NHSGGC Dietetics have produced a film to showcase their Practice Based Learning. The film details what students can expect from their placement and highlights the variety of opportunities NHSGGC has to offer.
Starting out in your first Job
Getting your first job can be difficult. We have produced a series of “how to” below. The how to provide some tips on how to fill out application forms, for before, during and after interviews.
Within NHSGGC we have updated the NHSGGC Career webpage and the AHP Professions webpage to include a tab for AHP return to Practice. This will guide AHPs who are returning to practice, directing them to the national return to practice webpage . We also have an agreed HR process for AHPs who are supporting periods of supervised practice which can be accessed on our AHP Practice Education Team page.
Overview NHS GGC Dietetics
NHSGGC Dietetic service has about 200 staff including managers, team leads, dietitians, dietetic assistants and administration staff.
Dietitians aim to support people to follow a healthy diet and treat health problems related to nutrition. We provide high quality nutritional care to people through therapy and treatment based on the latest scientific evidence. We are a key member of the multi-disciplinary team consisting of many different health care professionals including medical staff, nurse, ward staff, pharmacy, psychology and other AHP’s, working together to get you better
We work in a variety of settings, from hospitals, out-patient clinics in hospital and community, to domiciliary visits (attending your home).
The Adult Acute Dietetic Service provides in and out-patient services in three main Clyde Acute Hospitals, Royal Alexandra Hospital, (RAH), Inverclyde Royal Hospital, (IRH) and Vale of Leven Hospital, (VOL). Three Glasgow Adult Acute Hospitals, Queen Elizabeth University Hospital (QEUH), Glasgow Royal Infirmary (GRI), and Gartnavel General Hospital , (GGH). Rehabilitation settings including Lightburn Hospital, Glasgow’s three Ambulatory Care Hospitals including West Glasgow, Stobhill and the New Victoria Hospitals, and the Beatson West of Scotland Cancer Centre.
The 65 whole time equivalent Dietitians work across four Directorates and multiple specialities including:
Medical – including gastroenterology Respiratory – including Cystic Fibrosis and infectious diseases
Cardiology – including cardiac rehab Surgery – including orthopaedics, critical care and burns
Rehabilitation – including older adults, stroke, neurosciences, spinal and trauma
Diabetes, Renal, Oncology, Weight management and Anaphylaxis
Community dietitian’s workload is generally divided into a combination of three areas; care homes, home visits and outpatient clinics. Home visits are often for people who are house bound and who often need advice to help them gain or maintain their weight. In care homes, dietitians may offer advice to the staff when residents are struggling to maintain their weight. Outpatients clinics are mainly used for people who are referred from their health team for conditions such as IBS, diabetes, fussy eating, cow’s milk protein allergy and nutrition support. The out-patient appointment will either be in-person, via telephone or NHS Near Me (video).
Community dietetics in NHSGGC, is split into four quadrants:
Dietitians working within Adult Mental Health Services work with people with a range mental health conditions which can include anxiety, depression, autism, bipolar disorder, dementia, eating disorders, personality disorders, schizophrenia, drug and alcohol problems.
Good nutrition is important for both mental and physical health and the Dietitian will work with the rest of the multidisciplinary team to help individuals achieve their nutritional goals and develop a positive relationship with food.
In Greater Glasgow and Clyde you can find specialist Mental Health Dietitians in a range of different specialties and health settings. See below for more information on the different specialist areas.
Adult Mental Health Dietitians
Dietitians provide a wide range of dietary advice to both adults and older people during their in-patient stay within the psychiatric wards.
They also provide an adult out-patient consultation service at locations throughout NHSGGC either via face-to-face appointments, telephone consultations or video consultation via NHS Near Me.
Any staff member from the inpatient ward can referral onto the Dietetic service for nutritional assessment however for outpatients we only accept referrals for Adult patients who are under the care of an Adult Community Mental Health Team (CMHT).
Our locations
Glasgow city
Inpatient; Stobhill Hospital, Leverndale Hospital, Gartnavel Royal Hospital
Outpatient: Arran Mental Health Resource Centre, Rossdale Mental Health Resource Centre, Shawpark Mental Health Resource Centre
Clyde
Inpatient; Dykebar Hospital, Royal Alexandra Hospital, Inverclyde Royal Hospital
Outpatient: Charleston Mental Health Resource Centre, Crown House
Adult Eating Disorder Dietitians (AEDS)
The Adult Eating Disorder Service (AEDS) is comprised of a Multidisciplinary Staff Team from a variety of professional backgrounds, which includes Psychology, Psychiatry, Dietetics, Occupational Therapy and Nursing.
Dietitians working in AEDS provide specialist dietary advice to patients with an eating disorder, mainly anorexia nervosa, bulimia nervosa or other specified feeding or eating disorder (OSFED). The majority of the patients are seen in the community at Florence Street Resource Centre in the Gorbals. There are also 4 specialised inpatient beds in Armadale Ward at Stobhill Hospital. Patients can be referred to AEDS via their local CMHT.
Alcohol and Drug Recovery Dietitians
Drug and/or alcohol dependency can have a debilitating impact on nutritional status usually as a result of combined social and physical factors. Malnutrition and re-feeding syndrome are the most common referrals to the dietetic service however drugs and alcohol can impact on other physical health issues such as diabetes, pancreatitis, hepatitis and liver failure as well as having a strong relationship with mental health conditions therefore resulting in highly complex needs requiring individualised specialist nutritional advice.
The Dietitians working within the Alcohol and Drug Recovery Service provide input to the two inpatient detox units at Gartnavel Royal Hospital (The Kershaw Unit) and Stobhill Hospital (Eriskay House). Every person admitted to the unit will undergo nutritional screening and when dietetic input is indicated a referral will be made to the ward dietitian via the nursing staff. The Dietitian will then aim to complete a nutritional assessment during their stay on the ward.
The Glasgow Alcohol and Drug Recovery Service have community teams supporting patients with their alcohol and drug use in the South, Northeast, and Northwest of the city. There is a community Dietitian who works within these teams to help support patients in the community with their nutritional needs. Access to the community Dietitian is via referral from a member of the Alcohol and Drug Recovery Service team and the Dietitian will arrange to complete either a home visit, clinic visit or remote consultation.
The Alcohol and Drug Recovery Service Dietitians also provide input to the ARBD team (a specialist service providing support for those with brain damage as a result of alcohol) and to the 218 service (service which provides support to women known to the custodial service with problematic alcohol or drug use). A referral can be made to the dietitian providing input to these services by any member of the team.
More information on the different Alcohol and Drug Recovery Services available and how to access them can be found here
Forensic secure services provide therapeutic interventions for people with a mental health diagnosis who have had contact with the police or prison service. They may have been mentally unwell at the time of committing an offence or have become mentally unwell whilst in prison. Service users are detained under the Mental Health Act 1983, they are not free to leave the units at their leisure due to risks to either themselves or others. People with severe mental illness have a significantly higher mortality rate, up to three times higher than the general population, due to poor physical health. This is due to a combination of antipsychotic medications, lifestyle factors and low physical activity levels. Antipsychotics are often reported to increase hunger and cravings for sugary food and drinks, as well as reduce satiety.
Greater Glasgow and Clyde Forensic Services are based at Rowanbank Hospital (medium secure) and Leverndale Hospital (low secure). There is a dietetic service based at both of these sites. Every person within the service will undergo nutritional screening and when dietetic input is indicated a referral will be made to the dietitian via the multi-disciplinary team. The dietitian will work with the persons and other members of the MDT for a collaborative approach to improve the person’s overall health and well-being.
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Paediatrics
Paediatric dietetic services are mostly based at the Royal Hospital for children. Contact Number 0141 451 6443
Dietitians within the Community Rehabilitation Teams work together with other team members to support people at home to maximise their independence and quality of life. The team will identify any nutritional needs you may have and help set personal goals to improve your health and well-being. If you have been eating poorly for a while, are concerned that you are losing weight and this is affecting your function and strength, then we may be able to help you. Other dietary concerns may also be dealt with by ourselves or we can signpost you to the appropriate service.
REFERRAL CONTACTS:
East Dunbarton Rehabilitation Service- 0141 232 8213
East Renfrewshire Rehabilitation Service- 0141 800 7850
Inverclyde Rehabilitation and Enablement Service- 01475 714 350
The British Dietetic Association offers lots of resources for various clinical conditions, general nutrition and advice for certain populations e.g heart disease, calcium content of foods or nutrition information for children. These fact sheets are for information only and are not a substitute for proper medical diagnosis or dietary advice given by a dietitian. Please see link below to link to their factsheets
The “Free and Low Cost Food” map below is interactive. It works best if you put your postcode in, especially for areas outwith Glasgow City e.g Renfrewshire.
Healthy eating is about having a balance of different foods and nutrients in the diet for good health and wellbeing. Healthy eating is about enjoying your food, at the same time as being mindful about what you eat. See the links below for more information.
For people with cancer, the relationship between food and eating can change. The webpage below was written by Dietitians at the Beatson West of Scotland Cancer Centre to help you to take care of your food intake and nutrition by yourself. But if you are struggling to manage on your own you can ask a Dietitian for advice.
Dietitians and Support Workers can see you if you stay on a ward at the Beatson (or at your local hospital). Or you can ask your GP to refer you to see a Dietitian in a local clinic.
This information is for people who have been diagnosed with IBS.
Irritable bowel syndrome (IBS) affects 1 in 5 adults, primarily impacting the bowel and gut. Symptoms include diarrhoea, constipation, abdominal pain and/or discomfort, abdominal cramps, bloating, and excessive wind. Other symptoms are nausea, heartburn, lethargy and tiredness.
Although there is no specific test for diagnosing IBS, it is important to have a diagnosis confirmed. Tests are required to rule out other conditions like coeliac disease and Irritable Bowel Disease (IBD) (eg crohns disease, ulcerative colitis). If you think you might have IBS it’s important to speak to your Doctor before making dietary changes. It’s essential that you explain your symptoms, making sure to mention if you have any of the following:
– unintentional and unexplained weight loss
– rectal bleeding
– a family history of bowel or ovarian cancer
– a change in bowel habit to looser and/or more frequent stools persisting for more than six weeks in a person aged over 60 years
– iron deficiency anaemia
– nausea and / or vomiting
– reflux / heartburn
The cause of IBS is unknown, however symptoms can be improved through diet and lifestyle changes. This might include changes to what you eat and drink, exercising and finding ways to relax and manage stress.
The links below provide information and first line advice to help you manage your symptoms.
If your symptoms continue despite making these changes, speak to your Dietitian. Sometimes special Diets such as low lactose, wheat free or a low FODMAP diet can help. However these diets can cause nutritional deficiencies so always make sure that you get advice from a Dietitian before trying them. Your GP or health professional can refer you to your local Dietetic service.
When your liver is not working well, your body needs extra energy and protein. Malnutrition (weight loss and muscle wasting) is common in liver disease. This resource was written by dietitians in NHSGGC to help guide you on what to eat and drink if you have, or are at risk of, malnutrition.
For further information on nutrition, talk to your liver team. They may refer you for an appointment with a dietitian.
See Information Eating to Feel Better. Liver Disease for more information
The role of the dietitian includes nutritional assessment, diagnosis, intervention, monitoring and evaluation of nutrition related issues in respiratory patients. We are a link for nutritional advice for both the Community Respiratory Team and the wider respiratory team and contribute to the development of individual multi-disciplinary care plans.
Universally across respiratory conditions, the management of malnutrition is at the forefront of priorities for Dietitians – however both under nutrition and over nutrition are considered.
Having a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) means patients use 10 times more energy to breathe than someone with healthy lungs – Therefore COPD patients need more energy to do the work of breathing. A good diet can help prevent lung infections. Ensuring the patient has a sound nutritional status reduces the risk of getting infections, improves lung function and reduces both likelihood/ duration of hospital stay. Good diet also reduces the likelihood of unplanned weight loss from eating poorly which can weaken the muscles used for breathing. Poor nutritional intake/ status can make symptoms of COPD worse and it can also decrease a patients ability to exercise.
Community Respiratory Team can be contacted on 0141 800 0790.
Changes to your diet can significantly improve IBS symptoms in some people. Eating well, being well hydrated and increasing/ decreasing your fibre intake (based on symptoms) might be helpful in managing symptoms. Links below provide further information on diet.
Alcohol can make IBS symptoms worse. Reducing alcohol intake can help to reduce symptoms, as well as having positive effects on physical and mental health.
Starting solids is an important milestone in childhood development.
Starting solids means gradually introducing a variety of foods to your baby alongside breast milk or infant formula until they are eating the same healthy foods as the rest of the family. Sometimes this is called weaning, introducing solids or complementary feeding.
Cow’s milk protein allergy (CMPA) is a condition that can affect the gastrointestinal tract and cause problems such as wind, pain, constipation and loose stools. It can affect the skin, causing rashes or eczema and it can also cause lower tract respiratory infections or coughs. Many of the symptoms associated with CMPA can occur as a result of other common conditions, or as variants of normal, so it is important to consider CMPA as only one in a range of possible diagnoses.
CMPA can be either an IgE (immediate reaction) involving the immune system or Non IgE (non immediate) and not involving the immune system. If you feel your patient or your baby has CMPA please talk to the Doctor or Health Visitor.
There is information on this page which is designed to help Health Care Professionals diagnose and treat Non IgE CMPA.
There is also a section for parents or carers for the ongoing management of Non IgE CMPA below.
Cow’s Milk Protein Allergy For Health Care Professionals
The IDDSI (International Dysphagia Diet Standardisation Initiative) framework consists of definitions to describe texture modified foods and thickened liquids, where drinks are measured from Levels 0-4, and foods are measured from Levels 3-7.
NHSGGC Dietetics has worked closely with our Speech and Language Therapy colleagues to produce a series of videos about IDDSI and Dysphagia. For more information about Speech and Language Therapy within NHSGGC, please see their website below.
The first 3 videos provide an overview of IDDSI and dysphagia, including all IDDSI levels 0-7, hydration and food fortification.
The videos below, show demonstrations by an IDDSI trained chef. This gives insight into how some everyday foods can be modified to the correct recommended textures. The videos are broken down into the different components of the meal for easy accessibility.
Speech and Language Therapy talk on Dysphagia and IDDSI of video
Food, Fluid and Nutrition Nurse Talk on IDDSI Levels 1-4 and Hydration
Dietitian Talk on IDDSI Levels 5-7 and Food Fortification
Meet the Chef
IDDSI Thickening Instructions and Testing Methods for IDDSI Levels 1-4
Peaches Flow Test IDDSI Levels 0-4
IDDSI Level 3 Peaches
IDDSI Level 4 Peaches
IDDSI Level 5 Peaches
IDDSI Level 6 Peaches
IDDSI Level 6 Peaches Fork Pressure Test
IDDSI Level 7 Peaches
Comparison of Peaches Level 3-7
IDDSI Level 4 Salad
IDDSI Level 5 Salad
IDDSI Level 6 Salad
IDDSI Level 4 Chilli
IDDSI Level 5 Chilli
IDDSI Level 6 Chilli
IDDSI Level 4 Rice
IIDDSI Level 5 (and 6) Rice
Plating Up a Texture Modified Meal
NHSGGC Dietetics has worked closely with our Speech and Language Therapy colleagues to produce an IDDSI snack poster, which provides both sweet and savoury snack ideas for diet level 4 through to level 7 ‘easy to chew’.
Diabetes in Hospital: Carbohydrate Counting During Your Hospital Stay
Carbohydrate counting can be challenging when you are in hospital. The NHSGGC booklet, ‘Diabetes in Hospital: Information on Carbohydrate Counting During Your Hospital Stay’ can help to make this easier.
This booklet provides carbohydrate values for the food and drinks available during your hospital stay. It has been produced for both people living with diabetes and their healthcare professionals, and can assist with identifying carbohydrate sources, carbohydrate counting and insulin dose adjustment (if applicable). To access this booklet, ask a member of staff on your ward, or follow the link, below.
Gestational Diabetes (or GDM) is a type of diabetes which develops during pregnancy. Blood glucose levels can become too high, and it is important to control these to minimise health risks for both you and your baby.
The below patient education videos were created by NHSGGC Diabetes Dietitians, and focus on healthy eating with Gestational Diabetes. Patients can contact or be referred to the Diabetes Dietitians for more detailed advice, if required. These videos are available in other languages at the bottom of this series.
Video 1: What is Gestational Diabetes?
In this video, we will answer some important questions about gestational diabetes; discussing what it is, the symptoms it can cause, how it can affect you and your baby, and the ways in which it can be treated.
Video 2: Healthy Eating, and an overview of the food groups
In this video, we will be discussing healthy eating, the Eat Well guide, an overview of the food groups and providing a detailed overview of carbohydrates.
Video 3: Portion sizes, smart swaps and meal patterns
During this video we will be discussing portion sizes, smart swaps, snack ideas, meal patterns and foods to include or avoid during pregnancy
Video 4: Breastfeeding, post-birth and lifestyle
In this video, we will be discussing breastfeeding, the benefits of breastfeeding, what will happen after your baby is born and general lifestyle changes.
Video 5: Frequently asked questions, links and contacts
In this video, we will answer some frequently asked questions, share useful links to access further information, and provide the best contact details for the NHSGGC Diabetes Dietitians.
Information in other languages
The Gestational Diabetes patient education videos were created by NHSGGC Diabetes Dietitians and have been translated into 5 languages. Each of the 5 videos will automatically play in sequence. They focus on healthy eating with Gestational Diabetes. Patients can contact or be referred to the Diabetes Dietitians for more detailed advice, if required
Videos 1-5, in Arabic
VIdeos 1-5 In Urdu
Eating for a healthy heart
Diet and kidney disease
The above video highlights how appropriate dietary management can slow the progression of chronic kidney disease. This can delay the patients’ need to access renal replacement therapies such as haemodialysis, peritoneal dialysis and transplant.
This patient education video was created by NHSGGC Renal Dietitians as an introduction to diet and chronic kidney disease, with a focus on the no added salt diet. Patients can be referred to the Renal Dietitians for more tailored dietary advice.
As chronic kidney disease progresses, the kidneys become less efficient at removing potassium and other waste products from the body. This can lead to a raised potassium level in the blood. Once other potential causes have been excluded a patient may be advised by their healthcare team to follow a low potassium diet.
This patient education video was created by the NHS GGC Renal Dietitians as an introduction to the low potassium diet. For specific individual advice, patients should be referred to the Renal Dietitians.”
This video below explains the importance of keeping blood phosphate at a safe level. It will explain what a low phosphate diet is and show you types and portion sizes of phosphate containing foods. The video will also explain types of phosphate binders and how they work
The body needs a range of nutrients to keep it working well. If you, or someone you care for, does not eat enough of the right nutrients there is a risk of becoming malnourished. When a person loses their appetite it can become a struggle to eat enough food to provide the energy and protein to meet their nutrition needs and maintain their body weight. If this happens it can cause malnutrition.
Malnutrition can cause:
Low mood
Reduced energy levels
Reduced muscle strength
Reduced quality of life
Difficulty with carrying out daily activities
Increased risk of illness and infection
Slower wound healing
Increased risk of falls
If you are concerned about unplanned weight loss please speak with your health care professionals who will be able to screen you for malnutrition using a screening tool such as https://www.bapen.org.uk/screening-and-must/must/must-toolkit/the-must-itself This tool assesses individuals as being at low, medium or high risk of malnutrition.
It is important to deal with any underlying problems which cause weight loss or poor dietary intake.
Appetite can be affected by many different factors, e.g. low mood/depression, medication, constipation, problems relating to physical health. There can be physical limitations such as swallowing problems, poor tooth health or poorly fitting dentures. People with limited mobility or issues with their memory may benefit from support with shopping for and preparing meals.
If you are medium or high risk of malnutrition some simple changes to what you eat and drink can help you to improve your intake of nutrients such as energy/calories, protein, and vitamins.
NHS Greater Glasgow & Clyde has developed advice to help support a nourishing diet. In general we would recommend the following:
Aim for 3 small meals and 3 snacks per day
Use 1 pint of full cream milk daily
Include a pudding daily
Buy in foods that you enjoy
Ask for assistance with cooking where possible
Share cooking and eating at mealtimes with family and friends if possible
Try using a company that delivers meals directly to your door or do your shopping online
Include some fruit and vegetables e.g. fresh, tinned fruit or frozen
Keep a store cupboard with food such as soups, instant puddings and tinned fruits.
For more detailed advice please click the tiles below.
Do I need supplement drinks (oral nutritional supplements ONS) to gain weight?
Most people do not require supplement drinks to help them gain weight or maintain their weight at a healthy level. For those who do require this treatment it is usually short term (3- 6 months) and after this time the large majority of people can manage their weight and nutritional status with diet alone. Supplement drinks are prescribable products and strict criteria (known as ACBS criteria) must be followed for you to receive these products. If you do not meet this criteria there are similar over the counter products that can be purchased in community pharmacies, shops and supermarkets. A list of these products is available below.
Prescribed supplement drinks should only be taken if advised by a Dietitian.
The Care Home Dietitians in NHSGGC cover all Care Homes across Greater Glasgow and Clyde. Their job role is primarily training and quality improvement. This includes data collection, improvement work, menu analysis, close multidisciplinary team working, and mealtime observations.
We work in partnership with Care Homes by supporting them with the tools and education needed to improve resident care and outcomes from a food, fluid and nutritional care perspective.
Along with Community Dietetics, the Care Home Dietetic Team has a role within the Care Home Collaborative. For more information about this team, please see their website on the button below
Good nutrition has a vital role in supporting people of all ages to maintain good health, this is especially true within the Care Home setting.
To support the management of Malnutrition within Care and Residential Homes a series of MUST training videos have been developed. See below
MUST training in Care Homes
Video 1 provides an overview of the Malnutrition Universal Screening Tool (MUST) and how to carry out the calculations.
Video 2 describes The MUST Step 5 Management Plan.
Video 3 provides an overview of Food Fortification including Food First strategies, snacks and nourishing drinks.
Video 4 is a case study discussion to review the completion and progress of a MUST Step Management Plan from initial completion through to the 4 week review
Video 5 is a case study discussion to review the completion and progress of a MUST Step 5 Management Plan from initial completion through to the 4 week and 8 week review.