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        "title": "Community-based Dietetics Service Outpatient Letter",
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              "status": "generated",
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><td colspan=\"2\" style=\"width:100%\">Dear Dr. O'Reilly, <br />I had the pleasure of meeting \r\nMr. Linacre at the Community Nutrition and Dietetics outpatient clinic on 1 May 2017, \r\nreferred by Sugra Bibi, Hospital dietician at St Crispin's Hospital, Donaldstown, DO5 7TP.</td></tr><tr><th>Date and time of contact</th><td>01 May 2017 12:00</td></tr><tr><th>Contact type</th><td>First attendance face to face</td></tr><tr><th>Consultation method</th><td>Face-to-face</td></tr><tr><th>Responsible healthcare professional</th><td>Dr. Gerald McManus (Consultant Neurologist)</td></tr><tr><th>Specialty</th><td>Neurology</td></tr><tr><th>Service</th><td>Community-based dietetics service</td></tr><tr><th>Seen by</th><td><p>Prefix: Mrs</p><p>Given Name: Susan</p><p>Family Name: Blight</p><p>Role: Community Dietitian</p><p>Tel: 01234 569870 (Work)</p></td></tr><tr><th>Outcome of outpatient attendance</th><td>Appointment to be made at a later date</td></tr></tbody></table></div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Clinical summary</th></tr><tr><td>The estimated nutritional requirements for Mr. Linacre are Energy 1500kcla/day, \r\nProtein 80g/day, Fluid 2400mls/day.</td></tr><tr><td>Mr. Linacre is tolerating his feed and fluid flushes well as per his feeding regimen \r\nand he reports being compliant with his medication.</td></tr><tr><td>Mr. Linacre's peg site has healed and was clean and dry and exposed on assessment.</td></tr><tr><td>Mr. Linacre's bowels are opening daily (with no bowel meds), \r\nall pressure areas are intact and his weight is stable.</td></tr></tbody></table></div>"
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              "status": "generated",
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Name</th><td><p>Prefix: Mr</p><p>Given Name: Doug</p><p>Family Name: Sway</p></td></tr><tr><th>Role</th><td>Feeding Nurse</td></tr><tr><th>Organisation name</th><td>Company X</td></tr></tbody></table><table width=\"100%\"><tbody><tr><th>Name</th><td><p>Prefix: Dr</p><p>Given Name: C</p><p>Family Name: O'Reilly</p></td></tr><tr><th>Role</th><td>General Medical Practitioner</td></tr><tr><th>Organisation name</th><td>Canvas Health Centre</td></tr></tbody></table><table width=\"100%\"><tbody><tr><th>Name</th><td><p>Prefix: Ms</p><p>Given Name: Sugra</p><p>Family Name: Bibi</p></td></tr><tr><th>Role</th><td>Hospital-based dietitian</td></tr><tr><th>Organisation name</th><td>St. Crispin's Hospital</td></tr></tbody></table><table width=\"100%\"><tbody><tr><th>Name</th><td><p>Prefix: Dr</p><p>Given Name: Gerald</p><p>Family Name: McManus</p></td></tr><tr><th>Role</th><td>Consultant Neurologist</td></tr><tr><th>Organisation name</th><td>St. Crispin's Hospital</td></tr></tbody></table><table width=\"100%\"><tbody><tr><th>Name</th><td><p>Prefix: Mr</p><p>Given Name: Thomas</p><p>Family Name: Linacre</p></td></tr></tbody></table></div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Examination findings</th><td>Weight 80kg, Height 175cm, BMI 26kg/m2</td></tr></tbody></table></div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>GP name</th><td><p>Prefix: Dr</p><p>Given Name: C</p><p>Family Name: O'Reilly</p></td></tr><tr><th>GP practice details</th><td><p>Name: Canvas Health Centre</p><p>Address:</p><p>Address Line: 27, Acacia Road</p><p>Post Code: BM9 6PM</p></td></tr></tbody></table></div>"
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Presenting complaints or issue</th><td>Dysphagia</td></tr><tr><th>History of each presenting complaint or issue</th><td>Mr. Linacre attended the community nutrition and dietetics outpatient clinic \r\nfor review of feeding. During a recent admission to hospital Mr. Linacre was \r\nestablished on PEG tube feeding. The feeding tube insitu is a 15French PEG tube placed 05/04/17.</td></tr><tr><th>History since last contact</th><td>Mr. Linacre's feeding regimen being: 1000mls Fresubin Energy Fibre liquid unflavoured at 100mls/hours \r\nfor 10 hours (9am-7pm) with 1400mls water given as divided flushes (e.g. 10x140mls) \r\nthroughout the day e.g. before and after feed and with medications. His weight is stable. \r\nMr. Linacre has tolerated the regimen well.</td></tr></tbody></table></div>"
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Individual requirements</th><td>Patient requires a backpack as he did not like feeding during the night \r\nwhen he was in hospital and he feels restricted staying at home at present.</td></tr></tbody></table></div>"
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          {
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Information and advice given</th><td>Mr. Linacre was given the clinic contact details and a copy of his feeding regime with Trust guidance.</td></tr></tbody></table></div>"
            }
          },
          {
            "title": "Medications and medical devices",
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><td style=\"width:100%\">(only changes to medications and medical devices \r\nas a result of the outpatient encounter are included)</td></tr></tbody></table><table width=\"100%\"><tbody><tr><th>Medication name</th><td>Fresubin Energy Fibre liquid unflavoured (Fresenius Kabi Ltd)</td></tr><tr><th>Form</th><td>Gastroenteral liquid</td></tr><tr><th>Route</th><td>Gastroenteral</td></tr><tr><th>Site</th><td>PEG</td></tr><tr><th>Method</th><td>Pump</td></tr><tr><th>Dose amount description</th><td>100mls</td></tr><tr><th>Dose timing description</th><td>Per hour for 10 hours daily, 9am-7pm</td></tr><tr><th>Additional instruction</th><td>1400mls water given as divided flushes (e.g. 10x140mls) throughout the day e.g. before and after feed and with medications.</td></tr><tr><th>Indication</th><td>Medication to be ongoing and prescribed by GP.</td></tr><tr><th>Comment/recommendation</th><td>Mr. Linacre has been supplied with a feeding pump. Prescription to be sent directly to the feed company who will deliver direct to patient.</td></tr><tr><th>Status</th><td>Amended</td></tr><tr><th>Date of latest change</th><td>01/05/2017</td></tr><tr><th>Medication change</th><td>GP to prescribe 28 x 1000ml bags per month, ongoing.</td></tr></tbody></table></div>"
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              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Patient name</th><td>Official name <p>Prefix: Mr</p><p>Given Name: Thomas</p><p>Family Name: Linacre</p></td></tr><tr><th>Patient preferred name</th><td><p>Prefix: Mr</p><p>Given Name: Tom</p><p>Family Name: Linacre</p></td></tr><tr><th>Date of birth</th><td>1 January 1960</td></tr><tr><th>Gender</th><td>Male</td></tr><tr><th>NHS number</th><td>1234567891</td></tr><tr><th>Other identifier</th><td>TL98765</td></tr><tr><th>Patient address</th><td><p>Address Line: 29, Acacia Road</p><p>Post Code: BM9 6PL</p></td></tr><tr><th>Patient email address</th><td>thomas@linacre.net</td></tr><tr><th>Patient telephone number</th><td>Mobile: 077 7777 777</td></tr></tbody></table></div>"
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              "status": "additional",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Name</th><td>Susan Blight</td></tr><tr><th>Role</th><td>Community Dietitian</td></tr><tr><th>Specialty</th><td>Dietetics and nutrition</td></tr><tr><th>Professional identifier</th><td>HCPC: DT03001</td></tr><tr><th>Date and time completed</th><td>06 May 2017 16:42</td></tr><tr><th>Contact details</th><td>Tel: 01234 569870 (Work)</td></tr></tbody></table></div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Actions for healthcare professionals</th><td>A backpack has been ordered (05/05/17) so that Mr. Linacre can feed when he goes out during the day as he did not like feeding during the night when he was in hospital and feels restricted to stay at home at the moment.<br /><p>Person Responsible: Susan Blight - Community Dietitian, Adobe Health Centre Community Dietetics Department.</p><p>Action status: Completed</p><br />\r\n \r\n Follow-up via telephone within 1 month.<br /><p>Person Responsible: Susan Blight - Community Dietitian, Adobe Health Centre Community Dietetics Department.</p><p>Action status: Requested</p><br />\r\n \r\n Please prescribe 28 x 100ml bags per month. Prescription to be sent directly to \r\n the feed company who will deliver direct to patient. <br /><p>Person Responsible: Dr. C. O'Reilly - GP, Canvas Health Centre. </p><p>Action status: Requested</p><br />\r\n \r\n Feeding Company Nurse has been requested (05/05/17) to train Mr. Linacre on use of pump. <br /><p>Person Responsible: Doug Sway - Feeding nurse, Company X.</p><p> Action status: Requested</p></td></tr><tr><th>Actions for patient or their carer</th><td>Mr. Linacre has been asked to continue on feeding regime.</td></tr><tr><th>Agreed with patient or legitimate patient representative</th><td>Mr. Linacre has agreed to continue on the recommended regime.</td></tr></tbody></table></div>"
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        "telecom": [
          {
            "system": "phone",
            "value": "01234 567890",
            "use": "work"
          },
          {
            "system": "email",
            "value": "cndd@adobehc.nhs.uk"
          }
        ],
        "address": [
          {
            "line": [
              "Adobe Health Centre"
            ],
            "city": "Donaldstown",
            "postalCode": "DO1 4XP"
          }
        ]
      }
    }
  ]
}