Equality Impact Assessment– Initial Screening
Service/Function/Policy
Directorate / Department
Assessor(s)
Provision of total parenteral
nutrition (TPN) to patients
of the Trust
Pharmacy & Medicines
Management
SMT:
Andrew Barker
Val Drakeley
Roger Hancocks
Diane Hyde
New or Existing Service
or Policy?
Existing Service
Date of Assessment
21/4/08
1.1 Who is responsible for this service / function / policy?
Andrew Barker – Clinical Director, Pharmacy & Medicines Management
Roger Hancocks – Deputy Director of Pharmacy & Medicines Management
1.2 Describe the purpose of the service / function / policy? Who is it intended to benefit? What are the intended outcomes?
Total parenteral nutrition (TPN) is the practice of feeding a person intravenously, bypassing the usual process of eating and digestion. The patient
receives nutritional formulas containing salts, glucose, amino acids, lipids and added vitamins. TPN is normally used following surgery, when
feeding by mouth or using the gut is not possible, when a patient’s digestive system cannot absorb nutrients due to chronic disease, or
alternatively, if a patient’s nutrient requirement cannot be met by enteral feeding and supplementation.
The preparation of TPN for all patients of the Trust is carried out in Pharmacy’s Manufacturing Unit based at Bassetlaw Hospital. The preparation
of TPN is a highly-specialised service which can require decisions to be made regarding the prioritisation of the service when demand exceeds
capacity. At the present time there is no current guidance regarding prioritisation and the SMT feel that neonates may take preference over other
age groups.
1.3 Are there any associated objectives? E.g. National Service Frameworks, National Targets, Legislation
NICE Guidance on Adult Nutrition
NSF for Children
1.4 What factors contribute or detract from achieving intended outcomes?
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Capacity of the service to prepare individual TPN for all requests by medical staff
1.5 Does the service / policy / function / have an impact in terms of race, disability, gender, sexual orientation, age and religion? Details:
[see Equality Impact Assessment Guidance]
Potential for a minor impact on the grounds of age. There is no written guidance in place regarding prioritisation and the SMT feel that without firm
guidelines if two equal cases were received preference could be given to neonates over other age groups. All other age groups to be equal in
status and decisions based on clinical need
1.6 If yes, please describe current or planned activities to address the impact.
At the present time the Pharmacy Department sources alternative products to diminish the negative impact on adults.
1.7 Is there any scope for new measures which would promote equality?
Yes. The SMT have decided that the Lead Pharmacist (Specialised Dispensing) should formulate Practice Guidelines when the Manufacturing Unit
is unable to prepare TPN against all requests. This will ensure that when demand exceeds capacity, prioritisation decisions are based on evidence
based clinical criteria.
1.8 Equality Impact Rating [neutral, low, medium, high*]:
Low relating to the Age Equality Dimension
Race

Age

Disability

Gender
 Religion 
Sexual Orientation

*If you have rated the policy, service or function as having a high impact for any of these equality dimensions, it is necessary to carry out a detailed
assessment and complete a Detailed Assessment for High Impact Areas form
1.9 Date for next review
In 6 months (by 31 October 2008). At that stage we expect any negative consequence to be eliminated.
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