58 The Impact of Introducing an Upper Gastrointestinal Nutritionist to an Established Upper Gastrointestinal Dietetic Team

Abstract Introduction Upper Gastrointestinal (UGI) cancer dietetic (RD) services are nutritionally complex and often under resourced, in the current financial climate it is prudent to consider engaging a wide skill mix within an established UGI RD team, eluding a reduction of quality or escalation in risk. Method 0.5wte Band 5 12-month fixed term funding was sourced to pilot the use of a Specialist Upper GI Nutritionist (UGIN) working as part of an established UGI RD team. Key Performance Indicators (KPIs) were set to evaluate the project, themes included patient experience, RD capacity, Enhanced best supportive care (BSC), Admission avoidance, and accelerated discharge. The patient cohort being individuals diagnosed with UGI cancer on a non-curative pathway. Results Utilisation of Specialist UGIN services e.g. BSC clinics, SOS service, initiation of enteral feeding in the community, timelier pump training as an inpatient, and troubleshooting significantly optimised UGI RD capacity. On average, 10 hours per week of RD time was released, allowing a new UGI RD service development for complex benign UGI outpatients. Case studies and patient surveys confirmed high levels of patient satisfaction. Conclusions A Specialist UGIN can free RD clinical capacity. UGIN, that are members of a professional body, have the required skill set to safely manage a specified cohort of UGI patients when part of a wider UGI RD team. Of note, this would not be endorsed as an independent, stand-alone service. The appropriate use of an UGIN has the potential to free RD capacity to allow for additional UGI RD services to be delivered.