{"id":4220,"date":"2026-03-05T11:17:05","date_gmt":"2026-03-05T11:17:05","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=4220"},"modified":"2026-03-11T11:33:55","modified_gmt":"2026-03-11T11:33:55","slug":"best-value-ons-changes","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/best-value-ons-changes\/","title":{"rendered":"Best value ONS changes"},"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-4220-1\"><div class=\"fusion-panel panel-default panel-9b46435977fcebdff 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_9b46435977fcebdff\"><a aria-expanded=\"false\" aria-controls=\"9b46435977fcebdff\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4220-1\" data-target=\"#9b46435977fcebdff\" href=\"#9b46435977fcebdff\"><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=\"9b46435977fcebdff\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_9b46435977fcebdff\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\"><span class=\"NormalTextRun SCXW180037461 BCX8\">I<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">dentify patients prescribed ONS supplements which are not in line with the first choice Dorset formulary options.<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0Review the need for ONS prescription and where\u00a0<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">appropriate to<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0continue, change<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0prescription<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0to<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0a<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">first-choice<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0formulary\u00a0<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">option<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">\u00a0(see prescribing algorithm)<\/span><span class=\"NormalTextRun SCXW180037461 BCX8\">.<\/span><\/span><\/p>\n<p><span data-contrast=\"none\">Products should not be changed in the following patient cohorts:\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"-\" data-font=\"\" data-listid=\"30\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><b><span data-contrast=\"none\">Tube fed\u00a0<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"-\" data-font=\"\" data-listid=\"30\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><b><span data-contrast=\"none\">Dysphagia\/swallowing difficulties<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"-\" data-font=\"\" data-listid=\"30\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><b><span data-contrast=\"none\">Eating disorder<\/span><\/b><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"-\" data-font=\"\" data-listid=\"30\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><b><span data-contrast=\"none\">Under the care of a specialist dietitian in the last 6 months (e.g. gastroenterology\/oncology or other) with a request for a specific product)<\/span><\/b><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"-\" data-font=\"Aptos\" data-listid=\"31\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><b><span data-contrast=\"none\">Chronic kidney disease stage 4 or 5 (eGFR <20)<\/span><\/b><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-85b7f5aca15d6dc75 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_85b7f5aca15d6dc75\"><a aria-expanded=\"false\" aria-controls=\"85b7f5aca15d6dc75\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4220-1\" data-target=\"#85b7f5aca15d6dc75\" href=\"#85b7f5aca15d6dc75\"><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=\"85b7f5aca15d6dc75\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_85b7f5aca15d6dc75\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TextRun SCXW151829659 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW151829659 BCX8\">There is a need to optimi<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">s<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">e the cost-effectiveness of ONS prescribing while\u00a0<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">maintaining<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0patient care.\u00a0<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">The Dorset\u00a0<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">F<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">ormulary has been reviewed,\u00a0<\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW151829659 BCX8\">taking into account<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0nutritional content and cost effectiveness of ONS products, to\u00a0<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">provide\u00a0<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">first-choice<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0recommende<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">d options for people<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0requiring ONS prescriptions<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0in primary care<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">.<\/span><span class=\"NormalTextRun SCXW151829659 BCX8\">\u00a0<\/span><\/span><span class=\"EOP SCXW151829659 BCX8\" data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-a6a72d1ad10617e59 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_a6a72d1ad10617e59\"><a aria-expanded=\"false\" aria-controls=\"a6a72d1ad10617e59\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4220-1\" data-target=\"#a6a72d1ad10617e59\" href=\"#a6a72d1ad10617e59\"><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=\"a6a72d1ad10617e59\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_a6a72d1ad10617e59\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><b><span data-contrast=\"none\">Identify\u00a0patients prescribed relevant ONS\u00a0products using the\u00a0SystmOne\u00a0search provided:<\/span><\/b><span data-contrast=\"none\"> \u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Exclude\u00a0the following patient\u00a0cohorts from the product switches\u00a0<\/span><\/b><span data-contrast=\"none\">(coded entries have been built into the searches\u00a0but\u00a0information\u00a0below or dietetic input\u00a0may be in the patient notes\u00a0and\u00a0not coded, hence clinical oversight is\u00a0required): \u00a0\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li><span data-contrast=\"none\">Tube fed\u00a0<\/span><\/li>\n<li>Dysphagia\/swallowing difficulties<\/li>\n<li>Eating disorder<\/li>\n<li>Under the care of a specialist dietitian in the last 6 months (e.g. gastroenterology\/oncology or other) with a request for a specific product)<\/li>\n<li><span data-contrast=\"none\">Chronic kidney disease stage 4 or 5 (eGFR &lt;20), due to complex electrolyte needs<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Assess whether the patient still requires ONS, using the ONS Prescribing Algorithm in primary care. <\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">If ONS is indicated (e.g. MUST 2 and ACBS criteria fulfilled), swap to the suggested product. <\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Provide an acute prescription\u00a0(e.g.\u00a0up to\u00a03 months).\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Organise a review\u00a0for before 3 months to assess progress\u00a0against treatment goals,\u00a0and\u00a0suitability to\u00a0wean off\/stop the\u00a0product or continue\u00a0longer term.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Notify patients of changes to ONS using the patient template texts and letters provided in the SystmOne Comms Annexe. <\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-02d2743244b3bf0d6 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_02d2743244b3bf0d6\"><a aria-expanded=\"false\" aria-controls=\"02d2743244b3bf0d6\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4220-1\" data-target=\"#02d2743244b3bf0d6\" href=\"#02d2743244b3bf0d6\"><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=\"02d2743244b3bf0d6\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_02d2743244b3bf0d6\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">SystmOne searches are available in the DorsetSystmOneGPs&gt; PINH 2627&gt; F4b Oral Nutritional Supplementation<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Template patient letters \u2013 in SystmOne comms annexe<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Template patient text messages \u2013 in SystmOne comms annexe<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/Approved-ONS-Prescribing-Algorithm-in-primary-care-non-dietitians-FINAL.pdf?UNLID=1487182702026311113052\"><span data-contrast=\"none\">ONS Prescribing Algorithm for primary care<\/span><\/a><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"5\" data-aria-level=\"1\"><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2026\/03\/1a-First-choice-table-for-adult-ONS-in-primary-care.pdf?UNLID=1487182702026311113052\"><span data-contrast=\"none\">Primary Care ONS formulary \u2013 first choice product table<\/span><\/a><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"32\" data-list-defn-props=\"{\" data-aria-posinset=\"6\" data-aria-level=\"1\"><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2026\/03\/SOP-Implementation-of-ONS-formulary-changes.pdf\">SOP &#8211; Implementation of ONS formulary changes<\/a><\/li>\n<li><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=25&amp;SubSectionRef=A2.02&amp;SubSectionID=A100&amp;drugmatch=5913#5913\">Dorset\u00a0Formulary<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-d4d40cbbabb74893b 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_d4d40cbbabb74893b\"><a aria-expanded=\"false\" aria-controls=\"d4d40cbbabb74893b\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4220-1\" data-target=\"#d4d40cbbabb74893b\" href=\"#d4d40cbbabb74893b\"><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=\"d4d40cbbabb74893b\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_d4d40cbbabb74893b\"><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 class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/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-4220","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4220","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=4220"}],"version-history":[{"count":17,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4220\/revisions"}],"predecessor-version":[{"id":4491,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4220\/revisions\/4491"}],"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=4220"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}