WH's Nutrition and Dietetics Community Service provides evidence-based nutritional assessment and dietary advice to manage conditions like obesity, type 2 diabetes (not on insulin), irritable bowel syndrome, and nutrition support. It offers one-to-one dietary counselling to promote healthier, longer lives.

Eligibility Criteria

Inclusions

Summary of adult inclusion criteria:

• malnutrition (MUST score 2 or more)
• nutrition support (BMI <18.5, due to recent unintentional weight loss of 5%+)
• nutrition support (BMI <20 with recent unintentional weight loss of 5-10% within the last 3-6 months of referring)
• Oral Nutritional Supplement (ONS) review (only if currently taking these and need a review)
• pressure ulcers
• diagnosed dysphagia
• type 2 diabetes (those on insulin therapy should be referred to Intermediate Diabetes Service or if newly diagnosed, refer first to DESMOND programme where suitable). 
• pre-diabetes
• weight management (only BMI 30+, or BMI 27+ if from BAME background)
• hyperlipidaemia
• hypertension
• gastrointestinal disorders
• diagnosed nutrient deficiency (anaemia)
• diagnosed digestive issues (IBS), please always include investigation results with referrals.

Summary of child inclusion criteria (>18 months, Haringey only):

• diagnosed nutritional deficiencies 
• obesity >91st centile
• type 2 diabetes
• malnutrition (weight loss/underweight/ongoing poor appetite)
• constipation
• fussy eating
• failure to thrive
• diagnosed single food allergy
• diagnosed nutrient deficiency (anaemia)

Exclusions

Summary of adult exclusion criteria:

• referrals with insufficient information to ascertain nutrition status, regardless of reason for referral (e.g. no recent weight, weight history, height, BMI)
• IBS referrals that have not completed the IBS referral proforma (see How to refer)
• all type 1 diabetes
• type 2 diabetes on insulin and/or triple therapy
• suspected or confirmed eating disorders (refer to Eating Disorders Unit)
• palliative care at end of life: we do not accept referrals for patients who are end of life and they should not be given any ONS on prescription. To be offered food and drink for comfort. 
• patients who are alcohol/drug abusers: please do not initiate ONS until seen by dietitian ideally. If ONS is started, please ensure they meet the NCL criteria to be eligible. State if the patient is engaged in a support programme and which one. If they have a past history, then state on referral form if this is still an ongoing issue or if this has now been resolved.
• mental health patients: we cannot accept referrals for patients who have a current active mental health condition that is not being well managed. For all Haringey patients with unstable mental health need to be under the mental health team, and any patients already under a mental health team should be referred to the mental health dietitians (rf-tr.mhdietetics@nhs.net). 

Summary of child exclusion criteria: 

• young babies (<18 months)
  • refer to Haringey Child Development Centre (CDC) service
• children with an undiagnosed allergy
• children with an Islington GP - they should be referred to the Islington & Camden Community Dietetics team
• children with suspected or diagnosed behavioural conditions like autism, ADHD, ARFID and very restrictive diets
  • refer to CDC service or CAMHS
• children with eating disorders
  • refer directly to a specialist eating disorder service/CAHMS
• children with two or more food allergies or intolerances
  • refer these cases directly to the paediatric allergy service
• children with complex special needs e.g. downs syndrome, learning disabilities (often for children who are non orally fed)
  • refer to CDC dietetic service
• children with a Haringey GP who are tube fed; please refer to CDC dietitians.

How to Refer