{"id":4182,"date":"2026-03-05T11:16:26","date_gmt":"2026-03-05T11:16:26","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=4182"},"modified":"2026-03-11T12:00:08","modified_gmt":"2026-03-11T12:00:08","slug":"changes-to-dessert-supplements","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/changes-to-dessert-supplements\/","title":{"rendered":"Changes to dessert style supplements"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-4182-1\"><div class=\"fusion-panel panel-default panel-68c963a63b8fded8f fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_68c963a63b8fded8f\"><a aria-expanded=\"false\" aria-controls=\"68c963a63b8fded8f\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4182-1\" data-target=\"#68c963a63b8fded8f\" href=\"#68c963a63b8fded8f\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What work is required?<\/span><\/a><\/h4><\/div><div id=\"68c963a63b8fded8f\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_68c963a63b8fded8f\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><strong>Routine prescribing of dessert-style ONS in primary care is not supported.<\/strong><\/p>\n<p><strong>Review prescriptions of dessert style oral nutritional supplements (ONS).\u00a0<\/strong><\/p>\n<p>Where people have a <strong>MUST score 0-1<\/strong>:<\/p>\n<ul>\n<li>Issue one further months supply of ONS, then stop ONS prescription, consult <a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-ONS-Prescribing-Algorithm-in-primary-care-non-dietitians-FINAL.pdf?UNLID=148718466202631111576\">prescribing algorithm<\/a> and convert person onto <a href=\"https:\/\/www.malnutritionpathway.co.uk\/library\/pleaflet_yellow.pdf?UNLID=148718466202631111576\">food first.<\/a><\/li>\n<\/ul>\n<p>Where people have a <strong>MUST score &gt; 2:<\/strong><\/p>\n<ul>\n<li>Issue one further months supply of ONS, then stop ONS prescription, consult <a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-ONS-Prescribing-Algorithm-in-primary-care-non-dietitians-FINAL.pdf?UNLID=148718466202631111576\">prescribing algorithm<\/a> and convert person onto <a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/1a-First-choice-table-for-adult-ONS-in-primary-care.pdf?UNLID=148718466202631111576\">first choice ONS formulary product.<\/a><\/li>\n<\/ul>\n<p><span data-contrast=\"none\"><strong>Do not change\u00a0or stop dessert style ONS\u00a0in the following patient cohorts:<\/strong>\u00a0\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Ongoing swallowing difficulties or a diagnosis of dysphagia with a high risk of malnutrition (MUST 2)<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">CKD Stage 4\/5 (eGFR&lt;20)\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Those recommended a dessert style product by a specialist dietitian with a clinical rationale, or those under the care of a dietitian.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-e06d06d55f6e2b69b fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_e06d06d55f6e2b69b\"><a aria-expanded=\"false\" aria-controls=\"e06d06d55f6e2b69b\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4182-1\" data-target=\"#e06d06d55f6e2b69b\" href=\"#e06d06d55f6e2b69b\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why is this part of the contract?<\/span><\/a><\/h4><\/div><div id=\"e06d06d55f6e2b69b\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_e06d06d55f6e2b69b\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">There is a need to optimize the cost-effectiveness of ONS prescribing while maintaining patient care.<\/span><\/p>\n<p><span data-contrast=\"none\">The nutritional content of dessert-style ONS can easily be replicated by food and there are a wide range of products with equivalent calorie and protein content available to purchase in supermarkets.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">For\u00a0clinical and cost effectiveness,\u00a0powdered and liquid supplements\u00a0are favourable\u00a0alternatives\u00a0in those who need\u00a0ONS\u00a0(without dysphagia or swallowing difficulties).\u00a0They\u00a0contain\u00a0higher energy and protein then most dessert style ONS.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">This change is in line with other regions across England.\u202fRetail\u00a0puddings,\u00a0yoghurts\u00a0and desserts are readily available and often more palatable.\u00a0<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-c712e4bf1ed730b98 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_c712e4bf1ed730b98\"><a aria-expanded=\"false\" aria-controls=\"c712e4bf1ed730b98\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4182-1\" data-target=\"#c712e4bf1ed730b98\" href=\"#c712e4bf1ed730b98\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"c712e4bf1ed730b98\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_c712e4bf1ed730b98\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><b><span data-contrast=\"none\">Identify patients prescribed dessert style ONS using the S1 search:<\/span><\/b><\/p>\n<p>Dorset System One GPs> PINH 2627><span data-ccp-props=\"\"> Work to do: Dessert style ONS, consult ONS prescribing algorithm, stop and convert to food first (where MUST 0-1), or switch to first choice formulary ONS product (where MUST > 2), consult exclusion criteria prior to making changes.<\/span><\/p>\n<p><b><span data-contrast=\"none\">Exclude the following patient cohorts from the product switches<\/span><\/b><span data-contrast=\"none\">\u00a0(coded entries have been built into the searches but information below or dietetic input may be in the patient notes and not coded, hence clinical oversight is\u00a0required):\u00a0\u00a0<\/span><b><span data-contrast=\"none\">\u00a0<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">Ongoing swallowing difficulties or a diagnosis of dysphagia with a high risk of malnutrition (MUST 2)<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"none\">CKD Stage 4\/5 (eGFR<20)\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"28\" data-list-defn-props=\"{\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"none\">Those recommended a dessert style product by a specialist dietitian with a clinical rationale, or those under the care of a dietitian<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Use\u00a0the patient text messages and letters within\u00a0SystmOne\u00a0comms\u00a0annexe\u00a0to notify people of\u00a0the\u00a0relevant\u00a0change to\u00a0ONS:<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li><span data-contrast=\"none\">Encourage food first options as per the attached resource: 'Retail or Homemade Nourishing Snacks and Dietary Boosters' for patients with MUST 0-1 or at low risk of malnutrition<\/span><\/li>\n<li data-leveltext=\"-\" data-font=\"Aptos\" data-listid=\"29\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Prescribe an alternative product for those at high risk of malnutrition with a MUST score >2. Use the prescribing algorithm on the Dorset formulary to pick the most suitable of the four 'first choice' products<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"none\">Provide an acute prescription (e.g. up to 3 months).\u00a0<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Organise a review for before 3 months<\/span><\/b><span data-contrast=\"none\"> to assess progress against treatment goals, and suitability to wean off\/stop the product, or continue longer term with scheduled reviews.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-720b9437d4a6ccbbd fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_720b9437d4a6ccbbd\"><a aria-expanded=\"false\" aria-controls=\"720b9437d4a6ccbbd\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4182-1\" data-target=\"#720b9437d4a6ccbbd\" href=\"#720b9437d4a6ccbbd\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"720b9437d4a6ccbbd\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_720b9437d4a6ccbbd\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><strong>SystmOne search:\u00a0<\/strong><\/p>\n<p>Dorset System One GPs> PINHS 2672> F4b Oral nutritional supplements><span data-ccp-props=\"\"> Work to do: Dessert style ONS, consult ONS prescribing algorithm, stop and convert to food first (where MUST 0-1), or switch to first choice formulary ONS product (where MUST > 2), consult exclusion criteria prior to making changes.<\/span><\/p>\n<p><span data-contrast=\"none\">Template patient letter \"PINH 2627 Dessert style ONS prescription cessation MUST 0-1\"\u00a0 available in SystmOne comms annexe<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Template patient letter \"PINH 2627 Dessert style ONS prescription switch MUST > 2\"\u00a0 available in SystmOne comms annexe<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Template patient text messages available in SystmOne comms annexe<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><strong>Dessert style ONS prescription cessation MUST 0-1:<\/strong><\/p>\n<p>\"In line with other regions across England, NHS Dorset has asked all GP teams to stop the prescription of dessert style oral nutrition supplements (ONS). The nutritional content of dessert-style ONS can be found in food available to purchase in supermarkets; such as puddings, desserts, high protein and standard yoghurts. From next month, your prescription of dessert style supplement will be stopped, and we recommend purchasing dessert or yoghurt pots from the supermarket to consume in between regular meals. For more information please see retail or homemade nourishing snacks and dietary boosters sheet.<\/p>\n<p><strong>Dessert style ONS prescription cessation MUST >2:<\/strong><\/p>\n<p>\"In line with other regions across England, NHS Dorset has asked all GP teams to review the prescribing of dessert style oral nutrition supplements (ONS) and change prescriptions to NHS Dorset preferred ONS product choices. From next month your prescription of dessert style supplement will be changed to a powdered or liquid supplement that has a higher nutrient content, but will have a change to brand name.\u00a0 If you have any issues tolerating the new products, please discuss with your Community Pharmacist, GP practice or Dietitian.\"<\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-Position-Statement-on-the-Prescription-of-Dessert-Style-ONS.pdf?UNLID=1487182702026311113052\">NHS Dorset Position Statement on the Prescription of Dessert Style ONS<\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-ONS-Prescribing-Algorithm-in-primary-care-non-dietitians-FINAL.pdf?UNLID=1487182702026311113052\">NHS Dorset ONS Prescribing Algorithm in primary care non-dietitians<\/a><\/p>\n<p><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=25&SubSectionRef=A2.02&SubSectionID=A100&drugmatch=5913#5913\">Dorset\u00a0Formulary<\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-Retail-or-Homemade-Nourishing-Snacks-and-Dietary-Boosters.pdf?UNLID=1487182702026311113052\">Approved Retail or Homemade Nourishing Snacks and Dietary Boosters<\/a><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-48345fe5c068304ff fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_48345fe5c068304ff\"><a aria-expanded=\"false\" aria-controls=\"48345fe5c068304ff\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4182-1\" data-target=\"#48345fe5c068304ff\" href=\"#48345fe5c068304ff\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I calculate my progress against the target for this metric?<\/span><\/a><\/h4><\/div><div id=\"48345fe5c068304ff\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_48345fe5c068304ff\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Tracking achievement:<\/p>\n<p>Q4 ONS spend pro rata divided by Denominator PCN normalised population<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":3067,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-4182","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/comments?post=4182"}],"version-history":[{"count":20,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4182\/revisions"}],"predecessor-version":[{"id":4500,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4182\/revisions\/4500"}],"up":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3067"}],"wp:attachment":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/media?parent=4182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}