Contracting for enteral tube feeding

摘要

Over the past four decades, enteral tube feeding has changed from a hidden area of hospital practice, left largely to dietitians and general nurses, to a specialist, multiprofessional field of practice, crossing care boundaries and working with patients and families. Political, financial, clinical and industry changes have underpinned the change. First, an awareness of disease-related malnutrition led to increased use of enteral feeding. Second, a reduction in length of hospital stay and number of hospital beds was linked to a greater demand for home enteral tube feeding. Third, a home-care industry developed to support clinicians, patients and families in delivering safe enteral tube feeding at home. You may be familiar with the market leaders in enteral tube feeding, and could be forgiven for thinking that once you are set up with one company, there is no need to change, but this is not the case. This column presents a personal perspective of my experience of contracting for enteral tube feeding goods and services over almost 15 years.