How our Dietetics teams have adapted during COVID-19

Our Trust provides a Paediatric Dietetic Service to children aged 0-18 years, in the East Riding of Yorkshire and Pocklington. The paediatric team is specialised in nutritional needs for children with disease-related nutritional concerns, such as allergies, nutrition support, enteral feeding, faltering growth and nutrition deficiencies.

We recently spoke to Vanessa Smith, Professional Lead for Dietetics, and Nazrana Quareshy, Specialist Dietician, who told us all about what their team does, how their jobs have changed during the pandemic and what keeps them going when faced with challenges.

 

What does your team do and how has this changed?

When lockdown first began, we turned to virtual and telephone based appointments, but we quickly realised that this didn’t work for everyone, so we started to think outside of the box in terms of what we could deliver in a COVID safe way.

We then began using video consultations and working with Health Visitors, whilst also inviting certain individuals to meet face to face when necessary.

We just adapted as time went on, it was important that we reviewed things regularly and made changes when we saw room for improvement.

 

What did you find difficult in the beginning?

When the first lockdown was announced, we saw that quite a few of our allergy patients couldn’t get the products they needed due to stockpiling. We quickly reacted to this by arranging prescriptions in cases where possible, and to work with the nutritional representatives in the government, who helped with emergency stocks of things like baby formula.

We were lucky in some ways, as the government had already created a lot of information and resources for us to use. This meant that while we had to look for new ways of supporting people, there wasn’t many issues in actually accessing that support and connecting the dots.

As a result, we were also able to relieve some pressure from primary care and reduce referrals into secondary care, as we managed the issues before they could escalate.

These challenges, while difficult at first, certainly improved inter-team contact and meant that we had increasing opportunities to connect with others and attend meetings in other pathways which has remained useful for our service.

 

How are you and your team feeling about the ongoing crisis?

Now we’ve found a new routine, we are feeling pretty good, and proud of how quickly we adapted. The team is very supportive of one another, even when working from home, and I think that’s been vital to our wellbeing at this time.

We, like all NHS staff, also have personal lives that have been affected in different ways by this pandemic. We have children and families to think about, so having that support as a team has been wonderful.

 

Is there something that has changed, that you will continue into the future?

I mentioned it briefly already, but multi-agency working has been an amazing change for us. We now work with different people from hospitals across the patch, and while we did have those connections there before the pandemic, it now feels much more seamless and like teamwork has become a priority in supporting one another and getting things done.

We’re now communicating better than ever before. A good example is how we’re working closely with Health Visitors and the Nursing team - both have been extremely supportive and provided information we needed.

Microsoft Teams has enabled us to bring together these teams easily, without a need to travel and book in long meetings. We can now discuss best ways of moving forwards together and this has truly broken down barriers and allows us to get things done at pace.

We will also continue working electronically in general. No more paperwork as it’s all online, which is not only easier for us but also better for the environment.

 

How are your patients finding it?

We’ve had lots of positive feedback. At first, we didn’t know how they would find it, but it turns out that patients simply appreciate the fact that our service has remained open and that we’re helping them find alternative ways of managing their health during these uncertain times.

Most of our patients didn’t want to continue face to face appointments due to fear of transmission, so they were very excited by the video consultations and telephone appointments available. This shift has been more positive than we could’ve hoped.

It’s also been nice to see patients take a little more ownership and be more on board and involved with their care. No being able to come in for face to face appointments and rely on us for different things has changed how they view things. They’re realising that they can do things at home and take more responsibility in ensuring their condition is monitored and reported to us over time.

 

What would you say you have learned so far, from this experience?

How resilient NHS staff really are, and also, how small teams can achieve so much, even when they have a lot going on outside of work. We are all committed to providing the highest standards of care to our patients and that is what has pulled us through.

Supporting one another both professionally and personally has also been a morale booster during challenging days. 

 

Is there any advice you would give to other teams?

One thing we were worried about in the beginning was continuing to take on students during this time. We were concerned about the added pressure and being able to deliver the same experience as we would in ‘normal circumstances’.

We decided to take it slow by meeting with them online first and hearing more about their concerns. We provided them with the information we had, and a plan of how it could work if they were happy to proceed.

We left the call feeling relieved. Students were still enthusiastic about learning and were happy to see we had come prepared with a roadmap to manage expectations.

Since then, we have been so pleased that we didn’t let anything get in the way of them joining us. Students have let us know how much they’re learning and are enjoying the unexpected variety in what they’re doing.

It’s working, and it’s simply been an extremely positive experience. To any teams wondering if they should reintroduce students to the team, we would say ‘go for it!’

As these circumstances have continued for longer than I think any of us imagined, it’s important to look forwards and ensure our future workforce are equipped with a broad range of skills and are up to date with the current ways of working in their field.