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NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
Notes:

Nutrition/Blood related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Nutrition/Blood related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

 

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

 Details...
09.04.02  Expand sub section  Enteral nutrition
 note 

BSW Oral Nutrition Supplements Formulary

Before prescribing ONS, it is advisable to screen a patient to assess requirements using the MUST tool. See community MUST screening or care home MUST screening.

When introducing ONS to patients for the first time prescribe a small number of assorted flavours or a starter pack as an acute prescription.

 

Foodlink Complete
(Powdered MILKSHAKE style ONS)
View adult BNF View SPC online
First Choice
traffic lightGreen
  • First line option 
  • 57g sachets
  • To be mixed with 200ml full fat milk. Consider whether patient has access to milk and ability to make up the drink with milk. Consider cost to patient. Not suitable for those with lactose intolerance.
  • See ONS guidance for full product details
 
Aymes Shake
(Powdered MILKSHAKE style ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 57g sachets
  • See ONS guidance for full product details (link at top)
 
 
Fortisip
(Ready to drink MILKSHAKE style ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 200ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Ensure Plus
(Ready to drink MILKSHAKE style ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 220ml bottles
  • See ONS guidance for full product details (link at top)
 
 
Foodlink Complete Compact
(Powdered COMPACT style ONS.)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • For those who require smaller volumes or with fluid restrictions
  • 57g sachets
  • See ONS guidance for full product details (link at top)
 
 
Fortisip Compact
(Ready to drink COMPACT style ONS.)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • For those who require smaller volumes or with fluid restrictions
  • 125ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Altraplen Compact
(Ready to drink COMPACT style ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • For those who require smaller volumes or with fluid restrictions
  • 125ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Aymes ActaSolve Smoothie
(Juice style ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • Not suitable for people with diabetes, COPD and wounds - due to carbohydrate:protein ratio
  • 66g sachet
  • See ONS guidance for full product details (link at top)
 
 
Altrajuce
(JUICE style ONS )
View adult BNF View SPC online
Formulary
traffic lightAmber
  • Not suitable for people with diabetes, COPD and wounds due to carbohydrate:protein ratio
  • 200ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Fortijuce
(JUICE style ONS)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • Not suitable for people with diabetes, COPD and wounds due to carbohydrate:protein ratio
  • 200ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Foodlink Complete Powder with Fibre
(Milkshake style PLUS FIBRE ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • Contains fibre, consider for those with constipation
  • 63g sachet
  • See ONS guidance for full product details (link at top)
 
 
Ensure Plus Fibre
(MILKSHAKE style PLUS FIBRE ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • Contains fibre, consider for those with constipation
  • 200ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Aymes ActaGain 2.4 Maxi
(Ready to drink MILKSHAKE style HIGH Protein ONS)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 200ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Fresubin 3.2 kcal
(Ready to drink MILKSHAKE style HIGH Protein ONS)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 125ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Fortisip Compact Protein
(Ready to drink MILKSHAKE style HIGH Protein ONS)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 125ml bottle
  • See ONS guidance for full product details (link at top)
 
 
Nutricrem
(For Dysphagia Level 4 ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • FIRST LINE for Dysphagia Level 4 ONS
  • 125g pot 
  • See ONS guidance for full product details (link at top)
 
 
Nutilis Fruit Dessert Level 4
(For Dysphagia Level 4 ONS)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 150g pot 
  • See ONS guidance for full product details (link at top)
 
 
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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