PN
Spotlight on Parenteral Nutrition
28 November 2019

Following the success of the previous award-winning Parenteral Nutrition framework, the East of England NHS Collaborative Procurement Hub and East of England Neonatal Operational Delivery Network Dietitian Lynne Radbone worked to develop a replacement framework. The new Parenteral Nutrition (PN) framework gives trusts consistent, cost-effective access to PN products including the updated East of England Standardised Neonatal Formulations and has been extended to include standardised paediatric formulations.  

Most Parenteral Nutrition formulations are produced to the specific requirements of individual prescriptions at a high cost to trusts, and although use is increasing there is still a lack of understanding of the potential to standardise. While Neonatal standard bags are now more widely used across the UK, there is a limited range of paediatric standard bags available; these do not cover the wide age and weight range in this population and are supplier formulated bags. It is well recognised that a standardised PN formulation can be used in clinically stable patients and meet their nutritional requirements when supplied with an appropriate formulation for their age

When planning for the new framework began in late 2017, a decision was made to include standardised PN formulations within the scope; this strategy was then validated by the findings NHS Improvement released in the Pharmacy Aseptic Services Review in March 2018, stating that there is significant opportunity to standardise Parenteral Nutrition.  

Standardised PN is not only more cost effective but can improve patient safety by minimising risks associated with manufacturing by simplifying prescribing and compounding. This standardised approach has been recommended by both the Paediatric Chief Pharmacists Group and National Confidential Enquiry into Patient Outcome and Death reports. 

 

The framework is comprised of six lots: 

Lot 1: Standard Licensed Multi Chamber (2 and 3) Bags 

Lot 2: Ready to Use Standard ‘Supplemented’ Bags 

Lot 3: Components Used for Compounding and Additions to Bags (e.g. infusion fluids, vitamins) 

Lot 4: Unlicensed Bags Customised to the Specific Requirements of an Individual Patient (i.e. bespoke parenteral nutrition)  

Lot 5: Neonatal Standard Bags and Lipid Syringes 

Lot 6: Paediatric Standard Bags 

 

As the framework offers standardised formulations for adults, paeds and neonates, it is the first of its kind.   

The previous PN contract introduced the standardised neonatal formulations, which was well received, minimal suppliers were able to in a position to provide them. The new Parenteral Nutrition framework has been awarded to several suppliers to ensure the market is not reliant on one supplier, meaning trusts can source the same bags and formulations from multiple sources.

Potentially the most important benefit of the PN framework is that it will allow local units to initiate PN safely and accurately in non-critically ill children and enable tertiary services to potentially repatriate children on stable PN to their local hospital – thereby releasing bed capacity and allowing care closer to home.

 

If you would like further information on the Hub's Parenteral Nutrition framework, please contact Ruth McColl: ruth.mccoll@eoecph.nhs.uk

This is a printable version of https://www.eoecph.nhs.uk/?locid=0d6new08i&Lang=EN&htm=&pr=