NHS HPN update

28/05/2020



Information for home parenteral nutrition (HPN) patients
Updated 27 May 2020 - the original statement can be found here  


Your hospital clinical teams, homecare providers and the national NHS bodies in England and Wales are working closely together to ensure your service continues with minimal disruption throughout this time and in the future.

This information will help you understand the measures your hospital clinical teams and homecare providers are putting in place to protect you and continue to provide a safe service.

Update for patients receiving compounded nutrition

In our last update we said your healthcare team would arrange for a supply of multi-chamber bags (MCBs) and/or fluids for you to use only if your normal delivery or products are temporarily unavailable due to manufacturing levels of compounded bags being affected. Some patients will have already received their MCBs and/or fluids to keep at home. Through our discussions and planning preparations with hospital teams and homecare providers we are now arranging for a smaller group of patients to have an alternative ready at home, so that those patients who are in greatest clinical need can remain on their compounded nutrition.

Hospital clinical teams working with the compounding providers are now identifying a smaller group of patients who will have an alternative product ready in their homes in case needed. For example, if a high number of homecare delivery drivers or pharmacy staff at the compounding provider become sick, which affects the production of compounded nutrition or creates delays in deliveries.

If you or your child are identified for a supply of alternative nutrition products at home, your healthcare team will have arranged for a supply of MCBs and/or fluids. This is for you or your child to use only if your usual products are not available or your delivery is significantly delayed, to ensure you continue to have something at home ready to use.

If you are identified by your healthcare team, your parenteral nutrition provider will be in touch directly so you are aware there will be an extra element to your usual delivery. Your healthcare team will make the closest match possible, to avoid the worst-case scenario of you having nothing to infuse. If your child was usually receiving a separate fat bag, information will be provided for ‘all-in-one’ bags.

If and when the alternative product prescribed by your healthcare team needs to be used, you will be notified by your parenteral nutrition provider and your healthcare team will also be notified.

Hospital clinical teams are also identifying patients who, for clinical reasons, need to remain on compounded nutrition. These patients will be prioritised for compounded nutrition in the event of any production or delivery issues.

Update for all HPN patients

Buffer bags 

Healthcare teams and homecare providers are also working together to ensure all patients have an extra bag or two of your existing delivery to ensure you do not run out of nutrition before your next delivery.

Pumps

If you have any issues with your pump please contact your homecare provider in the usual way and they will send a replacement, if necessary. 

Advice from your hospital or homecare provider

Please continue to follow any specific advice that your healthcare team or your homecare provider has given you. It will be tailored to your personal treatment and circumstances and takes precedence over any generic advice. 

Deliveries

If the items being delivered do not need to be refrigerated and are not heavy, the driver will now be advised to leave the items in a secure place with prior agreement with you.

You do not need to sign for your delivery. Your driver will ring the bell and wait at a distance for you to answer the door. You will be asked a series of questions and the driver will sign to confirm you have received your delivery. Delivery drivers will not leave products unattended, in full view.
 
For deliveries into the home, you, and all other members of your household, should move to another room while the delivery takes place. Although many of you have regular drivers and this social contact is important, at this time please do not interact with your delivery staff unless it is absolutely essential. It may not be possible for you to have the same drivers you usually have.

If you have items that need to be returned, please contact your homecare provider before leaving anything for the delivery driver.

Please remember

  • All HPN patients should have a ‘buffer bag’ to ensure you do not completely run out of nutrition before your next delivery arrives.
  • If you receive compounded nutrition and you are identified by your healthcare team to have an alternative MCB at home, should manufacturing levels of compounded bags be affected, your homecare provider will contact you.
  • If you have questions about the government’s advice on shielding, please visit www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
  • Please continue to follow any specific advice your healthcare team or your homecare provider has given you.
 Thank you for your support and patience.

We are delighted that our plea for this update to be posted to all HPN patients will be done by the individual homecare companies. Please allow a few days for this to happen. Many thanks.


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