Providing dietetic advice to patients referred to new intensive weight management programme (Tier2+) commissioned by Dudley Public Health through Action Heart at Russell's Hall Hospital Dudley. Referral criteria BMI >40 (or > 35 with comorbidities). Working alongside physical activity professionals and councillor / mentor specialising in CBT, creating individualised weight management programme aiming for 5% weight loss in 12 weeks, in line with NICE guidance. Patients attend on a weekly basis so receive plenty of support and guidance to enable them to identify and make permanent lifestyle changes to achieve sustainable weight loss.

Working as part of Specialist weight management team for both adults and paediatrics as part of Tier 3 service. Providing individualised balanced eating plans based on REE and activity levels. Aiming for slow sustainable weight loss of 1-2 lbs per week whilst promoting lifestyle changes and positive change in body composition ie increasing skeletal muscle mass whilst reducing body fat stores (measured using Seca bio impedance). Working alongside physical activity specialist and councellor.Providing 1:1 weight management support and advice to families who are under child protection.

Covering a variety of adult clinics as required - Community (including Home enteral feeding, IBS, Type 2 Diabetes, nutritional support, Obesity), Coeliac, and Weight Management.Also covering number of paediatric clinics. Referrals include fussy eating, faltering growth, Coeliac and food allergies. Weekly domicillary visits to home enterally fed child with complex medical needs and protection plan in place. Working alongside specialist nursing staff from children's disabilities team and School health Advisor. Attending regular core group meetings.

Working for CCG medicine management team with practice based pharmacists auditing use of paediatric nutritional supplements in primary care, identifying cost savings, training needs and providing specialist dietary advice to families who are not already under a Dietitian. In the process of producing infant feeding guidelines for first line prescribing with respect to milk allergy, faltering growth etc in consultation with prescribing advisor and secondary care Paediatric Dietitian.

Completed project to review patient menus using Tillery Valley cycles, in line with PLACE requirements and BDA document "The Nutrition and Hydration Digest: Improving Outcomes through Food and Beverage Services". Draft Main patient menu and children's menu launched during "National Nutrition and Hydration week" and are now out for consultation. Menus coded for balanced choice, energy dense, soft, vegetarian, gluten free, milk free and finger foods to encompass the majority of service users. Additional special diets menu incorporating other allergens, halal and vegan meals also produced.

Providing dietetic assessments and treatment plans for children attending specialist feeding clinic.Areas of particular interest Enteral tube feeding, gastroenterology and food allergies.

Band 7 NHS Specialist Paediatric Dietitian - acute and communityAutonomous / multi disciplinary practitioner working with complex medical / social cases in a variety of settings - ward, clinics, domicillary visits and special Schools. Home enteral tube feeding Food AllergyCoeliac DiseaseFaltering GrowthGastrointestinal Reflux DiseaseMultidisciplinary feeding clinic dealing with neuro-developmental feeding difficultiesCystic FibrosisManagement of Complex Obesity PatientsStudent / junior dietitian trainingResource group chair