has never seen a dietitian and you think that they need to, referrals can be accepted in writing.
You will need to include the reason for referral, any relevant medical history, biochemical test results and other relevant information.
We accept referrals from GPs, consultants and hospital doctors and practice nurses (depending on the nature of the condition).

Some conditions (for example diabetes and coeliac disease) do not need re-referral if the patient has already seen a dietitian. Please call our offices if you would like to discuss a patient’s situation with us.

Inpatient services
Our acute services team is made up of dietitians who work within North Bristol NHS Trust providing a dietetic service to all the wards. The service is available between 9.00am and 5pm Monday to Friday.

Discharge Services
Patients who continue to need dietetic services following discharge from hospital will have a planned discharge which provides for continuing care between hospital and home.

Outpatient Services
Outpatient clinics are run at Southmead Hospital Bristol and Cossham Hospital where patients can be treated for a range of conditions. These include diabetes, coeliac disease, gastrointestinal disease, food allergy or intolerance or nutritional deficiencies, e.g. anaemias, and others. 

Coeliac Disease
It is very important that diagnosis is made by a Gastroenterologist following a biopsy of the small bowel.  Referrals should be received by letter citing all relevant medical history, current treatment, test results and medications.  Suitable cases for referral include those in whom a formal diagnosis of coeliac disease has been made or is suspected.
Coeliac disease cannot be treated with drugs. It is managed solely by dietary manipulation through the exclusion of all sources of gluten, both obvious and hidden. The dietitian plays a vital role in educating and supporting the coeliac patient.

General Gastroenterology
It is very important diagnosis is made by a qualified medical practitioner. Referrals should be received by letter citing all relevant medical history, current treatment, test results and medications.

Eating Disorders
Patients are only admitted through STEPS Eating Disorders Unit and referral must be made through their team.

Diabetes
All types of diabetes require dietary advice.  Type 1 diabetes is always treated with insulin injections; people with type 2 and gestational diabetes may take a combination of tablets, or insulin as well as changing their diet.
New patients to the service are seen initially at Southmead Hospital Bristol. Follow-up clinics currently run at Southmead Hospital Bristol and Cossham Hospital.

Neurology

Referrals are sent from neurology consultant to the dietitians.

Paediatrics
We provide an outpatient service at Southmead Hospital Bristol and Cossham Hospital and at some special schools.
For some very specialised areas eg Ketogenic Diets for control of epilepsy we also act as lead dietitians for the whole of the South West Region.
We can accept referrals from GPs or hospital consultants by letter.
GP practices can also book through the Choose and Book system.
Once we have accepted a referral we will invite the patient to contact us to arrange an appointment.

We only take referrals from Consultant Paedistric Neurologists for Ketogenic Diet for Epilepsy. We also need to have agreed funding from the local NHS Trust.

Immunology: Food Allergy and Intolerance
The diagnosis can be made with a combination of blood and skin tests, diet challenges and diet restrictions. GP may be able to diagnose food allergy refer to an immunologist.

HIV
HIV can be diagnosed through a blood test. If  diagnosed with HIV refer to specialist services.

Kidney Failure/Renal

Diet plays an important part in the treatment of kidney failure.

The dietitian will see patients at their kidney clinic appointment at Southmead Hospital Bristol and advise on altering the diet, if needed. Information is tailored to the needs of each patient taking into consideration their blood results, kidney function, treatment and food preferences. 

Advice may alter as the kidney function changes or following a kidney transplant. Diet should only be altered if advised by the dietitian or doctor.    
Bariatric Surgery
To be eligible for bariatric surgery, an individual should fulfill the following criteria:

  • Body Mass Index (BMI) ≥ 35kg/m2 plus 2 or more obesity related co-morbidities (e.g. type 2 diabetes, obstructive sleep apnoea)
  • BMI ≥ 50kg/m2

There is also a comprehensive assessment procedure in place which is aimed to ensure that patients are prepared fully for surgery, not only physically but also emotionally and psychologically. All patients are initially assessed individually by the consultant physician, the specialist dietitian and the specialist nurse.  This team then makes a decision as to whether the patient is suitable and if so what kind of support they might need to ensure that they are as well prepared as possible.