Intestinal Failure and Nutrition Support Team

The Cardiff Intestinal Failure and Nutritional Support Team (NST) at the University Hospital of Wales (UHW) is a specialised centre dedicated to the assessment and management of patients with severe intestinal failure. Our staff work hard to provide care in line with our values 'kind and caring, respectful, trust and integrity and personal responsibility' to ensure you have a positive experience throughout your stay and that the care you receive is safe and effective.

 The service was first founded in 1998 to provide Parenteral Support (PS) to in-patients with short term intestinal failure. Patients with severe intestinal failure and requiring long term PS were required to travel 4-5 hours to specialist centres in England. These specialist centres would provide patients with training to allow them to live independently at home. They also undertook any specialised surgery required when intestinal failure was reversible.

In 2001, having established our service we were finally able to start training and discharging our own Home Parenteral Support (HPS) patients with severe intestinal failure. This led to being recognised as a centrally funded service for patients requiring HPS. In 2005, our health care company contract was commissioned to enable more patients with intestinal failure to be trained to live at home independently. 

As the only Welsh HPS centre we are proud to be able to provide care and nutrition to patients throughout the South, Mid, West and East Wales. To date we have had over 360 patients living independently in Wales with HPS. 

Due to hard work and dedication of our team with setting up this service we were awarded the BMJ Gastroenterology Team of the Year award for the year 2015. This is a prestigious award and highlights how important our work is for our patients. You can read the judges comments here – 

What they did: Patients who suffer intestinal failure need parenteral feeding, delivering nutrients intravenously to compensate for the failure of the normal digestive process. This can be done at home, once patients are trained in the technique. But in Wales in the 1990s, such training was unavailable unless patients were willing to travel either to London or to Salford. A team at Cardiff and Vale Health Board, starting in 2004, commissioned a service for training in home parenteral nutrition for Welsh patients. When the service started, there were 22 patients in Wales on home parenteral nutrition – now there are 106.

“Training is vital because if you don’t use the full sterile technique you get fevers and have to be rushed into hospital,” says Dr Barney Hawthorne, the consultant gastroenterologist who chaired the group responsible for commissioning the new service. “And each time a new line has to be put in, you run a risk of damage to the big veins.”

The scheme has been a success, with low rates of infection, an average of 0.43 catheter-related infections per 1000 patient days. Patient satisfaction is high, with 97% pleased with the training they received, and costs are lower than when patients had to be sent to England for training.

Judges’ comments: Most impressive is the empowerment of patients to become confi dent in management of their own line care for TPN. At discharge from hospital, 85% of people are independent in line care (compared to 27.5% nationally).

Excellent team work with dedicated multidisciplinary approach and the impact on patients is what impressed us about this intervention. A great service for the population of Wales with very good patient satisfaction data, low line sepsis and a very high proportion of patients on independent line care.

We were impressed by the strong team, working well together with strong training and mentorship and patients managed superbly.

What is Intestinal failure?

The role of the intestine is to assist in the absorbency of nutrients (small bowel) and fluids (large bowel). Intestinal failure is a rare condition that occurs when the intestines are unable to absorb the nutrients and fluids that are required to survive. If left untreated, overtime this can lead to malnutrition and dehydration.

Click on the links below to hear more about our service and how we can support you –