Future Feeding Planning Pathway

This comprehensive pathway guides the process of making decisions about future feeding options with patients, for example those who have progressive neurological diseases.

Assessing capacity and making decisions around gastrostomy feeding versus risk feeding is often challenging.

Several years in development at the Royal Hospital for Neuro-disability (RHN), this pathway guides the process from start to finish and provides supporting information around the legal frameworks professionals need to work within.

The pathway includes guidance both for situations where the patient has capacity to make the choice for themselves, and where a best interests decision is required.

Alongside the pathway is a pack of documentation to provide an easy to use and accessible way to record the entire process and the decision made, in addition to useful supplementary materials.

All of this documentation is freely available below for you to download and use in your clinical practice.  There are also videos from our launch event in January 2017 that provide an overview of the pathway and documentation.

Videos – coming soon

Overview of relevant legal frameworks

Overview of RHN future planning pathway and documentation

Documents available for download*

Future Feeding Planning Pathway
This flowchart is an overview of the whole process in a step by step format. The text in red directs you to the section in the booklet to document this step.

Future Feeding Planning Booklet
The booklet is where the detail of the process is documented e.g. the decision made, legal documentation, education and capacity assessment, best interests meetings.  It links with the pathway and guides you as you progress through the process with what to do next.

Decision letter
This is an example of the letter that we circulate to appropriate professionals involved in the patient’s care (see suggested list on the final page of the booklet).  We suggest that you produce your own version of this letter with your own branding etc.

Annual review form
We suggest that the decision is reviewed annually or following a significant change in circumstances e.g. patient deterioration or family/patient request.

(*each title will take you to a download link that will open in a new window)

Supplementary materials

  • Yes/No questions – we use this as part of the capacity assessment process.
  • List of Talking Mat symbols – this is a list of the symbols we use at the RHN, when using Talking Mats as part of the education and capacity assessment process. We usually complete two mats – one on pros and cons of risk feeding, and one on the pros and cons of gastrostomy feeding. Visit the Talking Mats website for useful information and how to book onto training courses.