364 Needs and Challenges of Developing a Comprehensive UGI Dietetic Service at the Queen Elizabeth Hospital Birmingham

Abstract Introduction The Queen Elizabeth Hospital Birmingham is the major tertiary upper gastrointestinal (UGI) unit in Birmingham covering a population of 2.7 million. Until September 2023, specialist Dietetic resource was limited to 1x band 6 Dietitian who covered 2 weekly outpatient clinics as well as the inpatient unit. Aim The service underwent an uplift in September 2023 when a specialist Band 7 UGI and Sarcoma Dietitian was recruited alongside the existing band 6 Dietitian. The aim was to deliver a redesigned nutritional pathway, increase capacity and access to specialist dietitian to support improved patient function, quality of life and fitness for intensive therapies such as surgery and oncological treatment. Method Outpatient clinics were increased from 2 to 5 weekly plus capacity for additional walkins. A benign, virtual and specialist sarcoma clinic have all been set up. Additionally, there is now weekly attendance at the cancer multidisciplinary team meeting as well as routine screening of the ward patients allowing us to capture patients requiring Dietetic input that may not have been referred. Results There has been a 55% increase in outpatient capacity though the clinic uplift alone. Outpatient slot utilisation ranges between 82%-100% and clinic waits have reduced from 12 weeks > to currently 0-5 weeks. 100% of patients are seen within 48 hours of referral and relevant anthropometric measures conducted, additionally there is also specialist cover in times of leave and absence. Conclusions The uplift in service has demonstrated the value of an additional dietitian in supporting a more proactive specialist service.