1 June 2020

The Trust that runs Shropshire’s two acute hospitals is raising awareness of the invaluable work carried out by its Dietetics team throughout the COVID-19 (Coronavirus) pandemic as it marks Dietitians Week from Monday 1 June.

Dietitians at The Shrewsbury and Telford NHS Hospital Trust (SaTH), which runs the Royal Shrewsbury Hospital and the Princess Royal Hospital in Telford assess, diagnose and treat dietary and nutritional problems at an individual and wider public-health level. They work to tackle some of the biggest health issues facing the nation, from obesity and frailty to diabetes and cancer.

To mark Dietitians Week, Sarah Thomas, Specialist Dietitian at SaTH, explains the vital role she and her colleagues have carried out during the COVID-19 pandemic to support patients suffering or recovering from the virus.

She said “Good nutrition is crucial in supporting the body to get through and recover from COVID-19, but getting access to the right nutrition in the right quantities can be difficult, and the way in which the body uses nutrients can be greatly affected when a person is unwell.

“The majority of people with COVID-19 will experience only a mild cough and fever requiring rest and recuperation at home. However, some patients may experience far more severe symptoms, requiring the highest level of medical support available in our hospitals’ critical care units, and this includes the expertise of a dietitian.

“When a very ill patient is transferred to critical care they may be sedated and ventilated. In order for them to receive nutrition, hydration and medication, a tube is placed into the stomach via the nose and, for a small number, nutrition and hydration will be will be delivered directly into the vein.

“The clinical condition of COVID-19 patients can change quickly. Dietitians must be flexible and reactive to these changes to ensure that the patient receives the correct nutrition.

“Patients on critical care often receive medications that can affect their nutrition. Dietitians constantly assess what the patient’s nutritional requirements are and take these extra calories into consideration when formulating the patient’s feeding regime.

“Some medications can contain calories, whilst other medications can slow down gastrointestinal transit, or make it harder for patients to absorb nutrition. The role of the dietitian here is to recognise these medications and advise on different preparations of feed and alternative methods of feeding when required.

“When a patient is well enough to return to the ward after critical care for COVID-19, they must work hard to regain enough strength to return home. Their nutritional requirements are increased, and swallowing difficulties can also occur after critical illness as the muscles involved with swallowing become weak and tubes used to ventilate the patient can irritate the mouth and throat.

“Dietitians work closely with ward staff including the nurses, Doctors, ward housekeepers, Speech and language therapists and physiotherapists to ensure that there is a holistic approach to the patient’s recovery, and any aspects of their treatment which can impact on their nutrition (such as increasing mobility, swallowing difficulties or periods of nil by mouth for procedures) are accounted for.

“Dietitians are instrumental in providing education and support regarding food choices, and in many instances, will suggest nutritional supplements to help meet nutritional requirements for recovery and rehabilitation. This support does not stop when the patient leaves hospital. At this point, our outpatient team will work alongside GPs and community healthcare professionals to guide the patient as their health and strength return.

The past few months have felt uncertain and at times, scary, but the outpouring of support and love experienced from fellow NHS workers, patients and the general public has been nothing short of phenomenal. I have never been more proud to call myself a Dietitian.”

Maggie Bayley, Chief Nurse at SaTH, said: “Dietitians and Support Workers provide an invaluable service, both for their patients and for their colleagues. The team at SATH has been flexible and reactive during the COVID-19 pandemic and I’m proud to acknowledge their hard work and tenacity as we observe Dietitians Week.”