A proposal to support a review of oral nutritional supplement (ONS) prescribing and identify ways to drive forward high quality, effective and efficient ONS prescribing was accepted in 2016. This was in light of increasing trends in both ONS volume use and spend, plus variation in ONS prescribing across NHS Boards. An ONS Short Life Working Group (ONS SLWG) was established in December 2016 and concluded in February 2018. It was agreed that the work taken forward by this group would be shared with NHS Boards and would support the Once for Scotland approach described within the Scottish Government’s 2020 strategic narrative for the health sector.
The ONS SLWG representation was as follows:
- Lead dietetic representative for each territorial NHS Board in Scotland
- Effective Prescribing and Therapeutics Branch, Scottish Government
- The British Dietetic Association.
- Scottish Practice Pharmacy and Prescribing Advisors Association (SP3AA).
- Primary Care and Community Pharmacy Group.
- Community Pharmacy Scotland (CPS).
- Care Inspectorate.
- NHS National Services Scotland (NSS) National Procurement.
- Dietetic Project manager.
GP membership was also requested but unfortunately was not fulfilled.
The work of the ONS SLWG, driven forward by 3 sub-groups, resulted in a greater understanding of ONS prescribing across Scotland and why there is variation between NHS Boards. The ONS SLWG developed key recommendations and outputs to reduce this variation. Two key outputs, which are intended for use for use by colleagues working in health and care settings across Scotland, are:
The ONS SLWG recommend that NHS Boards make use of these when developing or next reviewing their ONS formulary. This supports the direction of travel towards a single national formulary.
The ONS SLWG recommend that these be implemented across all health and care settings and multi-disciplinary teams, making use of local processes for guideline acceptance and compliance. Current ONS policies and guidelines should be reviewed and updated in line with these.