OGC P12 The Current Landscape of Nutritional Care in Oesophahgogastric Cancer: Insights from The National Oesophagogastric Nutrition Audit (NONA)

Abstract

Abstract Background Specialist nutritional support is important during treatment for oesophagogastric (OG) cancer yet current practice remains unstandardised across the UK. The National Oesophagogastric Nutrition Audit (NONA) aimed to describe the current landscape of OG dietetic services in the UK and Ireland, with a specific focus on resource allocation, barriers to dietetic support, and the provision of support throughout the cancer pathway. Methods Tertiary cancer units, secondary care, and community services across the UK and Ireland were invited to complete a 28-point electronic questionnaire. Team leaders and senior specialist OG dietitians were the target respondents. All data points were peer-reviewed, piloted, and revised by the NONA steering committee before distribution. Data points covered a range of areas related to resources, skill mix, provision of support throughout the cancer pathway, and involvement with national audit and research. Results Complete responses were received from 50 units (surgical units, n=35 and oncology units, n=10). Secondary care/community services were underrepresented (n=5). The majority (77%) of tertiary surgical units agreed or strongly agreed they were able to provide adequate nutritional care in the post-operative period. However, confidence dropped significantly during the early diagnostic phase and in the neoadjuvant period, with 52% and 67% of units disagreeing that they could provide adequate dietetic support, respectively. Inadequate funding, understaffing, and prioritisation of inpatients were commonly reported barriers. There was significant variation in practice regarding nutritional service structure, and staffing resources across specialist units. Conclusions The NONA survey provides a ‘real-world’ landscape of nutritional care for patients with OG cancer. Lack of funding, resource, and evidence-base may explain the variation seen in services provided across the UK. Further research and consensus is required to help standardise nutritional care, guide service specification, and improve nutritional outcomes for patients with OG cancer. Further national consensus frameworks to standardise care in the UK are currently underway.