Food first and oral nutritional supplements (ONS)

Oral nutritional supplements (ONS) are commercially produced medicinal products that you can buy over the counter or get on prescription. They are used in addition to a fortified diet (a diet where you add more of the same vitamins and minerals to your food and drinks) and give you more calories, protein, vitamins and minerals to improve your nutritional health if you are malnourished, or if you have a small or reduced appetite. However, quite often these supplements are given to people who do not need them and would benefit more from getting the extra calories and protein through food and drink. 

Lots of people with small or reduced appetites worry that they will have to eat lots more, but often you can make small changes to the food and drink that you already eat that will boost the calories and help you gain weight healthily, without the need for supplements.  

We want people to be able to enjoy the food and drinks that they love, instead of having supplements that often might not be as nice. 

There are lots of little ways you can increase your calories to help you gain weight, such as adding toppings to your breakfast, or using fortified milk in your cups of tea.  

Because the evidence tells us that oral nutritional supplements do not provide you with anything more than food can provide, local clinicians are being asked to stop prescribing these supplements inappropriately to adults aged 18 and over in Staffordshire and Stoke-on-Trent. This means that they can only prescribe them to you if they have spoken to a dietitian, and the dietitian thinks you really need them. Instead, we want to empower people to keep having the foods they enjoy and making some small swaps or additions to simply help boost how nutritious your food is. 

If your loved one is receiving end of life/palliative care, we want them to also to be able to enjoy the foods and drinks they love, instead of them having to drink supplement drinks. 

Please note that this policy change does not affect people who have a feeding tube/peg or children and young people – it is only for people who drink the supplements themselves and are aged 18 and over. 

The Dietetics Service at Midlands Partnership University NHS Foundation Trust (MPFT) has created some recipes that you can easily make at home to help you if you need to gain weight or are no longer getting oral nutritional supplements on your prescription. These recipes sheets give examples of healthy, nutritious recipes, and tips on how you can make the foods you already eat, better for you if you need to gain weight.   

You can also view our patient FAQs to find out more information about this work.

Food First recipe sheets and FAQs

Recipe sheet – print at home

Recipe sheet – digital

Patient FAQs

If you are currently getting oral nutritional supplements on prescription, but you will no longer get these going forward, your GP will let you know and discuss this with you. 

If you have any questions, queries or complaints, you can contact the Patient Advice and Liaison Service (PALS) on freephone 0808 196 8861 or via email PatientServices@staffsstoke.icb.nhs.uk. PALS is open from 9am to 4pm, Monday to Friday (excluding bank holidays). 

Resources