In 2015, Oxfordshire Clinical Commissioning Group (OCCG) made a decision to add a “block” formulary status to ONS to “restrict prescribing of Oral Nutritional Supplements (ONS) for care home residents unless exception criteria are met including bowel diseases, enteral feeding, renal diseases, motor neurone disease and certain cancers” (Policy 277).
Our ICB aimed to evaluate the impact of this policy on care home residents at risk of malnutrition, and consider if it is appropriate to extend across the whole ICB.
10% of care homes in Oxfordshire participated in an evaluation survey on their food and drink service provision, malnutrition prevalence and accuracy of screening, and usage of ONS.
Overall prevalence of malnutrition of care home residents in this survey was 1 in 4, which is lower than national estimates of 1 in 3. Two thirds of care homes felt confident replacing ONS with homemade milkshakes. Usage of supplements was half that in Buckinghamshire and Berkshire West, and 0% of usage was in line with the Policy 277.
The findings show the policy has not negatively impacted risk of malnutrition, and ONS should continue to be available where clinically indicated, but monitored for appropriateness.
