- NHS England and MHRA looking at importing feed from other countries
- Hundreds of patients are suffering delays in vital IV feed supplies
- Patient safety director warns problem will last longer than expected
Dozens of patients including children have now been admitted to hospital because of the national shortage of intravenous food supplies for patients who cannot eat normal food, HSJ has learned.
Approximately 40 patients have been admitted to hospital while another 40 hospital patients have been stranded on wards unable to be discharged home because the NHS lacks the ability to supply them with food, NHS England has told HSJ.
The Department of Health and Social Care, NHS England, and the Medicines and Healthcare products Regulatory Agency are now looking at importing supplies of feed from Germany and Italy to tackle the lack of capacity in the UK.
Doctors told HSJ some patients needed admitting to receive intravenous vitamins and minerals or to simply keep them hydrated after the patient received no deliveries of the feed bags needed to keep them alive.
Some of the patients delayed in hospital include cancer patients, as well as post trauma and surgery patients who are newly diagnosed as needing intravenous feed, or total parenteral nutrition.
TPN feed is delivered directly into the bloodstream and bypasses the digestive system for patients who cannot eat normal food because of illness, injury or other long-term conditions.
The NHS has declared a national emergency over the shortage in supplies which was caused by MHRA imposing overnight restrictions on the manufacturer, Calea, following an inspection in June.
Across the UK, 511 patients have been switched to what are known as “off the shelf” bags, which provide some nutrition but do not include vital vitamins and minerals.
NHSE told HSJ approximately 450 patients in England were affected by the shortage with Calea serving 1,300 patients across the UK and Ireland.
NHSE said all patients, except one, now had a clinical plan in place to support them during the shortage with the remaining patient being resolved tomorrow.
An NHS spokeswoman said: “The NHS is working hard to minimise disruption to patients and ensure they are kept up to date, while supporting Calea to find a solution to the issue.”
Calea did not provide HSJ with a new statement but company sources told the BBC today normal service would not resume until “towards the end of the year”.
‘They are asking me to go without nutrition for four weeks’
Patients across the country have told HSJ they have endured days without nutrition because of IV feed delays and now face weeks of uncertainty and possible admissions to hospital.
Imogen Fox, aged 36, told HSJ she had been informed she would be switched from her usual bespoke prescription feed provided by Calea to “off the shelf” bags which lack the nutrition she needs and could mean she is admitted to hospital.
She said: “There are no vitamins and minerals in the standard bags. They are asking me to go without nutrition for four weeks. I will not be receiving any vitamins and minerals for the entire time I don’t have my normal bags.
“They have given us these off the shelf bags and they are nowhere near our prescriptions. I know someone who is going with a 2,000 calorie a day deficit because they don’t have a bag with enough calories that also match their electrolytes.
“My bags will actually have more calories than I need but won’t have enough potassium so we are looking at other ways I might be able to get potassium which means I won’t have to go into hospital to have IV potassium once a week.”
Off the shelf bags also contain fat or lipids which Imogen does not need every time she uses a feed bag. She said: “I experience quite a lot of pain when I use fat bags, the abdominal pain is enough to wake me up in the night sometimes.”
She said Calea’s communication had been “atrocious”. She was also woken at 1am in the morning with a delivery of bags she could not use.
She continued: “I have got a massive pile of bags that have gone out of date because they have sent me so much stock I didn’t ask for and can’t use.
“I am literally throwing my own food away and there is nothing I can do about it.
“I have absolutely no idea when this will end.”
Elsewhere, HSJ has learned of patients, including children, being admitted to hospital for IV fluid hydration. In other cases, patients have received letters advising them to take vitamin supplements even though they cannot digest them.
One clinician working for an NHS hospital said off the shelf bags were better than no nutrition at all and added NHS teams were working hard to make sure all their patients were kept safe.
Many patients switched to off the shelf bags have been told they will need weekly blood tests to check their health.
Information supplied to HSJ
- Acute care
- Board Talk/governance/assurance
- Clinical news (NICE, NSFs)
- Community services
- Department of Health and Social Care (DHSC)
- Independent providers
- Medicines and Healthcare Products Regulatory Agency
- NHS England (Commissioning Board)
- NHS Improvement
- Patient experience
- Patient safety
- Policy and regulation