The referral process
Referrals will be accepted from Community Paediatricians, GPs, health care professionals and families by electronic referral form or via System One. All referrals are initially triaged and prioritised based on clinical need.
The service can often accept ‘self-referrals’ directly from families, but there are times when further information is needed from the health professionals involved in their care prior to the referral being formally accepted.
The service is commissioned to provide a range of different dietetic and feeding services across the Mid and South Essex (MSE) ICS.
Referral criteria:
The service referral criteria is dependent on the where the child lives within the MSE and what they are being referred for. Referrals that do not meet the services referral criteria will be rejected.
Mid and South Essex Wide Service
Inclusion criteria includes:
- Living within MSE and registered with an MSE GP
- Under 1 with a suspected or confirmed non-IgE cows milk allergy
- Using prescribed cows milk allergy formula
Mid Essex
Inclusion criteria includes:
- Babies, infants and children aged from Birth – 16 years old (19 year old with Special Educational Needs and Disability SEND)
- Physically have a feeding tube in place
- Living in Mid Essex and registered with MSE GP
Basildon, Brentwood and Thurrock
- Babies, infants and children aged from Birth – 16 years old (19 year old with Special Educational Needs and Disability SEND)
- Faltering growth / poor weight gain (as defined by NICE)
- Children requiring enteral tube feeding
- Acute or chronic illness requiring nutritional support
- Preterm infants with poor weight gain or those requiring specialist feeding advice
- Over 1 Non IgE Confirmed food allergies and intolerances (See exclusion criteria)
- Dietetic support for conditions including Coeliac Disease, Prader-Willi Syndrome
- Constipation, only if coupled with significantly reduced food intake and / or faltering growth and only after first line advice has been provided
- Primary iron deficiency anaemia
- Advice and support for weight management 0-5years of age with a BMI >98th centile
- Advice and support for weight management for children >5 yrs of age where a group setting is not suitable
- Selective and restrictive eaters with limited diets where there is significantly reduced food intake and or faltering growth and first line advice has been provided
- Difficulty with swallowing that affects a child/young person’s ability to eat and drink
- Difficulty with sucking, chewing and oromotor impairment
- Learning, physical, communication, sensory, and behavioural needs which results in nutritional and/or developmental concerns
- Dietary assessment due to concerns relating to specific symptoms where diet is suspected and assessment is require to consider its impact.
Exclusion Criteria:
- Children not registered with a Mid South Essex GP
- Children in Mid Essex who no longer physically have a feeding tube
- Children requiring dietetic support whilst admitted to hospital
- Children requiring community dietetic support in Mid Essex (excluding milk allergy and tube feeding) or Southend regions (excluding milk allergy) — Refer to Acute Paediatricians at childs local hospital who can refer to their acute paediatric dietitians for support
- Suspected or confirmed eating disorders and ARFID (pre-diagnosis) — Refer to SET CAMHS Eating Disorders or ARFID Team (>8yrs) OR suspected ARFID (<8yrs) referral to Tertiary centre
- Diabetes — Refer to Acute Paediatricians at childs local hospital
- Multiple delayed and/or single or multiple immediate IgE food allergies — Refer to Acute Paediatricians at childs local hospital
- When primary dietetic management is provided by specialist tertiary services who do not require tube feeding – I.e Ketogenic diet, Cystic Fibrosis, inborn errors of metabolism — A referral may be accepted due to oral feeding safety or skills development (Basildon/ Thurrock Only) but primary dietetic management remains with specialist tertiary service. Local service can support equipment ordering as directed by tertiary service.