Introduction There is still uncertainty about the resource distribution between spinal cord injury centre (SCICs) and this may have implications to the quality of patient care.1The present study aimed to review the service provision in SCICs; to establish and compare how much time dietitians spend in direct and indirect contact with patients, and to document current nutritional screening practices.
Method All 12 SCICs in the United Kingdom and the Republic of Ireland were surveyed by questionnaire in April 2014. Data collected included the number of whole-time-equivalent staff available, whether they use of nutrition screening tools. A work sampling tool was used to capture dietetic activity for a period of one week.
Results Eight (66.7%) SCICs responded (390/531 of total beds) and the average numbers (median) of patients per whole-time-equivalent staff, including consultants (18), nurses (1.3), dietitians (93.4), physiotherapists (5.9), occupational therapists (10) were recorded and comapred with previous published figures (Table 1). Six out of eight SCICs used a validated nutritional screening tool. Thirty-two work sampling tool were analysed, dietitians spend 39.1% of the working day in direct patient-related activities. Dietetic staffing levels are varied and below clinical recommendations in 6 out of 8 SCICs.
Conclusion The resources allocated to nutritional care in SCICs appear to be limited. This suggests malnutrition may continue to be under-recongnised and under-treated. To address the complex nutritional needs of this special population group, there is a clear need to establish staffing level for dietitians. Information collected from the present study could contribute to the supply analysis of future workforce planning exercise.
Disclosure of interest None Declared.
Wong S, et al. Spinal Cord. 2012;50:132–135
NHS England. NHS standard contract for spinal cord injuries (all ages). NHS England, Redditch. 2013. http://www.england.nhs.uk/wp-366content/uploads/2013/06/d13-spinal-cord.pdf[accessed 07.02.2015]