We came, We saw, We conquered?

A follow up to #WeCanICan on World Cancer Day.

WCD_LOGO_4CLast week we blogged about this year’s World Cancer Day and their #WeCanICan campaign. We urged you to get involved and highlighted the SCPN annual conference which was happening on the same day with the same goal: to raise cancer awareness, and press governments to take further action against the disease. Debbie Provan (National AHP Lead for Cancer Rehabilitation) was at the event and she and many others tweeted throughout the day. If you weren’t able to attend and you’d like to catch up on the highlights check out the storify. You’ll see it was a very interactive event with lots of influential and inspiring speakers.

Near the end of the programme the audience were shown a selection of 4 cancer prevention video campaigns; they were asked to choose their favourite which would then be awarded the 2016 Communication Prize. Dr Drew Walker spoke earlier in the day and highlighted the issue of health literacy. This affects a large number of people across Scotland with as many as 23% of people essentially being considered illiterate when it comes to reading and understanding health information, and a further 32% experiencing real difficulty in understanding.  With this in mind it is evident we should consider how we communicate potentially life saving messages. Perhaps videos are the way forward? The winner of the day was the David Cornfield Melanoma Fund’s video “Dear 16-year-old Me”.

The runners-up can be viewed directly via the SCPN website. And if the statistics about health literacy have made you think about your practice and how you relay important information more information about NHS Scotland’s Health Literacy Action Plan for Scotland can also be found here.

The Cabinet Secretary Shona Robison was also present on the day. She reiterated our potential to impact on cancer through engaging in screening, making healthy choices and working together on issues such as tobacco and alcohol. She also highlighted the opportunity to influence the direction of government through engaging in the National Conversattion. To find out more and have your say go to: http://healthier.scot/.

Hopefully you’ll agree that this year’s World Cancer Day and the SCPN Conference both played a huge part in, and succeded in their aims of, raising awareness of cancer and cancer risk factors whilst highlighting ways to influence government. However it is perhaps a little to early to say we have ‘conquered’! Despite that it is clear we are making progress, and if we all keep up the momentum of World Cancer Day we may be able to say this in future, so remember #WeCanICan.

#WeCanICan on World Cancer Day

This Thursday  is World Cancer Day.

“World Cancer Day takes place every year on 4 February and unites the world under a single theme to highlight the on-going fight against cancer. World Cancer Day aims to reduce the number of preventable deaths each year by raising cancer awareness amongst the general public and pressing governments to take further actions against the disease.” – Official World Cancer Day Guide by Union for International Cancer Control (UICC).

WCD2016_Poster_WeCanICan-Generic_web_EN_FA-724x1024This year’s theme is ‘We Can I Can’ and it is designed to highlight the fact that we can all play a part in cancer prevention and awareness. We can do this through simple changes to our diets or activity levels; or they could be larger pieces of work aimed at challenging policies and creating environmental changes. To help us all get on board and contribute UICC have produced an array of resources, which have been made available on their World Cancer Day website. One resource is a short video highlighting how and why should get involved. Another is the social media guide. This a great guide to help support the campaign through your Twitter, Facebook and Instagram accounts; but it is also a great general guide for anyone new to social media and campaigning. Why don’t you take a look at the guide and get involved.

The Scottish Cancer Prevention Network (SCPN) will also hold their annual conference on Thursday. This is a deliberate clash which aims to show their support of the initiative and illustrate that they share the aims of World Cancer Day. The SCPN conference has a wide and varied programme and people will be tweeting throughout the day highlighting key messages and showing how they are helping the UICC and SCPN meet their aims. If you can’t make the conference why don’t you take a look at the programme and tweet some questions for the speakers via @TheSCPN, or take a look at the other areas of the SCPN website for some cooking inspiration, information about current initiatives and campaigns, and to join the network itself.

WCD_LOGO_4C.jpgAHP Scot Blog and the National AHP Lead for Cancer Rehabilitation (@DebbieProvanRD) will be showing their support of #WeCanICan on World Cancer Day. Debbie will be tweeting from the SCPN conference and AHP Scot Blog will be showcasing the range of ideas that come from the day via a storify next week. We hope you will join us in this venture and get involved. Remember #WeCanICan.

Canny Cooking: Good Nutrition Needn’t Cost The Earth


By Tracy Moynihan

NHS Ayrshire and Arran Health Promotion Dietitian

Cropped Toolkit 2

In 2008 NHS Ayrshire and Arran’s Health Promotion Dietetic Team received funding from Community Food and Health Scotland (CFHS) to produce the CAN (Cheap and Nutritious) Toolkit. The Toolkit began as a way of engaging low income groups in practical cooking classes which produced healthy and quick one-pot meals using fresh ingredients.

With thCAN Toolkit Recipee increase in foodbanks our team recognised there was a need to devise simple meal ideas using common store cupboard/food bank ingredients. This led to phase two of our project which aimed to produce a range of tasty, nutritious meals based around the Eatwell plate, which could be made quickly and easily with the ingredients on offer. To ensure success each meal idea was tried and tested by our team and piloted with local community projects and foodbanks. Where necessary, tips were added to improve flavour, meaning the finalised meal ideas were all rated as “tasty”, and costs ranged from as little as 50p to a maximum of 92p per portion. These simple meal ideas are now incorporated into the CAN Toolkit and its associated training.

Evaluation of the CAN Toolkit and the newly incorporated meal ideas, has been extremely positive. Users report improved confidence when cooking with many surprised at how easy it is to make affordable food that appeals to the whole family. This illustrates how the Toolkit overcomes traditional barriers and challenges common misconceptions that a healthy diet is unaffordable and unachievable for those with low incomes and limited cooking facilities or equipment. Other service users state they are now able to incorporate more fruit and vegetables into their diets, and reduce their meat intake without sacrificing protein. This is key for future health, as these changes are associated with reduced risk of heart disease, stroke, cancer, diabetes and obesity.

Recent developments have led us to produce posters which display the simple meal ideas. They are being displayed at foodbank collection points in NHS Ayrshire and Arran premises, supermarkets, and in foodbanks themselves. This encourages the public to donate the items required to produce a simple meal and subsequently helps foodbank users to receive a balanced meal.

In East Ayrshire some Council for Voluntary Services (CVO) volunteers have been trained on the CAN Toolkit and they deliver sessions to food bank users. Following these sessions it has become apparaent to both the Health Promotion Dietetic Team and the CVO Team that fuel poverty has become a major barrier and it is preventing service users from utilising their new cooking skills at home. In response to this we have worked together to secure funding which is enabling us to produce and trial heat retention cookery (HRC) and incorporate it in our CAN Toolkit training sessions.

WonderbagFor those unfamiliar with a heat retention cooker; it works in the following way. A user heats a pot of food to boiling on the hob; they then remove it from the heat and place it in an insulated container (the HRC), leaving the pot to cook through using only the retained heat.The poster opposite shows one commercial product which is available and re-iterates how it works.

As we are producing our own HRC we needed to design and brand it. Through consultation with users, our local group have decided to name our cooker ‘The Canny Cooker’. This illustrates its links to the CAN Toolkit and the simple meal ideas made from canned foods; it also makes reference to the Scottish word ‘Canny’ meaning shrewd or clever.

Despite being in the early stages of the HRC phase of the project, we believe it could help to address fuel poverty, relieve financial pressures, address this financial barrier to good nutrition, and improve overall quality-of-life. One trial of HRC carried out with a service user in a neighbouring Healthboard supports this theory; it demonstrated a 30% reduction in fuel costs. A reduction in fuel usage also has a positive environmental effect and it was this factor, alongside the potential for cost savings and our planned partnership with GRAFT to use recycled materials that led us to our strapline: Good Nutrition Needn’t Cost the Earth.

GRAFT (Gain Respect and Foster Trust) is a furniture re-use, re-cycle centre which helps to furnish new tenancies for people who’ve experienced homelessness. The project is partially staffed by volunteers and occassionally they also supervises people undertaking community payback orders. GRAFT have agreed to make and supply our “Canny Cookers”, and in future they hope to make them from donated materials and launch a social enterprise.

It was hoped that the CAN toolkit would be used by those teaching cooking skills to low-income groups, and that as a result it would support local people to eat well on a limited budget. This goal has been achieved and the impact of the toolkit has surpassed all expectations. The toolkit and Simple Meal Ideas are now used throughout Scotland by a range of individuals, groups and services, including learning disability services, children and young people, and those with limited cooking skills and/or low literacy. This illustrates the project’s transferability and by making a number of the training resources available via our online resource library, others can adopt our approach and roll-out the programme. Click here to view it.

Our Canny Cooker is already receiving interest from far and wide, including foodbank users, low income groups, those with learning disabilities/mental health issues and older people relying on home carers who have limited time to cook. In future we plan to make the pattern for the Canny Cooker and the cooking times associated with each of the CAN Toolkit meal ideas available to anyone interested in developing this service in their area.

For more information follow the link to the resource library above or contact Tracy Moynihan at Tracy.Moynihan@aapct.scot.nhs.uk

Procrastination Central


By Fraser Ferguson (@FraserAHP)



January is the time for making resolutions.The list above is not all mine. One of my resolutions was to write more blogs for AHPScot Blog and support all the amazing bloggers who annually take the time and effort to produce a high quality tale to share. Rather than just sit back and luxuriate in the wonderful stats the blogs get, why not step forward and write one myself? If noting else it would help to fill the historically quiet spell for blog submissions that generally follows the start of the year; probably due to AHPs in Scotland being too busy working their way through lists like that above.

I have spent a lot of time procrastinating about what to write. Which one of the many great projects I know of, should I write about? Which of the many amazing AHP colleagues I work with should I mention in the blog? The more effort I put into thinking what I should blog about, the further away I actually got from producing anything that would be a coherent tale of something AHP focused. This fact reminded me of my oldest son, who in December spent every night for three weeks writing his ‘statement of support’ for his university application. At the time I tried to point out to him that pro rata he had probably worked longer and harder on that statement than he would during his whole four year course! As they say the apple doesn’t fall far from the tree. Evidently this also applied to me; I had procrastinated so much about what to write that I had wasted more time and effort than I would have just sitting down and writing.

But still the procrastinating continued. What had I done which demonstrated an interesting and impactful piece of work that was worthy of sharing on AHPScot blog?

It eventually became apparent to me that the best thing I could blog about at this time, which showed the strengths, the skills and depth of knowledge, was AHPScot blog itself. It truly is a cornucopia of everything good about AHPs. AHPScot Blog has been around since April 2014 and is now positioned as the main source of blogging and sharing good practice with the AHP Community in Health and Social Care in Scotland.

At the end of 2015 a blog smashed all AHPScot Blog records. Readers from all of the world – and I don’t use that term loosely – flocked to the site to read….

How far that little candle throws his beams! So shines a good AHP in a weary world.

Screen Shot 2016-01-14 at 19.29.53

Not only did this blog present to us the astounding role that each of our individual AHP Professions play in patient care but it wasn’t even written by ‘one of our own’ so to speak, it was writen Scotland’s Chief Nursing Officer Fiona McQueen Profile

It went to show that not only has AHPScot Blog grown, so to has the allied health professions as other professions appreciate and acknowledge our individual and combined inter and intra professional roles.

And, it’s not just that other professions recognised our impact; more and more people are coming to read AHPScot Blog to hear about the breadth and depth of our roles.


Screen Shot 2016-01-14 at 19.37.26

Just this week AHPScot Blog had it’s 10,000 visitor. A huge milestone for the blog – but in the context of the world’s top visited blogs it still has a way to go….Screen Shot 2016-01-14 at 19.36.33.png

But to put it into cotext, before April 2014 where were AHPS in Scotland able to share and comment on the work we currently do, the work we have done and the work we aspire to do? In my procrastination phase I looked at the breadth and depth of the blogs AHPscot has published over the last 18 months. From Dietetics to Dementia, from Macmillan cancer care to care of the elderly. Blogs by new grads. Blogs by under grads. Blogs by world leaders in their field, and blogs by AHPs who just want to share their practice and showcase the impact they have made and will continue to make in Scotland. Blogs from Scotland and blogs from further afield. Even heads of AHP Professional Bodies took the time to write for the blog.

These blogs are not all painting a rose tinted glasses view of AHP roles in Scotland. These blogs are honest, thought provoking and some will challenge our AHP comfort zones. Even in the record breaking blog [AHPScot  – not Huffington Post standards!] Fiona McQueen challenges us to prove “in every health board area, can AHPs truly say they are working as well as they can together?” AHPs have always loved a challenge and will work hard at answering that question. But AHPScot Blog had provided a platform from which we can discuss these issues widely and deeply.


So procrastinate no longer like I have done. Join AHPScot blog. Share you successes, your goals and dreams – ideally AHP related but not bound too strictly to that ideal.

The less you procrastinate the more I can.



Care at Home Pre-Registration Training

Catriona Begg & Andrea Cox

Dietitians have historically delivered 1-1 therapeutic advice and support to service users in their own homes and care home settings. However, practice placements have largely focussed on training within clinical settings rather than social care. With Scotland committed to delivering care at home or in a homely  settings there is a compelling arguement for more diverse training models.

In 2014 a partnership group, comprising NHS Education for Scotland (NES), NHS Highland, Parklands care group and Robert Gordon’s University (RGU) piloted and successfully developed a model for the placement of student dietitians within care homes. The placements have been thoroughly evaluated and widely shared, and as a result other Health Boards are now implementing dietetic care home placements.

This new placement model has opened up our experiences of social care, allowing new dietitians to better understand how to work within this context. However 1900 people in NHS Highland alone, receive care at home and the provision of adequate nutrition and hydration can be a challenge within this setting yet student dietitians rarely have the opportunity to experience the reasons for this, or the opportunity to present solutions. As a result, in 2015 NES, the Care inspectorate, NHS Highland, RGU and Highland Home carers (HHC) agreed to go one step further than care home placements, and test another new model of training student dietitians; this time in the context of ‘care at home’ settings.

Now two student dietitians, Andrea Cox and Catriona Begg, have been given the opportunity to work alongside ‘care at home’ teams, in Inverness and Kirkhill as part of the very first care at home placement pilot. Andrea and Catriona spent two days per week over a five-week period observing, gathering information and carrying out project work to help understand the nutrition and hydration challenges faced by increasingly dependent service users and staff. They conducted an audit of care staff hydration; drew-up case profiles of service users’; assessed food and fluid storage and potential nutritional risks to service users; and presented their work to dietetic and care at home staff.

Stephen Pennington, managing director of Highland Home Carers, said:

“We are excited about being involved in this new development since we are committed to enabling people in the Highlands to have the best quality care in their own homes. The opportunity for dietitians in training to learn about the issues that care at home workers are dealing with every day and then contribute to their resolution, can only be of benefit to them and us. We continue to sponsor social care workers to undertake social work training and it is a logical next step to assist Allied Health Professionals with their development.”

Whilst there is still a great deal to explore and to plan so that service users can remain nutritionally well in homely settings, this model of placement offers opportunities to develop our learning about what service users want from care at home services. Registered Dietitian Evelyn Newman is currently evaluating the pilot, however Andrea and Catriona both believe the experience has been extremely beneficial:

“We were able to gain useful insight into the close working relationships of carers with clients and the challenges associated with providing food and fluids. We were able to work with patients who had a wide variety of conditions such as visual impairment, reduced mobility, dementia and Huntington’s disease.” said Andrea.

“This placement helped identify the possible challenges which can be faced in achieving adequate nutrition and hydration with those relying on support from carers.” said Catriona.

With the above in mind, initial results indicate that social sector placements for student dietitians can be used as an alternative model to conventional NHS-centred clinical placements. They can also challenge the differing perceptions among the profession about suitable learning environments for students and they provide a great opportunity for us to plan ahead and support the needs of individuals and their families, in a very proactive, person-centred placement model.

For more information please contact: Evelyn.newman@nhs.net (Nutrition and Dietetics Advisor – Care Homes) or follow on twitter @EvelynNewman17

How far that little candle throws his beams! So shines a good AHP in a weary world.

ProfileBy Fiona McQueen (@FionaCMcQueen)

Chief Nursing Officer for Scotland

How far that little candle throws his beams! So shines a good AHP in a weary world. (Merchant of Venice)

ShakespeareWith apologies to lovers of Shakespeare for modifying this quote from the Merchant of Venice. However when I think of the impact AHPs have on people’s lives, I have images of highly professional practitioners, who are often not at the forefront of the general public’s minds. I rather suspect if you ask the general public about clinicians in the NHS – they are most likely to talk about doctors and nurses……….

But a bit like a secret ingredient in a much favoured recipe, care and support for people is often never complete without AHP input. And how far the professions have travelled in recent years.

As a practicing clinician, and also in my personal life, I’ve witnessed the transformation AHPs can bring about in people’s lives; so why then is some of the work invisible to the public, and does this matter? Mark you, AHPs are only invisible to the public who haven’t been supported by one of the professions. The lives that are touched by AHPs are improved, at times beyond recognition; and lives can be saved. So what have I found since taking up the post of CNO Scotland?

x-rayWell, there’s no doubt that Jacqui the Chief Health Professions Officer has certainly (ably supported by Tracy) created the climate for AHPs to flourish. Whether it’s securing a debate in Parliament to showcase the work that AHPS do, or ensuring effective leadership within each NHS Board area, there has been real leadership shown by senior AHPs across the country. And a great example of professions working together for the greater good of patients and the public. It’s easy to forget that it was only recently Boards didn’t have Board AHP leads; and where they have – they have made remarkable differences in people’s lives. Reporting radiographers have reduced complaints about missed fractures and improved reporting times. Consultant AHPs in dementia are also enriching people’s lives and making real differences to communities.

However I do think there are some areas where more could be done. And I would ask, in every health board area, can AHPs truly say they are working as well as they can together? Are they a real force to be reckoned with? Because they should be! The first ever National Delivery Plan for AHPs was ambitious. But fortune favours the brave and the National Delivery Plan challenged AHPS to focus on the contribution they can make, and the impact they can have on the delivery of national policy, patient experience and outcomes across health and social care. It gave a renewed focus to AHP policy when it was launched in 2012 and much has been achieved since then, including:

  • MSKThe National Falls Improvement Programme has made progress through co-production across health, social care, the ambulance service and local communities leading to reductions of up to 50% in hospital admission after a fall;
  • People with dementia are staying a part of – rather than apart from – their communities through the dementia friendly community initiative, supported by AHP consultants in dementia;
  • Introduction of self-referral to musculoskeletal therapists, including physiotherapists has helped redesign orthopaedic services, reducing waiting times by up to 25%, reducing MRI scans by up to 30% and improving patient experience as well as ensuring those who need surgery will get it sooner.

A refresh of the National Delivery Plan was announced by the Minister for Public Health on 19 May 2015. The refresh will take the form of an Active and Independent Living Improvement Programme and will focus on improvements in population health, experiences and quality of care for people who use services and better outcomes for lower cost across health and social care.If you haven’t taken part in the engagement sessions – then make your views known.

EngagementAHPs have always been ingenious in the ways they find to support people improve health, avoid hospital admission, or reclaim their lives. Showing creativity and ingenuity, the strides AHPs have taken are an example to us all. Keep being bold and ambitious-and show the way.

The government’s 2020 Vision of people living longer healthier lives at home or in a homely setting, and accessing world class healthcare can only be reached if the potential of AHPs is truly exploited. The cracks we see in some services, I have no doubt can be replaced with strong sustainable services when AHPs’ contributions are felt. So keep throwing that beam and shining the light on new and novel solutions.

N.B: If you’d like to hear more about the progress of the Active and Independent Living Programme to date take a look at the community of practice.

Irritable bowel syndrome and the low FODMAP Diet

MaireadBy Mairéad Keegan

Senior Specialiast Dietitan, NHS Lanarkshire

As a Dietitian, I regularly see patients with irritable bowel syndrome (IBS). People often wonder what exactly IBS is and whether the symptoms as ‘bad’ as patients say? Firstly, let’s look at some of the basic facts before we explore the symptoms:

  • IBS is a chronic and debilitating, functional, gastrointestinal disorder
  • It affects 10-15% of the population, with nearly twice as many women than men being affected
  • It costs the NHS £45.6 million per annum to treat, so potentially reviewing our treatment approach for this cohort of patients, could save the NHS millions of pounds (1,2)
  • Dietitians are extremely well placed to deliver this treatment(3)

So, going back to the initial question: ‘are symptoms as bad as patients say?’ Well, the answer is yes. For some patients, symptoms include: diarrhoea; constipation; bloating; pain; wind; lethargy and nausea. In some cases, symptoms are severe, resulting in numerous medical investigations, reliance on medications for symptom relief and repeated visits to GP’s in primary care or gastroenterologists in secondary care. For others, symptoms may result in unnecessary dietary restrictions and nutritional inadequacies in the diet, reduced quality of life and social isolation. Many patients I have seen reported that they felt their treatment journey was like a ‘revolving door’ with no exit in sight.

As a clinician, there was a point in my career when I felt disheartened and ineffective, when treating patients with IBS. It appeared we could never fully help our patients with symptom resolution or control. Although some did improve with first line National Institute for Health and Care Excellence dietary advice, the majority of patients were discharged with slight, but rarely significant, symptom improvement.

However, all hope was not lost; in February 2012 I finished my training on the low FODMAP diet. The low FODMAP diet has revolutionised the dietetic input for managing patients with IBS. Put another way: FODMAP treatment could be compared to the ‘holy grail’ when it comes to treating patients with IBS. However, before we delve any deeper into this area, let’s take a look at what FODMAPs are.

FODMAP is an acronym for Fermentable, Oligosacchardies, Disaccharides, Monosaccharides And Polyols – all of which are short chain carbohydrates. FODMAPs do not cause the underlying, functional, gastrointestinal disorder that is IBS; but their dietary management offers an opportunity to reduce symptoms. FODMAPs are poorly absorbed in the small intestine but rapidly fermented by bacteria in the large bowel(4). Typically in the UK, we consume moderate to high quantities of foods containing FODMAPs on a daily basis. It’s surprising how many ‘every day’ foods we consume that could be potential triggers for patients with IBS, due to their FODMAP content.

Prior to patients commencing on a low FODMAP diet, we firstly need to ensure suitability/appropriateness of the referral. Within NHS Lanarkshire, we firstly check to ensure the patient does not have Coeliac Disease or any symptoms which would act as a ‘red flag’ for further investigation to rule out any gastrointestinal disease. Once completed, patients receive an initial appointment for first-line dietary advice and one follow-up appointment within our general Out-Patient clinics. At this second appointment, if patients have not had adequate symptom relief and are appropriate, they are then transferred into our specialist low FODMAP IBS clinics. However, it is important to remember a low FODMAP diet isn’t appropriate for all patients with symptoms of IBS (e.g. constipation predominant IBS, or patients in whom psychological factors have a role in IBS pathophysiology).

In NHS Lanarkshire, patients going into the low FODMAP IBS clinic are seen twice. During the first appointment, I gather a detailed diet history from the patient to assess the FODMAP content of his/her diet, as this varies from individual to individual. Much of the consultation is spent going through suitable, alternative foods which patients can have, as-well-as educating patients on food labelling. The patient will be expected to maintain this diet strictly for 8 weeks before returning for their second appointment. Patients often look terrified when you outline the lists of foods which need to be excluded. One patient always sticks in my mind when she said “I’m not eating much now and from what you’ve said I think I’ll starve on this diet”. However, once we went through suitable alternatives, she was relieved and, ironically, when she returned 8 weeks later, she had actually gained weight, as the variety in her diet had significantly increased!

At the return appointment, if the patient has seen symptom improvement, he/she will enter into the food reintroduction phase of the low FODMAP diet. The shear thought of this reintroduction phase can be a daunting process. Patients can achieve such significant, symptom improvement while following the low FODMAP diet that they are often hesitant to reintroduce foods. Explaining to patients this is an exciting time for them to be able to find out their specific trigger foods is essential. Ultimately, we are educating patients to take ownership of the management of their condition.

An example of the dramatic, improvement patients can achieve, while following a low FODMAP diet is demonstrated in this brief case study.

A 29 year old female reported severe symptoms of: abdominal pain; bloating; flatulence; urgency to open-her-bowels; reflux and lethargy. At the time of her assessment, she was opening her bowels 12-15 times per day. She was regularly absent from work. She was terrified to use public transport and had stopped socialising with friends and family due to the embarrassment of her symptoms. She commenced the low FODMAP diet and returned 8 weeks later. In her own words, the low FODMAP diet had ‘worked wonders’ and changed her life. When we re-examined her symptoms, most of them had completely resolved and she classified those that remained as mild and affecting her only occasionally. The biggest change was in her bowel activity and she was now opening her bowels 2-3 times/day. She said her life was changing as she could now go out and socialise with friends and family. She also felt like a ‘normal’ adult again and one whose life didn’t revolve around ‘bathroom activity’.

Similarly, many other patients report dramatic improvements in symptoms. Here are a few comments I’ve gathered from patients;

‘At first I thought the diet would be a nightmare to follow but once I started to feel the benefits of it, it was no longer a chore. My wife even benefited from me completing the diet. I was no longer passing foul smelling wind or having to use the toilet constantly. What a difference it made to both of us’ Male aged 50.

‘My job involves travelling all over the world and this becomes problematic when you’ve got a crazy bowel without any control. Prior to going on the low FODMAP diet, I took Immodium all the time and avoided eating, if I had to go to a conference or travel. Now, I’m like a new woman, I no longer take Immodium and eat regularly throughout the day. Life is so much better and a little less stressful’ Female aged 32.

From this very brief article I hope you can see the effectiveness of this treatment and recognise the potential cost benefits that come from a reduction in prescriptions/medications, GP/consultant visits and unnecessary investigations. Not only does Dietetic-led FODMAP Clinics offer financial savings to the NHS but the clinical effectiveness of this dietary approach for IBS will potentially reduce sickness absence in those affected, and more importantly, it promotes and empowers patients to manage their condition with a successful outcome. Dietitians, within the NHS, now have the opportunity to use their expert knowledge to lead and promote the low FODMAP diet in managing patients with symptoms of IBS.


  1. Maxion-Bergemann S, Thielecke F, Abel F & Bergemann R. Costs of irritable bowel syndrome in the UK and US (2006) Pharmacoeconomics 24(1) pp21-37.
  2. Williams M: How CCGs can successfully and economically manage Gastro conditions in the new NHS (2013) Complete Nutrition Focus 5(3) pp51-53.
  3. Staudaher HM, Whelan K, Irving PM & Lomer MCE. Comparison of symptom response following a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome (2011) Journal of human nutrition & dietetics 24 (5) pp487-495.
  4. Gibson PR & Shepard SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach (2010) Journal of Gastroenterology and Hepatology 25(2) pp252-258.

Mairead can be contacted on: maireadkeegan@nhs.net