A-Z of Services

Nutrition and Dietetics

  • Service Contact: ch-tr.dietetic@nhs.net
  • Address: Woodcroft Wing (green section) Croydon University Hospital 530 London Road, Croydon, CR7 7YE
  • Reception phone number: 020 8401 3095
  • Service hours: Monday to Friday from 09:00am to 17:00pm, excluding Bank Holidays

About us

We are a team of experts in the field of nutrition and dietetics working to promote nutritional health and wellbeing. We interpret the science and translate this into practical advice and information to support clients, patients, carers and colleagues in the London Borough of Croydon. 

Dietitians are qualified to assess, diagnose and treat dietary and nutritional problems, and are regulated by the health and care professions council (HCPC).

 

Staff List

Dr Nicky Saini – Head of Dietetics & Service Lead for Tier 3 Weight Management Services

 

Administrative Team:

          Michelle Lowe – Lead Dietetics Administrator

          Jenny Nash – Dietetics Administrator

 

Adult Acute Team

          Kay Eaton – Principal Adult Dietitian

          Shade Bello – Specialist Gastro Dietitian

          Lara Dami – Stroke Dietitian & Community Dietitian

          Isabella Stephens – Adult Dietitian

           Mahmoud Natty  – Adult Dietitian

 

Adult Community Team

          Mala Bhinda – Community Adult Lead & HEN Dietitian

          Zuzana Vadova – Community Dietitian

          Aleksandra Czarnecka – Community Dietitian

          Katie Arbuckle – Adult Learning Disability Dietitian (based in Community LD Team)

          Eduardo Pasetti – Prescribing Support Dietitian (based at SWL CCG Croydon)

 

Paediatric Team

              Thomina Mirza – Specialist Paediatric Allergy Dietitian 

              Maleeka Khan - Paediatric Dietitian

 

Dietetic Assistants:

          Margot de Dominicis – Dietetic Assistant

 

Appointments

Referrals are triaged weekly, and you will receive an appointment by letter.  You may also be sent a food diary – please complete this and have it available at your appointment.

If you have not received an appointment letter, or you wish to cancel or re-schedule your appointment, please contact the department on 0208 401 3095, or email ch-tr.dietetic@nhs.net.  You may be required to leave a message and we will return your call as soon as possible.

If you have to cancel your appointment, we kindly ask that you provide us with 24 hours’ notice. If you do not attend an appointment without cancelling or contacting the department, we may discharge your referral and you will need to seek a new referral from your GP.

 

Covid 19 Update:

To reduce the number of patients attending the hospital and to support Government guidance on social distancing, until further notice our face to face clinic appointments will be replaced with video or telephone consultations.  You will receive a letter with details of how to access your video appointment

Video consultation instructions:

  1. Click on the following link to set-up and access the "waiting room" - https://nhs.vc/nutrition-and-dietetics
  2. Click on "start video call"
  3. Follow the instructions
  4. Wait in your private video room

Embed Youtube video:  https://youtu.be/sDmSZyquNGc

If we are unable to establish a connection with you via video link at the time of your appointment, we will contact you via telephone to conduct a telephone consultation.  Please ensure that the department has your up to date contact details. If we are unable to contact you at your appointment time via video or telephone call your referral will be discharged back to your GP.

If the Dietitian decides a face to face appointment is needed, we will contact you separately to arrange this.

For the latest advice on Coronavirus (COVID-19) please visit www.nhs.uk/coronavirus

As a Trust we will continue to review this situation and resume normal services as soon as it is practically possible.

Paediatric Team

Our paediatric dietetics team offer an expert evidence-based nutritional assessment, dietary advice and support for all paediatric inpatients, outpatient and day-care services.

The paediatric team

The team is comprised of a group of qualified experts in the nutrients in food, how nutrients are used by the body, and the relationship between diet, health and disease. All registered dietitians are regulated by the Health and Care Professions Council (HCPC).

Inpatients – children admitted to Rupert Bear Ward and the Neonatal Unit

Virtual/Outpatient clinics – Provide expert evidence-based nutritional guidance to help people make long lasting beneficial changes to aid alleviation or correction of nutrition-related symptoms such as

  • Selective eating problems including in autistic spectrum disorders and attention deficit hyperactivity disorder
  • food allergy/intolerance
  • coeliac disease
  • overweight and obesity
  • mineral/vitamin deficiencies, for example anaemia
  • constipation.
  • weight faltering
  • underweight (excluding known eating disorders)

Virtual Education Group – We offer 90 min virtual group education sessions for groups no larger than 3-4 families for both Milk free weaning and weight management.

Food Allergy Service – Allergy specific dietary advice, monitoring and food challenges for IgE mediated and or multiple allergies within a multidisciplinary team.

Children Community

  • Special schools – a clinical service for children with special needs and have eating and drinking difficulties
  • Home enteral tube feeding a clinical service for children with complex feeding difficulties

 

Helpful Resources

Premature babies 

https://www.bliss.org.uk/

Breastfeeding

https://www.breastfeedingnetwork.org.uk/

Under 5’s

https://www.healthystart.nhs.uk/

https://www.croydon.gov.uk/community/childcare/childcentres/best-start-childrens-centres-in-croydon

https://www.nhs.uk/conditions/pregnancy-and-baby/understanding-food-groups/

https://infantandtoddlerforum.org/

Children

https://www.nhs.uk/change4life

Adolescents and teenagers

https://www.nhs.uk/live-well/eat-well/healthy-eating-for-teens/

Autism

https://www.autism.org.uk/about/what-is/asd.aspx

Attention deficit hyperactivity disorder

https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/

Coeliac Disease

https://www.coeliac.org.uk/home/

Food Allergy

https://www.allergyuk.org/

Lactose Intolerance

https://www.nhs.uk/conditions/lactose-intolerance/

Weight Management

https://www.palaceforlife.org/project/healthy-eagles/

https://www.nhs.uk/live-well/healthy-weight/overweight-children-advice-for-parents/

http://www.bdaweightwise.com/index.html

Adults Acute Team

Our acute adult team offer expert evidence-based, patient centred, nutritional assessments, dietary advice and support for all inpatients and outpatients.

 

Our team provides expertise in a wide range of specialties including:

  • Diabetes
  • Cardiology
  • Renal
  • Critical Care
  • Gastroenterology (e.g. IBD, Coeliac, Pancreatic and Liver diseases)
  • Neurology
  • Stoke
  • Elderly Care
  • Nutrition Support
  • Obesity
  • Cancer

             

Inpatients

The department provides a service to all wards within Croydon University Hospital.  Dietetic input aims to prevent, correct and/or control nutrition related symptoms and/or disease and monitor and manage patient’s nutritional status.

 

All adult patients admitted to Croydon University Hospital are screened for malnutrition using the ‘Malnutrition Universal Screening Tool (MUST)’ and, dependent on the score (0 to 6), will have set action plans in place.  All patients that score a MUST of 2 or more are referred to the inpatient Dietitians.

 

Patients nutritional needs in hospital can be met via oral, enteral (via specialist feeding tubes) or parenteral (via specialist central intravenous lines).

 

Dietitians work closely with the Catering department, ward staff, medical teams and the patient or their relatives/carers to help meet patient’s nutritional needs.  We have a wide range of specialist nutrition products to help support and meet any nutritional deficits identified by Dietitians.

 

Croydon University Hospital has a  well-established Nutrition Support Team (NST) (established in 2010).  The NST is Dietitian led and consists of a Consultant Gastroenterologist, Consultant Biochemists and Specialist Pharmacists.  NST primarily aims to reduce the inappropriate use of parenteral nutrition (PN) and ensure the safe administration of PN but will also see patients with very complex nutritional needs.

 

Outpatients (virtual until further notice)

There are one-to-one dietetic clinics each week to educate and help support and manage patient’s dietary needs.  These clinics can be accessed by GP or consultant referral.  Currently the consultation is virtual (telephone or video link).

 

Group educations (virtual until further notice)

We offer the following:

  • ‘Weight Management’
  • ‘Gut health’ (IBS/Functional Gut disorders)

Adults Community Team

The community dietetic service is based at Lennard Road in Croydon, and provides input to adult patients (aged 18 and above) who have a Croydon GP.  We accept referrals for a range of conditions, including:

  • Nutrition support – including
    • home enteral feeding and
    • oral nutrition support
  • cardiovascular disease
  • gastroenterological illness
  • nutrient deficiencies
  • pregnancy
  • PCOS
  • COPD

Please refer to our service referral criteria for more details.

Address: 12-18 Lennard Road, Croydon, CR9 2RS

Telephone number: 0208 274 6406

Email:  ch-tr.communitydietitian@nhs.net

  • Home enteral feeding

The home enteral feeding service provides dietetic support to patients who rely on enteral feeding once discharged from hospital.  The service offers home visits and phone consultations and works closely with the Nutricia nurse. 

  • Community clinics

Community clinics are held at the following locations across the borough:

  • Purley Memorial Hospital, Purley
  • Leander Road Surgery, Thornton Heath
  • Parkway Health Centre, New Addington
  • Woodside Health Centre, South Norwood

 

  • Home visits/ Virtual clinics:

We are able to offer virtual (telephone) clinic appointments for those who are unable to attend clinic in person, including care home residents, and also provide a limited domiciliary service.

Learning Disability – Adults living with a Learning Disability are seen by a Specialist Dietitian within the Community Learning Disability service   https://www.croydonhealthservices.nhs.uk/a-to-z-of-services/service/learning-disability-185/

How to refer

Community/outpatient referrals can be made using the following referral forms. Service inclusion and exclusion criteria are included within each form.

Please ensure that referral meets the service inclusion criteria, and complete all relevant information, including weight, height, and weight history. Referrals may be rejected if it the information is not completed in full.

Adult referral form  Adult Dietetic outpatients referral form & criteria.doc [doc] 304KB

Paediatric referral form  Paediatric Dietetic outpatients referral form & criteria.doc [doc] 278KB

Learning Disability – https://www.croydonhealthservices.nhs.uk/a-to-z-of-services/service/learning-disability-185/

 

Helpful resources

General

Specific Conditions

Nutrition Support/Malnutrition

Covid – 19

Support for those in Croydon:  https://new.croydon.gov.uk/coronavirus-information-and-service-updates

How to contact us

Acute and Paediatric teams:

Address:  Nutrition and Dietetics, Woodcroft Wing, ground floor (green zone), Croydon University Hospital, 530 London Road, Croydon, CR7 7YE

Department number: 020 8401 3095

General enquires: ch-tr.dietetic@nhs.net 

Paediatric team:  ch-tr.paediatricdietitians@nhs.net

Open 9 am to 5pm Monday to Friday, excluding bank holidays.

 

Community team: 

Address: 12-18 Lennard Road, Croydon, CR9 2RS

Telephone number: 0208 274 6406

Email:  ch-tr.communitydietitian@nhs.net

Information for Care Homes

Malnutrition

Malnutrition is a state in which the body does not have sufficient nutrients from the diet to maintain optimal functioning. It affects all systems in the body and can lead to illness and reduced functioning1

In the UK the risk of malnutrition increases with age, with the highest rate amongst those age 65 and above2. Surveys have found that more than one in three of those admitted to care homes are at risk of malnutrition2.

Due to the impact of malnutrition on the body, preventing and treating malnutrition can reduce the risk of developing a number of health conditions, including infections, pressure sores, respiratory illness, as well as reducing the risk of falls3,4. Consequently, managing malnutrition through screening and monitoring, and suitable diet and care planning, can reduce the likelihood of residents requiring hospital admissions, reduce the length of hospital stays, improve residents’ response to treatment, and improve quality of life3,5.

Screening for Malnutrition

The recommended care pathway for managing malnutrition in care homes in Croydon can be found in the SWL Adult Malnutrition Care Home Quick Reference Guidelines, here.

It is recommended that care home residents are screened for malnutrition on admission, monthly and where there is clinical concern.

The MUST tool (Malnutrition Universal Screening Tool) is a validated screening tool used to screen an individual’s risk of malnutrition, using weight, height, BMI and weight history.

The BAPEN website contains further information and resources for using the MUST tool to measure resident’s risk of malnutrition, as well how to manage malnutrition through appropriate diet and care planning.

 

Care planning for individuals found to be at risk of malnutrition (MUST score 1-2)

It is recommended that individuals found to be at risk of malnutrition should be given a high calorie/protein diet, in order to treat the condition and reduce risk.

Resources including recipes for homemade high calorie drinks, snacks and food fortification can be found here.

Requests to the GP for ONS prescription should only be made for residents of MUST score 2 and above, where high calorie/protein diet has been implemented for at least 1 month, with no improvement. The form for requesting ONS prescription from the GP can be found here.

 

Malnutrition Training for Care Home Staff

An online training webinar for care homes, which covers malnutrition screening and treatment through diet, can be found here.

For more information and dietary resources, please contact Helen Dady, Prescribing Support Dietitian; h.dady@nhs.net.

 

Obesity

It is known that obesity and overweight can increase an individual’s likelihood of developing related co-morbidities, such as diabetes and kidney disease, worsen their progression, and worsen mobility and quality of life. Recently there has been additional concern with regard to the observed link between obesity and prognosis with diagnosis of covid-19.

 

What leads to obesity and overweight in older adults?

Older adults may be prone to weight gain due to a combination of factors:

- Low physical activity

- Slower metabolism

- Intake of calories in the diet in excess of what the body is able to burn off through physical activity

 

How to measure obesity

Obesity can be measured through calculation of BMI.

BMI = W (kg)  /  H (m)2

Obesity is classified as BMI of 30 kg/m2 or above, therefore for residents in this category, you may consider implementing a care plan that includes a low calorie diet.

Practical advice for managing obesity in care home residents, including low calorie diet, can be found in the following guidelines.

Tips for managing obesity through diet

1) Reduce portion size:

- limit portion sizes of carbohydrate foods (potato/pasta/rice) to 1/4 - 1/3 plate

- Limit portion size of protein foods (meat/poultry/eggs) to 1/4 - 1/3 plate.

- If possible increase portion size of vegetables/salad/fruit

- limit bread to 1-2 pieces per meal

- offer small bowl or cereal/porridge

2) Offer half size portions of puddings

3) Avoid offering extra servings of meals, snacks and puddings

3) Use low fat dairy foods – including milk (use skimmed or semi-skimmed), yoghurts and cheese

4) Avoid high/fat and high sugar foods – choose low fat/low sugar alternatives, including snacks and meals

5) Offer low sugar/diet drinks, reduce sugar added to hot drinks if taken or use sweetener

6) Maintain a regular meal pattern and balanced diet

 

 

 

References

1. NICE. CG32 Nutrition support in adults. https://www.nice.org.uk/guidance/CG32 : National Collaborating Centre for Acute Care, 2006

2. Russell CA and Elia M. Nutrition Screening Survey in the UK and Republic of Ireland in 2011. A report by BAPEN, 2012

3. Stratton RJ et al. Disease-related malnutrition: an evidence-based approach to treatment. Oxford: CABI publishing, 2003

4. Brotherton, A, Simmonds, N and Stroud, M on behalf of BAPEN. Malnutrition Matters. Meeting quality standards in nutritional care, UK: BAPEN, 2010

5. Elia M on behalf of the Malnutrition Action Group of BAPEN & the National Institute for Health Research Southampton Biomedical Research Centre. The cost of malnutrition in England and potential cost savings from nutritional interventions (short version), 2015