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in TOUCHIssue No. 72, February 2014

BAPEN ConferenceHighlights

www.bapen.org.uk

Featuring...

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Nutrition and hydration week is 17th – 21stMarch 2014. This is the third year of theevent and its purpose is to raise awarenessof all matters related to these areas, bothin hospital and the community. There areendless examples of awareness days andweeks, from the silly and frivolous (NationalFlip-Flop Day, National Talk Like a PirateDay, British Tomato Week) to the veryserious, such as breast cancer awareness,dementia awareness and all sorts ofdifferent cancer awareness events. Theintention of these events is to highlightthe topic in question and to do exactly whatthey say in the title – to raise awareness.Sometimes I wonder how useful they areand whether they actually achieve anything.However, there are good examples ofsuccessful campaigns, such as the massiveincrease in GP consultations following thebowel and bladder cancer events, and thesignificant profile and money generated byRace for Life. So, while there is a lot ofsilliness in some of the topics identified,there is also a lot serious business beingconducted. So what could we hope for fromNutrition and Hydration Week?

The readers of this article will alreadybe converted to the nutrition/hydrationcause but, as you will all appreciate, thereare so very many in healthcare that are not.Most of us have reason for campaigning forbetter services, resources, education andincreased appreciation of the relevance andimportance of good quality nutrition andhydration care for patients. In the currenthealthcare climate, such pleas often fall ondeaf ears. Perhaps Nutrition and HydrationWeek can be your platform to shout moreloudly to get people to listen, be it a

Trust Chief Executive and Board, a ClinicalCommissioning Group, a ward sister orconsultant, a colleague or a trainee. Weknow the worth of good quality care andwe endeavour to deliver this year-round,but I bet most of us get little recognition forthis and almost certainly little thanks forgoing over and above in trying to do thevery best for our patients, invariably withinadequate resource. So perhaps Nutritionand Hydration Week is your chance to focuson a particular message you want to convey– which will vary depending on professionalgroup and healthcare environment – and toget it the attention it deserves from thepeople it is intended for.

The Week is formally promoting the 10Key Characteristics for Good Nutritional Care,protected mealtimes and nutrition/hydrationadvocates in all areas, amongst others (seewww.nutritionandhydrationweek.org). Exampesof activities being planned are AfternoonTea for service users and visitors acrossthe country (in fact across the world)on Wednesday 19th March, cateringdemonstrations and food tasting, diningwith the Chief Executive, demonstration ofscreening, and many educational events.

At BAPEN we are currently putting planstogether for activity during this week andthere will be information on our websitefrom the end of February so don’t forget tokeep an eye out. May I suggest that youalso get together with your teams andconsider how you can take advantage of thisnational campaign to further your serviceand improve the quality of care that youdeliver. Opportunities in the current NHS aredifficult enough to come by, so grasp thisparticular nettle and go for it. Good luck.

Nutrition and Hydration Week 2014

A message from BAPEN’sPresident

In Touch No.72, February 2014 www.bapen.org.uk1

British Association for Parenteraland Enteral Nutrition

BAPEN is a Registered Charity No: 1023927

BAPEN is a Charitable Association that raisesawareness of malnutrition and works to advancethe nutritional care of patients and those at riskfrom malnutrition in the wider community.

BAPEN brings together the strengths of its CoreGroups to raise awareness and understandingof malnutrition in all settings and provideseducation, advice and resources to advance thenutritional care of patients and those at risk frommalnutrition in the wider community.

BAPEN’s Core Groups include:

• Dietitians – The Parenteral & Enteral Nutrition Group of the British Dietetic Association (PEN Group)

• Doctors & Scientists

• BAPEN Medical

• The British Society of Paediatric Gastroenterology, Hepatology and Nutrition(BSPGHAN)

• Nurses – National Nurses Nutrition Group (NNNG)

• Patients – Patients on Intravenous and Nasogastric Nutrition Therapy (PINNT)

• Pharmacists – British Pharmaceutical Nutrition Group (BPNG)

BAPEN works with all stakeholders, includingpatients and professionals, healthcarecommissioners and providers at local, regionaland national levels, and industry to deliver thenutritional agenda www.bapen.org.uk

In Touch – The Newsletter of the British Associationfor Parenteral and Enteral Nutrition

Cost per issue: £2.00 to non members Printed version: ISSN 1479-3806. On-line version: ISSN 1479-3814.

All contents and correspondence are published at thediscretion of the editors and do not necessarily reflect theopinions of BAPEN. The editors reserve the right to amendor reject all material received. No reproduction of materialpublished within the newsletter is permitted withoutwritten permission from the editors. BAPEN accepts noliability arising out of or in connection with the newsletter

Contents

Dr Tim Bowling, BAPEN President

Welcome

Welcome 1

Conference Highlights 2

What’s New 9

Committee/Core Groups 11

Communications Roundup 13

Diary Dates 14

BAPEN Contacts 15

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www.bapen.org.uk In Touch No.72, February 2014 2

BAPEN’s Programmes Committee Members Pete Turner (Chair) andJennie Mort (Sovereign Conference), along with the Symposia Chairs,report on this year’s BAPEN Conference.

Malnutrition MattersHighlights from the 2013 BAPEN Conference26th & 27th November 2013 • Harrogate International Centre, UK

The 2013 BAPEN Conference offered delegates an extensive range of clinical and scientific topicsrelevant to both acute and community settings. With ten symposia, two keynote lectures, oralcommunication sessions incorporating top scoring abstracts submitted, and the BAPEN 21st AnnualDinner celebrations, the Conference enabled delegates to hear of cutting-edge and innovativepractice, with an abundance of practical take home messages to facilitate improvements in thedelivery of nutritional care back in the workplace, in addition to ‘down-time’ to celebrate BAPEN’s21 years of ‘combating malnutrition’.

BAPEN Conferences are renowned for their ‘buzz’ and this year, again, proved to be no exception.Whilst it is not possible to describe all of the sessions in detail, this review provides insight intosome of the Conference highlights.

The BAPEN Conference 2013 began with our President, Dr Tim Bowling, celebrating the work ofBAPEN over 21 years and outlining some of the opportunities and challenges for the future.

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Opening Symposium – BAPEN’s Response to Francis andBerwick: What can you do as BAPEN members to make adifference? Reported by Dr Ailsa Brotherton, past Honorary Secretary, BAPEN

The opening session focused on the key issues highlighted in theFrancis Inquiry and the Berwick Report, with updates from eachhome country. BAPEN Secretary, Ailsa Brotherton chaired andopened this session with an overview of the Berwick Report,highlighting the eight areas where improvements are requiredand the three that would be the focus of the symposium:patient centred care; leadership and measurement. Ailsa shareda film developed by the Cleveland Clinic 'Empathy: The humanconnection to patient care' (do watch the video if you haven'tseen it) before handing over to Steve Brown, General Secretary ofPINNT, to present the patient perspective. Steve shared withdelegates his experiences of what it feels like to be 'told ofdecisions about his care' and how it feels when he is empoweredto be part of the decision-making process; it was an unbelievableinsight into patients understanding of policy and the design anddelivery of patient centred care.

Sarah-Jane Hughes, Clinical Lead Dietitian (NutritionSupport/Intestinal Failure), Belfast Health and Social Care Trust,presented the cutting edge work that has been ongoing inNorthern Ireland to engage with patients and capture the patientvoice. We then turned our focus to leadership and Dr AlastairMcKinlay, Consultant Gastroenterologist, NHS Grampian, gave asuperb (and highly entertaining) presentation of the nutritionleadership journey in Scotland.

The symposium then addressed one of the biggest challengeswe face in delivering improvements in nutritional care – how dowe measure our progress and success? Judyth Jenkins, Head ofNutrition & Dietetic Services, Cardiff and Vale University HealthBoard NHS Trust, outlined the current work on nutritionalmeasures and Kate Cheema, Specialist Information Analyst,the Quality Observatory, concluded with an overview of theopportunities to design a new nutrition measurement tool. Thiswork will be developed by BAPEN's Quality Group.

Symposium 1 – Nutrition in Hostile EnvironmentsReported by Dr Sheldon Cooper, Consultant Gastroenterologistand Nutrition Lead, The Dudley Group NHS Foundation Trust

The Education and Training Committee Symposium at the AnnualBAPEN Conference took a different angle this year to provide aninteresting look at ‘Nutrition in Hostile Environments’. We weregiven insight into not only the challenges of life but also thatof the effect of being in the Afghanistan theatre of war andnutritional status by Major Neil Hill. This was a rare opportunityfor delegates to understand nutritional challenges faced by ourarmed forces, and also how challenging research can be in such

environments. Dr Mike Stroud then took us to the extremes inboth North and South Poles, providing us with a different angleon how the environmental hostilities faced in the world canchallenge the human nutritional status. The nutritional contentof the presentation was enhanced by fantastic images of thepolar regions. The symposium was then brought back to ourmore usual situation with Andrea Cartwright, Consultant NurseSpecialist, discussing nutrition in the challenging environmentof the NHS ward, and the on-going actions to improve thenutritional care of our patients, and how these are beingdeveloped in England. Our final presentation by Joe Colby,Nutrition Nurse Specialist from Coventry, provided some mostpractical insights into distal feeding.

Symposium 2 – A Rocky Ride Down the Gut Reported by Joanna Sayer, Consultant Gastroenterologist,Doncaster & Basetlaw Hospitals NHS Foundation Trust

Our journey commenced with Dr Philip Bliss, from AintreeUniversity Hospital, and his vomiting patients with gastroparesis.He provided a succinct description of the condition, how toinvestigate and how to interprete gastric emptying studies,then an algorythm of treatment options, including dietarymanipulation and gastric pacemakers.

Dr Jon Shaffer from Salford took us through the shoals ofprotein-losing enteropathy and the nutritional deficiencies thatcan result from this condition. He also highlighted the widerange of medical conditions that can lead to protein-losingenteropathy, many of which are amenable to treatment.

Professor Alistair Forbes from University College Hospitalin London, then took the helm, leading us through themanifestations and causes of intestinal pseudo-obstruction,separating those associated with visceral neuropathy or visceralmyopathy from secondary causes, such as scleroderma.

The dysfunction associated with scleroderma was furtheremphasised by the final presentation by Dr Liz Harrison. Shedescribed the outcome for patients with systemic sclerosis onhome parenteral nutrition at the Intestinal Failure Unit inSalford, emphasising the low rate of parenteral nutrition-relatedcomplications and the high disease-related mortality for thosedependent on long-term parenteral nutrition (PN).

Satellite Symposium – Home Parenteral NutritionFramework for England – A practical guide Reported by Jackie Eastwood, Pharmacy Manager, St. Mark’sHospital, NWLH Trust

This was a last minute symposium put together by amultidisciplinary group who had worked on the specification andadjudication of the Home Parenteral Nutrition (HPN) Frameworkfor England. The symposium looked at and discussed how thetender was designed, how to work with some of the changes thathave occurred and how we work now the tender is in place. Thestandardisation of forms and processes were shown and discussedwith the benefits that will be fulfilled with achieving this.

At the end, a Q&A session allowed delegates to ask questionsand give comments on how and what they would like to seetendered next. All in all a productive session, many thanks to allthat joined us and took part.


BAPEN Conference Highlights

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Symposium 3 – Innovations to Improve QualityReported by Dr Mike Stroud and Dr Ailsa Brotherton

The Quality Improvement Symposium at the BAPEN Conferencewas based around various pieces of work at Salford Royal NHSFoundation Trust.

Kirstine Farrer, Consultant Dietitian, began with anoverview of the Nutrition QI Project in Orthopaedics and sharedwith delegates some of the approaches being implementedto improve nutritional care (such as extensive use of visualdata management boards, patient fridges in the ward bays)and presented the data re: weight loss during inpatient stays.BAPEN's Secretary, Dr Ailsa Brotherton, then provided anoverview of how the NHS QUEST Network (a network offourteen Foundation Trusts) is utilising clinical communitiesto improve nutritional care at all participating sites, includingthe presentation of the results from baseline audits whichclearly demonstrate 100% compliance using the standardsurvey approaches often used to evaluate nutritional care. Shealso described how the teams are focusing on improving theway we measure compliance to standards and guidelines.

Finally, Dr Emma Donaldson, a Quality ImprovementResearch Fellow and SpR in Gastroenterology, gave aninspirational presentation on how to lead quality improvementwork with a focus on social movements and creating afollowing. Emma is now going to lead a virtual qualityimprovement programme for BAPEN members and if youhaven't signed up but wish to, please contact the BAPENOffice: [email protected].

Symposium 4 – Innovations in the Science of ClinicalNutrition Reported by Professor Marinos Elia, Professor of ClinicalNutrition & Metabolism, Institute of Human Nutrition,University of Southampton

This well attended symposium considered the steps needed toimplement innovations in routine clinical practice. In her talk‘New Developments in Self-screening: Can anybody ‘MUST’?’,Paula McGurk from the Department of Dietetics, UniversityHospital Southampton NHS Foundation Trust, presented someof her interesting work showing that self-screening in hospitaloutpatients is feasible with an automated system thatmeasures weight and height simultaneously. This couldreduce the work load on healthcare professionals, and withappropriate discussion of the results, allow patients to becomemore involved in their management. The study (Nutrition 2013;29(4): 693-6) also found that screening could be undertakenaccurately and reproducibly in just over a minute. There wasconsiderable interest in the possibility that manufacturerscould produce a tailor made self-screening instrument forevaluation at multiple centres by 2014. The discussionsuggested that with favourable future developments, such aninstrument could find application in routine practice in thenear future.

The second talk by Professor Marinos Elia ‘NewDevelopments in Bioelectrical Impedance: Overrated orunderused?’ outlined the principles of bioelectrical impedance,

and the way they have been used to assess body compositionand predict important clinical outcome measures, such aslength of hospital stay and mortality. The development ofnew multi-frequency devices that can quickly measureimpedance on the whole body as well as body segments, notonly raises opportunities for assessing body compositionand fluid distribution in the body and in body segments, butalso prediction of clinical outcomes. However, the discussionindicated that further evidence of clinical validity andpracticality would be needed before such devices couldbecome incorporated into routine practice.

There were also a couple of original presentations in thissession. The first ‘Quality Assurance of Parental Nutrition –How safe is your PN?’ (ITHPharma, London) drew attention topotentially common unidentified errors in the compoundingof PN, and how a spectrophotometric method could identifythem. Although the results were very encouraging, the highrunning costs of the instrument meant that the new techniquemay not find application in routine practice in the immediatefuture. The second original presentation ‘The Role ofEndoplasmic Reticulum Stress in Intestinal Failure Associatedwith Liver Disease’ (Departments of Gastroenterology andPathology, Cambridge University Hospitals NHS FoundationTrust) summarised interesting subcellular work on themechanisms involved in intestinal failure associated liverdisease. The discussion suggested that there was still furtherwork to be done before such scientific developments couldfind their way into routine practice.

BAPEN Medical Trainees SymposiumReported by Liz Harrison and Chris Mountford

For their inaugural symposium, the newly formed BAPENMedical Trainees Group hosted a lively balloon debate. Thedebate, introduced by Dr Christopher Mountford, the Chair ofthe BAPEN Medical Trainee Committee, and chaired bytrainees Dr Robert Fearn and Dr Fiona Leitch, posed thequestion: ‘Who is most suited to lead a nutrition supportteam: a gastroenterologist, surgeon or clinical biochemist?’Consultant Gastroenterologist Dr Simon Gabe was first tostake his claim to lead the team, followed by ConsultantSurgeon Dr Ruth McKee and Clinical Biochemist Dr MichaelColley. An audience vote, after a dynamic but light-hearteddebate, resulted in the gastroenterologist being declaredthe best person to lead the nutrition support team.



The Pennington Lecture – Intestinal Failure –Concept, realisation and disseminationTuesday’s programme concluded with the prestigiousPennington Lecture delivered by Dr Jon Shaffer, EmeritusConsultant Gastroenterologist, Hope Hospital, Salford.His review of the history of intestinal failure in the UK was both fascinating and emotional. He included footage of the late Chris Pennington presenting in Salford, which was visibly moving for many members of the audience.

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During the course of the symposium the trainees highlightedthe successes of their first year as a group as well as plansfor the year ahead. This included the results of their nationaltrainee survey as well as their contribution to the developmentof e-learning resources soon to be made available to BAPENmembers.

Symposium 5 – A Spoonful of Sugar: Glucose control andnutritional support Reported by Dr Ruth McKee, Consultant Surgeon, GlasgowRoyal Infirmary

This symposium started with a tour de force through theevidence for tight glucose control in critical care from Greetvan den Berghe of Leuven. She is the world expert in thisarea and the clear demonstration of the outcomes of animpressive variety of studies was extremely helpful. As withmany interventions, the key seems to be in the ability to applythe intervention well – tight glucose control can produce anincrease in hypoglycaemic episodes if it is less well monitoredand this may explain some of the less dramatic resultsfrom other groups researching in this area. It may also bethat patients with a chronically high blood sugar toleratehypoglycaemia less well, though groups such as children,show surprisingly little evidence of harm from episodes ofhypoglycaemia in this group’s studies. On a practical level, itmay be better to aim for a slightly higher target range ofblood sugar than that proposed in the first studies, as thismay be more safely achievable in most units.

Dr Aled Roberts then brought a useful practicalpresentation about the management of diabetes in patientswho require artificial nutritional support – guidelines from theBritish Diabetic Association on this topic are probably not wellknown beyond the diabetic experts but could be very useful ininforming our protocols for management of these patients.

Symposium 7 – Liquidised Food and Feeding Tubes Reported by Anne Holdoway, Chair of the Parenteral andEnteral Nutrition Group (PENG) of the BDA

After many years of almost universal use of commerciallyavailable feeds, there are a growing number of patients and

carers who wish to administer liquidised food through enteralfeeding tubes. Healthcare professionals have cited significantrisks associated with this practice, including infection,nutritional deficiencies and tube blockage. Despite this,patients and, in particular, carers of children on tube feedingare continuing to choose to prepare and administer ‘home-made’ liquidised feeds for tube feeding providing anecdotalyet convincing arguments of social and medical benefits.With the drive to put the patient at the centre of our decision-making, healthcare professionals are being asked to supportindividuals to utilise a method of feeding that has beenperceived as going against medical reasoning.

In light of the degree of debate amongst healthcareprofessionals, and associated uncertainty on the suitabilityand safety of this practice, PENG led a timely, multidisciplinarysession to explore the issues this emerging practice presents.The session was chaired by Anne Holdoway, Chair PENG.

Professor Kevin Whelan, Professor of Dietetics, King’sCollege London, opened the session with an eloquentoverview of the history regarding the use of liquidisedfood, current knowledge and trends. Drawing on publishedliterature, Kevin provided insightful comparisons of proposedbenefits and risks of liquidised food versus enteral formula.By highlighting the deficits in our knowledge Kevin provokedideas on how we might begin to address the gaps in ourthinking and populating the evidence base.

Dr Susie Lapwood, Head of Research, Education andProfessional Development and Senior Specialty Doctor,Helen and Douglas House Hospices for children and youngadults, Oxford, provided a seamless transition building onKevin’s presentation and highlighting the benefits cited bycarers when using liquidised real food diet for childrenwith life-limiting neurological conditions. With extensiveexperience in the palliative care setting, Susie shared herinsights into working with the children and carers who hadsuccessfully employed the use of liquidised food for tubefeeding.

To address the practical issues faced by healthcareprofessionals when asked to support patients and carerschoosing liquidised foods for tube feeding, Ailsa Kennedy,Home Enteral Feeding Dietitian, Liverpool Community Health,rounded up with a pragmatic presentation outlining thepotential implications of this method of feeding in practiceand the guidelines under development. Ailsa highlightedthe progress to date in developing resources to facilitate

BAPEN’s 21st Birthday Celebrations Held at the Majestic Hotel, Harrogate, this prestigious Victorian landmark was the ideal venue to host this year’s BAPEN Annual Dinner,celebrating 21 years! The after-dinnerspeech by Professor David Silk, one ofthe original founders of BAPEN, concluded with the BAPEN Oscars presented by Pete Turner for excellence ina number of categories rating from best sporting accoladeand best publication to best dressed male and female. Theevening ended with the usual suspects on the dance floorgrooving away to the sounds of the DJ or for those a littleless energetic a ‘tipple’ on the casino tables, whilst themulti-disciplinary teams visited the photo booth!

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decision-making, anticipate the challenges and reduce risksthat could potentially arise amongst patients/carers choosingthis method of feeding. Ailsa outlined the main components ofthe ‘risk assessment’ tool developed in collaboration withother specialist groups, including the Paediatric Group andDISC group of the BDA, representatives from the NNNG, PINNT,industry and practitioners with experience in caring for thoseusing liquidised feeds.

Presenters: Kevin Whelan, Ailsa Kennedy, Susie Lapwoodwere joined by Kelly Larmour (BSPGHAN), Barbara Dovaston(NNNG) and Carolyn Wheatley (Chair PINNT). Together the‘Liquidiser experts’ fielded questions from the audience anda lively debate pursued.

Overall, this session highlighted the central role ofpatients and carers in decision-making. The presentations anddiscussion provided delegates with a balance of knowledgepotentially required when encountering the issue in practice.Through the experiences relayed from both a panel ofexperts, as well as a full capacity and engaging audience,this symposium challenged and debated our perceptionsand beliefs regarding the use of liquidised enteral feed andevoked the need for us to investigate and undertake researchto provide evidence-based practical recommendationsand guidance that are now required. Whilst debate amongsthealthcare professionals, consultation with patients and carersand the development of standards and guidelines remains‘work in progress’, this session provided the opportunity forall involved to explore the issues and air their views. It wassatisfying to know that the content of the session has beencaptured on film and will become a BAPEN eLearning moduleavailable to BAPEN Members and the dietetic profession in thefuture. BDA members, including representatives from PENG,DISC and the Paediatric Group, are currently finalising the ‘riskassessment tool’ for use by dietitians and other healthcareprofessionals with expertise in clinical nutrition.

Symposium 9 – Nutrition in the Neurologically Impaired Reported by Dr Susan Hill, Consultant Paediatric Gastroenterologist,Great Ormond Street Hospital for Children, London

As a result of concerns expressed by the arrival in adultservices of artificially fed teenagers with severe neurologicaldisabilities, BSPGHAN arranged their first BAPEN symposiumon the challenging subject of ‘Feeding the NeurologicallyDisabled’. A good general introduction on what approach touse and how to feed the neuro-disabled child was given by

Clare Skeets, Community Paediatric Dietitian Dorset HealthCareUniversity Foundation Trust. A comprehensive in-depth reviewfollowed of possible intestinal motility investigations andwhen to consider using them by Dr Keith Lindley, ConsultantPaediatric Gastroenterologist, Great Ormond Street, London.Karen Horridge, Disability Paediatrician, Sunderland RoyalHospital and Chair of the British Academy of ChildhoodDisability, rounded off the symposium by discussing socialand ethical considerations and advice on how best totransition children to adult services. The symposium waswell received and will hopefully contribute to smoothing thepath for this needy group of young adults as they take thestep from paediatric to adult care.

Symposium 10 – Have I Got Fluid News for You! Reported by Pete Turner, Chair of BAPEN ProgrammesCommittee

The closing symposium ‘Have I Got Fluid News for You!’ startedwith an update on the new NICE guidelines on IntravenousFluid Therapy in Adults. The very real dangers of poor i.v fluidprescription were outlined by the chair of the guidelinedevelopment group Dr Mike Stroud. These include sodiumand fluid overload, severe oedema, delayed recovery andhyperchloraemia, leading to acidosis and constriction ofrenal arteries. The guideline uses three easy to followalgorithms to assess individual patients requirements andavoid these problems. They include resuscitation, maintenanceand replacement.

The panel game of ‘Have I Got Fluid News for You’ had thefollowing take home messages:• There is little evidence to support the hypothesis that infusing water into jejunal feeding tubes is a risk for bowel necrosis.

• There is a small risk of bowel necrosis with jejunal feeding tubes. It is mainly a risk on ICU in patients who are poorly resuscitated, haemodynamically unstable, with ileus or distension.

• It is very difficult to follow the NICE GC32 refeeding guidelines for electrolyte replacement without giving excess fluid, sodium or chloride.

• When replacing potassium or phosphate intravenously in refeeding syndrome it is best to use 5% dextrose and take the energy into consideration.

• There is no scientific evidence that marshmallows reduce stoma output.

BAPEN Keynote Lecture New for 2013, BAPEN’s Keynote Lecture ‘Use of Glutaminein the Critically Ill’ was delivered by internationallyrenowned Professor Jan Wernerman, Professor ofAnesthesia and Intensive Care Medicine from theKarolinska Institute in Sweden. Professor Wernerman, awell published expert on the protein and musclemetabolism, provided an independent update on aminoacids, such as glutamine, following the recently publishedand highly controversial REDOXs Trial.

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In Touch No.72, February 20147

BAPEN Nutricia Award 2013 ‘Call to Action’ This year’s Award was presented by Professor Marinos Elia, Chair ofMalnutrition Action Group, BAPEN, and Kate Ashman, Medical AffairsAdvisor, Nutricia, to Dr Laura Wyness, Dr Elaine Bannerman and JacklynJones, Queen Margaret University, Edinburgh, for: An exploratory study todetermine the prevalence of different nutritional and functional statesoccurring in older adults living in a community setting and to explorescreening measurements to complement ‘MUST’.

Awards and Recognitions

BAPEN 2013 Recognition Awards Presented by Dr Tim Bowling, President, BAPEN

BAPEN introduced the first STUDENT AWARD 2013, which was awarded toCharlotte Johnston and student nurse colleagues from University of Lincoln,in recognition of their contribution to the ‘Stop the Pressure’ campaign.

BAPEN Roll of HonourPresented by Dr Tim Bowling, President, BAPEN

This year’s Roll of Honour were awarded to Dr Ruth McKee for her workfor BAPEN over many years, including BAPEN Medical, and to Faye Eaglefrom Complete Media & Marketing Ltd. as Publisher and for her editorialcontribution to In Touch.

Honorary Life Membership of the AssociationHonorary Life Membership of the Association wasbestowed on Ken Cottam.

Powell-Tuck PrizeThe BAPEN Medical Award, the Powell-Tuck Prize for the best abstract submitted by adoctor in training was presented to Dr Lisa Sharkey, Cambridge University HospitalsNHS Foundation Trust. Runner-up prizes were also awarded to: Dr Chris Mountford,submitted by the BAPEN Trainee Committee and BAPEN Medical Committee; andDr Bobbie Drinkwater, Dudley Group NHS Foundation Trust.

BAPEN’s Best Oral Communication and Best Poster AwardsThe Oral Communication Award was presented to Mia Small for‘NG Checks: validity and reliability of measurements by pH indicators’.

The Poster Award was presented to lead author Dr Chris Mountfordfor the poster entitled: ‘The Northern Nutrition Network regionalaudit of nasogastric tube insertions for feeding in adults’

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ExhibitionThe exhibition, housing over 30 healthcare companies with an interest in nutrition, along with BAPEN and the Core Groups:BPNG, NNNG, PENG and PINNT became the ‘hub’ of this year’s networking, as delegates participated in the Exhibition PassportGame – a first for BAPEN – and three lucky winners took home Amazon Gift Vouchers for visiting every exhibitor and collectinga world flag to stick in the passport. Congratulations to Beth Williamson, University of Lincoln; Fae Postles, Hull Royal Infirmary;and Claire Gill, Basingstoke Hampshire Hospitals. The exhibition area also accommodated 66 posters of which some werepresented as oral communications over both lunch periods.

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What’s New


The American Society for Parenteral and Enteral Nutrition(A.S.P.E.N.) selected Gil for its 2014 DistinguishedInternational Nutrition Support Service Award. Founded in1976, A.S.P.E.N has more than 5,500 members, making itthe leading worldwide interdisciplinary organisation fordietitians, nurses, pharmacists, physicians, scientists andother health professionals, involved in every facet of clinicalnutrition, including parenteral and enteral nutrition (PN andEN) therapies.

The award was formally presented to Gil by the A.S.P.E.NPresident, in Savannah Georgia USA at Clinical Nutrition Weekin January 2014.

Gil Hardy is Professor of Pharmaceutical Nutrition at TheUniversity of Auckland and Professor of Clinical Nutrition at

Massey University in New Zealand. He is a founder and trusteeof The IPaNEMA Charitable Trust and current Treasurer ofParenteral Nutition Down Under (PN-DU), the Australasianpatient support group for those receiving PN at home (HPN)for intestinal failure. He has published over 200 research andreview papers in the field of clinical nutrition and served onthe Research, Publications and Membership Committees ofA.S.P.E.N.

A.S.P.E.N is dedicated to improving patient care byadvancing the science and practice of clinical nutritionand metabolism. The society presents annual awards tooutstanding members who have contributed to clinicalnutrition by showcasing exceptional expertise in clinicalpractice, research, education and advocacy.

The ‘Managing Adult Malnutrition in the Community’ AwardsScheme’ offers professionals the opportunity to be awarded£500 towards attendance at an educational event orconference of their choice. During 2014 up to six £500 awardswill be given to projects which are chosen by the panel asbest practice examples of implementing the ‘Managing AdultMalnutrition in the Community Pathway’.

To share a best practice example simply download andcomplete the short application form (http://malnutritionpathway.co.uk/best-practice-awards) and email the completedform to [email protected]. All applications receivedwill be assessed by a panel of experts in the area ofmalnutrition and those deemed to be suitable for inclusion onthe www.malnutritionpathway.co.uk website will receive acertificate and the £500 award.

The ‘Medicines Services City Healthcare PartnershipCIC’ in Hull, has kindly shared a summary of a project*(http://malnutritionpathway.co.uk/files/uploads/Hull_summary_for_Malnutrition_Pathway_October_2013.pdf) they haverecently carried out to assess the effectiveness of a nurse ledpolicy for the management of malnutrition in care homes byimplementing standard screening and management plansbased on NICE Quality Standard 24 and the ‘Managing AdultMalnutrition in the Community Pathway’.1 The project showedthat screening and appropriate management of malnutritionlinked to risk, for all care home residents was effective. Overall,they found that the costs to screen and manage malnutritionwere more than offset by a reduction in healthcare costs,

including reduced admissions to secondary care, with overallbenefit to the residents.

“We hope the work we have carried out will encourageothers to implement screening and appropriate managementof malnutrition in order to improve care and outcomes,” saysRichard Maddison, Medicines Development Manager, CityHealth Care Partnership CIC, Medicines Service in Hull. “Wewould like to see further wide scale evaluation of themanagement of malnutrition.”

“Malnutrition is still a major financial burden, costingan estimated £13 billion per year in the UK,2 and we knowmanaging this can have positive benefits to both theindividual patient and wider healthcare system,” says AnneHoldoway, Specialist Dietitian, Chair of the Parenteral andEnteral Nutrition Group (PENG) of the BDA and Chair of theConsensus Panel which developed the guide.“We hope thatencouraging professionals to share their experience of the useof the Managing Adult Malnutrition in the Community pathwaywill encourage others to implement best practice projectswhich will ensure that vulnerable individuals, who are at riskof malnutrition, are screened early and receive appropriatenutritional care in the community. The work carried out in Hullis an excellent example of how this is happening.”*NB: ‘this is a best practice example and not an award winner’References: 1. Baggaley E, et al (2013). Effectiveness of implementing a nurse ledpolicy for the management of malnutrition. Clinical Nutrition (Supplements); 32(Supp 1): S231 2. Elia M and Stratton RJ. Calculating the cost of disease-relatedmalnutrition in the UK in 2007 (public expenditure only) in: Combating Malnutrition:Recommendations for Action. Report from the advisory group on malnutrition, ledby BAPEN. 2009.

Professor Gil Hardy Receives Prestigious Award

Managing Adult Malnutrition in the CommunityLaunches Award Scheme to Encourage Sharing ofBest Practice

Professor Gil Hardy PhD FRSC of Auckland, New Zealand, has received a prestigiousinternational award in recognition for his outstanding services to clinical nutritiontherapy in USA, Latin America, Europe and Australasia.

Professionals involved in the identification and management of adult malnutrition in the communityare being encouraged to share best practice via the www.malnutritionpathway.co.uk website.

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What’s New

"Because low vitamin D levels are common and can be easilyand safely increased by oral supplementation, these findingsmay contribute to better outcomes for many MS patients," saidlead author Alberto Ascherio, Professor of Epidemiology andnutrition at HSPH.

The study appeared online January 20th, 2014 in JAMANeurology.

MS is a central nervous system disease that causes problemswith muscle control and strength, vision, balance, feeling, andthinking. It's estimated by the World Health Organization thatroughly 2.5 million people in the world have MS.

Previous research indicated a connection between lowlevels of vitamin D and risk of developing MS or having MSsymptoms worsen, but those studies included patients withlongstanding MS whose vitamin D levels could partly be aconsequence, not a predictor, of disease severity. The new studylooked at vitamin D levels among patients at the time of theirfirst symptoms of the disease.

Researchers analysed data from 465 MS patients from 18European countries, Israel, and Canada who enrolled in 2002and 2003 in the BENEFIT (Betaseron in Newly Emerging MultipleSclerosis for Initial Treatment) trial, which was aimed atcomparing the effectiveness of early versus late interferonbeta-1b in treating the disease. The scientists looked at how thepatients' vitamin D levels, which were measured at the onset of

their symptoms and at regular intervals over a 24-month period,correlated with their disease symptoms and progression over aperiod of five years.

They found that early-stage MS patients who had adequatelevels of vitamin D had a 57 per cent lower rate of new brainlesions, a 57 per cent lower relapse rate, and a 25 per cent loweryearly increase in lesion volume than those with lower levels ofvitamin D. Loss in brain volume, which is an important predictorof disability, was also lower among patients with adequatevitamin D levels. The results suggest that vitamin D has a strongprotective effect on the disease process underlying MS, andunderscore the importance of correcting vitamin D insufficiency,which is widespread in Europe and the US, the researchers said.

"The benefits of vitamin D appeared to be additive to thoseof interferon beta-1b, a drug that is very effective in reducing -MS activity. The findings of our study indicate that identifyingand correcting vitamin D insufficiency should become part ofthe standard of care for newly diagnosed MS patients," saidAscherio.HSPH's Kassandra Munger, research associate in the Department of Nutrition, was aco-author on the study. Funding for the study came from the National Institute ofNeurological Diseases and Stroke and the National Multiple Sclerosis Society. "Vitamin D as an early predictor of multiple sclerosis activity and progression,"Alberto Ascherio, Kassandra L. Munger, Rick White, Karl Köchert, Kelly Claire Simon,Chris H. Polman, Mark S. Freedman, Hans-Peter Hartung, David H. Miller, XavierMontalbán, Gilles Edan, Frederik Barkhof, Dirk Pleimes, Ernst-Wilhelm Radü, RupertSandbrink, Ludwig Kappos, and Christoph Pohl, online January 20, 2014.

Boosting Vitamin D could Slow Progression and ReduceSeverity of Multiple Sclerosis

The 'MUST' App!BAPEN’s popular and validated screeningtool for identifying malnutrition – ‘MUST’ –converted into an iPhone App that can beused across all health and care settings byfront line staff.For further information or to downloadBAPEN’s ‘MUST’ App visit:www.bapen.org.uk.

Or scan the QR code with your iPhone cameraQR reader to download the 'MUST' App.

For patients in the early stages of multiple sclerosis (MS), low levels of vitamin D were found to stronglypredict disease severity and hasten its progression, according to a new study led by Harvard School ofPublic Health (HSPH) investigators in collaboration with Bayer HealthCare. The findings suggest thatpatients in the early stages of MS could stave off disease symptoms by increasing their vitamin D intake.

Androidversioncoming soon

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PENGKate Hall, Communications Officer [email protected], www.peng.org.uk

For those of you who were unable to come along tothe BAPEN Conference session on blenderised feedsthat was hosted and organised by PENG, the BDA haslaunched its public facing document and initialguidance on the topic please see – www.bda.uk.com/policies/LiquidisedFoodPolicyStatement.pdf

The topic remains controversial and this hasbeen further demonstrated through debate at recentconferences. PENG hope to enable you, as members,should you encounter this request in practice withthe knowledge and skills to support your patients tomake an informed choice, fully aware of the potentialrisks to health.

The risk assessment template, which AilsaKennedy presented on at the BAPEN Conference, maybe incorporated into local risk assessment tools toensure patients can make an informed choiceregarding the implications of this mode of feeding.The tool may also be used to highlight potential riskof administering via the enteral route products notrecommended as enteral formulae.

In November, the new sections of the PENGPocket Guide to Clinical Nutrition were officiallylaunched covering bariatrics, pancreatic disease andCOPD – these are available free to all PENG members

2012/13 and 2013/14, please visit www.peng.org.uk formore information on these sections.

You may notice a subtle change in PENG over thenext few months and a new look – have you spotted ityet? We asked members to vote in December on thenew logo and the result was a resounding yes forthe new refreshed logo which really distinguishesPENG, so that as PENG we really stand out – thiswill be followed through onto all of the PENGcommunications over the coming months.

February marks our first Committee meeting as anew bigger committee with the addition of clinicalleads for clinical research, home enteral feeding andparenteral nutrition and we look forward to sharingour three-year strategy for PENG, with support frommembers, in a future edition of In Touch.

With March fast approaching, PENG has signedup to support Nutrition & Hydration Week and isencouraging members to get involved as well.

If you are a PENG member or would like to becomea PENG member – the new membership year starts1st March 2014, so please do remember to renewand/join by visiting the PENG website for moreinformation about what being a member of PENGmeans and how to become one: www.peng.org.uk oremail: [email protected]

It was a busy end to the year for 2013 with the Autumn edition of e-PENlines going out in mid-Decemberallowing 'hot off the press' feedback following the BAPEN Conference, with contributions from the PENGAward winners of 2013: Rhys White, Toril Ofstad, Lucy Barthowiak and Ann Ashworth.

It is with a little surprise that I am writing another In Touchupdate from BAPEN Education and Training Committee. I washanding on the chairmanship but unforseen circumstanceshave meant my continued stewardship in the interim. This willprovide some continuity as the faces on the Committee areshuffling around this year, and we look to having a new Chairby the middle of the year. For those who are moving on, I ammost grateful for their help over the years. We are also due tobe joined by representatives from the Royal College of Speechand Language Therapists and BSPGHAN this year, furtherincreasing the breadth of expertise on the Committee.

In the meanwhile, I am pleased to report we had a good

symposium at the Annual Conference (please see AnnualConference report) and look forward to continuing toproviding future symposia. We are due to have the next waveof Decision Trees launched this month (February), as the peer-review process is complete, and the next set about to enterpeer review. The production process is now a fully chargedconveyor belt, and we should see regular releases of newDecision Trees. The majority of the new Trees will requiremember only access to the website, so make sure you haverenewed and obtained your sign-in details. If you feel thereare any subjects that are within your expertise and you wishto contribute, please make contact.

BAPEN Education andTraining CommitteeDr Sheldon Cooper, Chair of BAPEN Education and Training Committee

Committee/Core Group Updates


Rhys WhitePENG Award Winner

Toril OfstadPENG Award Winner

Lucy BarthowiakPENG Award Winner

Ann AshworthPENG Award Winner

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www.bapen.org.uk 12

Committee/Core Group Updates

In Touch No.71, November 2013

There have been a number of changes to the NNNG Committee;Neil Wilson has completed his term of office on the Committeeand, although this will free up some much needed time topursue his academic goals of a PhD, Neil will be continuing hiswork on the website and conference organising. Carolyn Besthas moved into his position and Angie Davidson-Moore,who is a Lead Nurse within industry, has filled the role ofCommunications Officer. Bridget Penny has also joined theCommittee; Bridget currently works as a Care Specialist and hasa national remit for nutrition in older people living in carehomes. Bridget brings a new focus for oral nutrition, making thecommittee a more rounded body and reacting in response tothe changing membership.

The group is busy with a number of high profile workstreams, which include being part of a UK stakeholders meetingworking on the ISO standards for connectors. This work isaddressing the global public health concern of medical devicemisconnection and the UK’s delegation to this work is vital toensure international harmonisation of these standards as theypublish.

In November 2013, the Department of Health announced theformation of a brand new Hospital Food Standards Panel to be

chaired by Dame Dianne Jeffrey. It was the idea of Dr DanPoulter, Under Secretary for Health. The aim of the Food Panelis to look at the whole patient experience of hospital foodfrom where it is sourced, what is produced and offered andwhat care is given in ensuring that patient’s nutritional needsare met. It has been clearly recognised that nurses play a keyrole in the nutritional care of patients and the NNNG aredelighted that they have been asked to represent nursing onthis important panel and the aim is for guidance to be producedby summer 2014. Liz Evans, Chair of the NNNG, will be attendingall future meetings.

The NNNG is promoting Nutrition & Hydration Week(March 17th – 23rd 2014) by sharing examples of goodpractice, encouraging participation in activities and seekingopportunities to support local organisations. In recognition ofoutstanding individual contribution, Liz Evans has beenpersonally invited to be a Nutrition & Hydration Week 2014Ambassador.

The NNNG Conference for 2014 is to be held on 7th & 8thJuly at the lovely Chesford Grange, Kenilworth. A well preparedand diverse programme will ensure that this Conference will beeven better than the last! Book early to secure the best rates.

NNNGAngie Davidson-Moore, Communications Officer NNNG www.nnng.org.uk

I would like to begin this BAPEN Medical report by thankingDr Ruth McKee for her leadership of BAPEN Medical over the lastfew years which have seen this Core Group grow in strength,including the inception of BAPEN Medical Trainee Committee. Iwould also like to take this opportunity to wish her all the bestin taking on the role of BAPEN Secretary. I now have the honourof chairing BAPEN Medical and, even though I may be only a fewmonths into post and yet to have our first committee meeting,we are already developing new avenues, beginning with ourfirst symposium at the British Society of Gastroenterologymeeting in 2014, joining forces with the Small Bowel and

Nutrition section of the BSG, being most ably co-ordinated byDr Penny Neild. The programme is already firming up to lookvery good indeed.

The second initiative which BAPEN Medical hope to explorein 2014 is that of enhancing the research opportunities that canbe nurtured within the field of nutrition. This is an area whichdeserves exploration and the enthusiasm is not lacking! Finally,we aim to develop on recent plans from 2013 with investmentinto developing the ESPEN LLL programme further in the UK.We aim to increase the number of those able to deliver themodules by running the T-LLL module.

BAPEN Medical Dr Sheldon Cooper, Chair of BAPEN Medicalwww.bapen.org.uk


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Communications Roundup


At the Conference, as part of the 21st Birthday celebrations, wealso launched our publication ’21 Ways to Make a Difference’.The publication set out 21 shortlisted ideas and initiativesthat have been introduced by BAPEN members over the past 21years. It was designed to showcase the real differences BAPENmembers have made through initiatives which have madepositive changes to patients’ lives. The publication has beenreally well received because it really does demonstrate ‘at aglance’ the fantastic work that has, and continues to be, doneby BAPEN and our members. The challenge we faced in thecommunications department was narrowing it down to just 21.If you haven’t seen a copy you can view a PDF on the BAPENwebsite: www.bapen.org.uk/images/pdfs/bapen-21-ways-to-make-a-difference.pdf

Hopefully you will have been receiving our new BAPENNews bulletin which launched on 6th November and goesout to members by email to alert them to any newannouncements or news items posted on the website. Weconducted some research and discovered that membersweren’t visiting the website very often. However, there areso many good resources and useful information there thatwe felt members could be missing out. The BAPEN News

bulletin is a reminder signposting the new initiatives andnews that members should find helpful. Understanding howbusy everyone’s inboxes get, the bulletin goes out on aWednesday – but only when we have something new to say.

Nutrition and Hydration Week (17th -24th March) is our nextmajor focus and we are looking at a number of ways to helpmaximise the noise generated during this awareness week.Keep an eye out on the website for more information.

Journalist enquiries continue to grow and BAPEN is beingregularly requested to provide comment and insight on avariety of issues relating to nutrition and hydration. We nowhave a growing number awaiting the four year NSW analysisdata that we hope to launch at the end of March.

Please do regularly check the BAPEN website and forthose who engage in social media don’t forget to follow us onTwitter and Facebook so you are aware of all the latest news.

We will continue to keep you up-to-date with allcommunications activities and in the meantime, if anyonehas any news or information they would like to share withtheir fellow members, please contact Helen Lawn or CharlotteMesser in the BAPEN Press Office on 01892 525141 – we wouldlove to hear from you.

The BAPEN Conference at the end of November was a really positive way to end the year. A major initiativeundertaken at Conference was to encourage as many BAPEN members as possible to sign up to workwith us regionally in 2014 to make a real difference. We developed a map of the UK which outlined thecurrent healthcare regions and this was prominently displayed on the BAPEN stand. Throughout theConference delegates were encouraged to sign up by filling in their details and pinning them on theirown particular region on the map. We had 112 people sign up to get more involved, which is a tremendousresult. Following on from this, we now have a meeting scheduled for the 27th February to which anyoneinterested in getting more involved in BAPEN activity regionally is attending. If you didn’t put your nameon the map but are still interested in working with us regionally, however big or small a way, please letJennie in the BAPEN office know as we would love to see you there.

BAPEN CommunicationsRoundupHelen Lawn & Charlotte Messer Helen Lawn & Associates

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Diary DatesMarchDiabetes UK Professional ConferenceDate: 5th – 7th March 2014Venue: ACC, Liverpool, UKWebsite: www.diabetes.org.uk/Diabetes-UK-Professional-Conference

International Congress on Obesity Date: 17th – 20th March 2014Venue: Kuala Lumpa, MalaysiaWebsite: www.iaso.org

BAPEN Scotland Meeting – Patient Safetyin Nutrition Support Date: 20th March 2014 Venue: Stirling Management Centre, ScotlandEmail: [email protected]

May7th International Immunonutrition Workshop –Eating for PreventingDate: 1st – 3rd May 2014Venue: Hotel Riva Marina, Carovigno (BR), ItalyWebsite: www.immunonutritionworkshop.com

The 7th Pan-London Regional MeetingA day of seminars, debate and networking opportunitiesDate: 9th May 2014Venue: UCLH Education Centre, LondonTopics include: Gastrostomy insertion in neurologicaldisease: Who, How, Where and When; Nutrition research inLondon: Regional BAPEN Update and AGM; Keynote debate:The use of Parenteral Nutrition in End of Life CareEmail: [email protected] and refreshments included, CPD Approval Pending

June47th Annual Meeting of ESPGHANDate: 9th – 12th June 2014Venue: Jerusalem International Convention Centre, Jerusalem, IsraelEmail: [email protected] Website: www.espghan.org

International Scientific Conference on Probioticsand Prebiotics – IPC2014Date: 24th – 26th June 2014Venue: Budapest, HungaryWebsite: www.probiotic-conference.net

BIFA Symposium at Tripartite Meeting:Intestinal Failure – Current and Future Management Date: 30th June 2014Venue: International Convention Centre Birmingham, UKTopics include: Enterocutaneous fistula management and abdominalwall reconstruction (Robert G Martindale, Oregon, USA); Mesentericischaemia (Jeremy Nightingale, UK), New therapies for patients witha short bowel (Palle Jeppesen, Denmark), Complications of ParenteralNutrition (Michael Stroud, UK), Small bowel transplantation (SteveMiddleton and Surgeon, UK), Surgery for the Short Bowel (GordonCarlson, UK), Prevention of Post-operative Ileus (Dilip Lobo, UK).Website: www.tripartite2014.org

July

HEART UK Summer ConferenceHot Topics in Hyperlipidaemia – The impact ofpersonalised medicineDate: 2nd – 4th July 2014 Venue: Warwick Arts Centre, University of Warwick, UKWebsite: http://heartuk.org.uk/news-and-events/meetings-conferences/heart_uk_annual_conference

NNNG ConferenceDate: 7th & 8th July 2014Venue: Chesford Grange, KenilworthEmail: www.nnng.org.uk

September

ESPEN Congress Date: 6th – 9th September 2014Venue: Geneva, SwitzerlandWebsite: www.espen.org/congress

OctoberGastro 2014 Date: 6th – 9th October 2014Venue: Buenos Aires, ArgentinaWebsite: www.gastro2014.com

BAPEN Annual Conference Date: 14th & 15th October 2014Venue: Harrogate, UKEmail: www.bapen.org.uk

UEG Week 2014 Date: 18th – 22nd October 2014Venue: ACV Vienna, AustriaWebsite: www.ueg.eu/week

November

Food Matters Live A new annual event exploring one of the most importantchallenges of our time: the relationship between food, healthand nutrition.Date: 18th – 20th November 2014Venue: ExCeL, London, UKEmail: www.foodmattersglobal.com

2014 Courses

PENG Clinical Update Course Date: Starts in March, when pre-course workis sent out, and ends in September when thepost-course assessment is submitted. Venue: Queen Margaret University, EdinburghEmail: [email protected] Website: www.qmu.ac.uk/dn/default.htm

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BAPEN Contacts

Executive CommitteePresidentDr Tim BowlingTel: 0115 919 4427 Fax: 0115 875 4540Email: [email protected]

President ElectDr Mike StroudTel: 0238 079 6317Email: [email protected]

Honorary TreasurerDr Nicola SimmondsTel: 01582 497 519Fax: 01582 565 439Email: [email protected]

Honorary SecretaryDr Ruth McKeeTel: 0141 2114 286 (secretary)Email: [email protected]

Honorary Officer – Membership Andrea CartwrightTel: 01268 593 112Fax: 01268 593 317Email: [email protected]

Honorary Officer – Data & MeasurementDr Trevor SmithTel: 02381 204 153Fax: 02381 205 203Email: [email protected]

Honorary Officer – CommunicationsWendy-Ling RelphTel: 07795 450 160Email: [email protected]

Council MembersChair: BAPEN Medical and Education& Training CommitteeDr Sheldon CooperTel: 01384 244 074 (Secretary)Fax: 01384 244 262Email: [email protected]

Liaison Officer: BSPGHANDr Susan HillTel: 0207 405 9200 Ext 0114Fax: 0207 813 8258Email: [email protected]

Chair: BPNGJackie EastwoodTel: 0208 235 4094Fax: 0208 235 4101Email: [email protected]

Chair: FacultyChristine RussellTel: 01327 830 012Fax: 01327 831 055Email: [email protected]

Chair: MAGProfessor Marinos EliaTel: 0238 079 4277Fax: 0238 079 4277Email: [email protected]

Chair: NNNGLiz EvansTel: 01296 316 645 Email: [email protected]

Chair: PENGAnne HoldowayTel: 01225 722 851Email: [email protected]

Chair: PINNTCarolyn WheatleyTel: 01202 481 625Email: [email protected]

Chair: Programmes CommitteePete TurnerTel: 0151 706 2121Fax: 0151 706 5840Email: [email protected]

Regional RepresentativesNorth East & Chair:Barbara Davidson - Senior Dietitian Tel: 0191 244 8358 Email: [email protected]

ScotlandEmma Tease – Specialist DietitianTel: 01463 704 473Mob: 07795 953 758Email: [email protected]

Northern Ireland Sarah-Jane Hughes - Chief Dietitian/Clinical Team Lead Tel: 02890 634 386Email: [email protected]

WalesDr Barney Hawthorne - ConsultantGastroenterologist Email: [email protected]

North West Dr Simon Lal - ConsultantTel: 0151 529 8387Email: [email protected]

Trent Melanie Baker - Senior SpecialistDietitianTel: 0116 258 6988 or bleep 4600 Email: [email protected]

West MidlandsVacant

Thames ValleyMarion O’Connor - Nutrition SupportDietitian Tel: 01865 221 702/3Fax: 01865 741 408 Email: marion.o’[email protected]

East AngliaDr Crawford Jamieson - ConsultantGastroenterologist/NSTEmail: [email protected]

North ThamesDr Andrew Rochford - ConsultantGastroenterologistTel: 07946 411 973Email: [email protected]

South ThamesMr Rick Wilson - Director Dietetics& Nutrition Tel: 020 3299 9000 x2811 Email: [email protected]

South WestDr Tariq Ahmed - ConsultantGastroenterologist Tel: 01392 406 217 Email: [email protected]

SouthPeter Austin - Senior Pharmacist Tel: 02380 796 090Fax: 02380 794 344 Email: [email protected]

South East Dr Paul Kitchen - ConsultantGastroenterologist Tel: 01634 833 838Fax: 01634 833 838 Email: [email protected]

Industry Representative Carole Glencorse - Medical DirectorTel: 01628 644 163Mob: 07818 427 905Fax: 01628 644 510Email: [email protected]

in TOUCHIssue No. 72, February 2014

To Contribute to In TouchFaye Eagle – PublisherComplete Media & Marketing Ltd.Tel: 01920 444 063 Fax: 01920 444 061Email: [email protected]

BAPEN Media EnquiriesHelen Lawn & Charlotte MesserHelen Lawn & Associates PR LtdTel: 01892 525 141Email: [email protected]: [email protected]

BAPEN OfficeBAPEN, Secure Hold Business Centre,Studley Road, Redditch, Worcs, B98 7LGTel: 01527 457 850 • Fax: 01527 458 718Email: [email protected] Website: www.bapen.org.uk

InTouch 72_March 2013 07/02/2014 10:30

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