How to cut SIP spending is a priority for all Healthcare Organizations around the world. They are useful and help supplement patient’s oral nutritional intake – but they cost a lot.

Here in the UK the National Health Service spends over £300 million P/A on SIP Feeds.  We are a small Country. Others will be spending far more.

Many will be trying to cut their SIP Feed spend by reducing inappropriate prescribing and waste. There are lots of useful guidelines like the one from Solihull Care Trust below. But they could go further one step further?

Insist prescribers ask…“Does this patient have dysphagia?”

If they do, prescribing ordinary powdered or liquid SIP feeds with tins of gum or starch based thickeners is a waste.

They won’t thicken SIP feed effectively – if at all, because their high fat content prevents the thickener bonding to it. Consequently, there is a high risk they are not the right consistency for the patient, they can’t drink it and remain nutritionally compromised.

Until March this year – 2016, the only way to prevent wasting budgets on this combination of products and reduce risk of aspiration pneumonia was prescribe pre-thickened liquid supplements. Being pre-thickened, they are safer – but they are astronomically expensive.

Our answer to these problems, after 4 years of work are Slõ Milkshakes+.

The first pre-thickened powdered protein rich milkshake.

They contain a thickener that actually works with milk and thicken to the right consistency first time.
To make, just add 200ml of whole milk.

No waste, no stress for the maker and the drinker has all the security of a pre-thickened liquid SIP Feeds.

They have virtually the same nutritional content (330+ calories, 20g+ of protein, + a mix of essential vitamins and minerals) BUT cost the same as powdered feeds.

84p.

Here in the UK over pre-thickened supplements that’s a saving of over £ 80 per month per patient!
Imagine the savings with 20, 30, 50 patients.

Slõ Milkshakes+ are therefore the most cost effective thickened supplements you can use to supplement a dysphagia patients oral nutritional intake.

But the only way to find out if a patient is needs them and reduce spend on inappropriate and costly alternatives is to start encouraging SIP Feed prescribers to ask the question…

…“Does this patient have dysphagia?”

This is a summary of the actions Solihull Care Trust took to reduce spending on Sip Feeds.
Full details of the project can be found by clicking here

• Promote effective nutritional screening at all levels to identify patients at risk of malnutrition using ‘MUST’
• Update local guidelines for management of malnutrition with the inclusion of care pathways and care plans to help to identify and treat malnutrition and to enable the on-going management of complex and chronic oral nutrition support patients.
• Provide access to resources (patient advice leaflets) to support a first line ‘food first’ approach within GP Practices, Primary Care settings, residential and care settings and amongst Practice Nurses, District Nurses and Community Pharmacists.
• Work with Medicines Management to identify high priority Practices based on high sip feed expenditure
• Provide support for Practices to review existing patients on sip feeds and move those who are able onto a nutritionally adequate diet without sip feeds.
• Provide guidance on ‘end points’ for sip feed prescribing.
• Provide dietetic support with nutritional management of complex patients.
• Review repeat prescribing. Review of patients who are currently taking prescribed nutritional products, who have either not been assessed in the community or have no plan for monitoring in place – often this happens as a result of a discharge on sip feeds from acute services where follow-up is passed back to the GP.
• Work with the acute setting to manage the different approaches for discharging patients on sip feeds, streamlining information provided across the acute and community settings to ensure GPs are given clear guidance on nutritional screening and ongoing management of malnutrition, especially following discharge from hospital.
• Provide expert advice on product selection where sip feeds are genuinely needed – most cost effective product, assessing patient preferences and compliance (use of starter packs) maximise rebate.
• Feedback and identify ongoing training needs and delivery plan individualised to each Practice and any local nursing / care homes.
• Work with nursing homes/care homes from all sectors to promote a ‘food first’ approach. Promoting the use of regular, nourishing foods and drinks and appropriate feeding strategies to prevent and treat malnutrition without prescribed sip feeds – this is particularly relevant to care facilities where inappropriate use of prescribed sip feeds was commonly encountered.
• Provide regular updates to GPs and commissioners on the progress and outcomes of the project