Adequacy of dietetic service provision to adult critical care: a survey of 33 centres in Northern England

BACKGROUND: Nutrition interventions improve morbidity, mortality and length of stay in the critically ill. Dietitians play a central role in facilitating these interventions. However, data regarding the current level and adequacy of dietetic service provision to critical care in the UK is lacking. This study aimed to clarify current service trends in Northern England for critical care, in relation to dietetic funding, grading and activity characteristics and comparisons with nationally recognized standards of care. METHODS: A work profile questionnaire was sent to 53 dietitians in Northern England. Data was collected on funding, activity patterns, organization of nutrition support, pay banding/grade and arrangements for cover during absence. RESULTS: The response rate was 66% (35/53). Thirty-three hospitals were represented. No critical care centre funding or actual activity achieved national guidance for funded dietetic full-time equivalents (FTE). Total sample deficit for funding against recommendations was 32.9 FTE. Staff pay bands/grades were inconsistent. Routine patient review occurred on a daily basis by 31% dietitians and 23% were members of a nutrition support team. Cover during absence was limited or provided by a dietitian at a lower staff grade in 67% of centres. CONCLUSIONS: Serious deficiencies exist in dietetic services to critical care in the sample studied. Further work is now required to identify inter-regional and national trends and to define appropriate dietetic job profiles for critical care.