Background Many life-limiting conditions negatively impact on an individual’s ability to eat and drink pre-disposing an individual to malnutrition including its adverse consequences. Enjoyment and pleasure from eating and drinking can decline and diet becomes a source of psychological stress and anxiety. Although there exists a sound clinical rationale for dietetic interventions to optimise nutrition and alleviate symptoms dietetic services to hospices remains limited. In our own setting a specialist dietetic post (0.23 w.t.e.) was established in 2012. The service evolved to offer:

• a nutrition component to the patient rehabilitation and carer courses

• one to one consultations for patients with complex conditions requiring specialist dietary advice

• education and training for staff (internal and external).

Demand quickly out-stripped provision and therefore a creative, cost-effective solution was sought to continue to support patients and carers.

Aim To meet growing demand for dietetics with a newly created dietetic assistant post.

Results Following scoping and recruitment to the post, training was provided through case studies, supervision and e-learning. Since recruitment it has been possible to

• Further develop resources including a range of ‘Handy Hints’ (printed and web-based)

• Provide timely first-line dietetic interventions for patients and carers.

• Better support the specialist nurses.

• Streamline the use of oral nutritional supplements saving costs for the CCG.

A tool to identify patients requiring referral to the specialist dietitian for complex management has been validated and introduced.

Patient feedback in the form of patient evaluation and outcome measures have demonstrated the positive impact of the new service.

Conclusion To our knowledge this is the first hospice-based dietetic assistant post in the UK. Supervised by the specialist dietitian, this post has been better able to meet patient’s needs. Similar posts across the UK would assist in meeting the growing demands of clients requiring supportive care who would benefit from diet modifications to maximise quality of life.