Ancillary Item List


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Enteral Feed Ancillary Equipment used in
Birmingham Community Healthcare NHS Trust (BCHC)
The following table of equipment is available to be ordered for patients on an enteral feed and who have a Birmingham GP.
*Please ensure you use the correct form when ordering items:
Vygon form – requests for Mic-key extension sets and buttons, enteral male adaptors, etc., will only be accepted via a Vygon New Registration form, or Change of Reg form (currently paper form to be faxed to Nutrition Support Team for authorisation – DO NOT FAX DIRECT TO VYGON AS THEY WILL NOT BE ACCEPTED.
Homeward/Connections – everything else
When completing any changes/additions on Homeward e-Connections, please make sure you add details in the additional information box at the bottom of the form. This may stop any unnecessary delays to your request. Some items may not be visible to you on e-Connections. This does not necessarily mean that they are not available. Please request these items by completing the additional information box
Please only use items as advised on this list. If you wish to use anything else or in quantities above those specified, please contact us prior to completing the online e-Connections form.
Our contact details are:
Nutrition Support Team Priestley Wharf 1, Holt Street, Aston, Birmingham B7 4BN Tel: 0121 683 2300 Fax: 0121 615 2908

ANCILLARY ITEM LIST – provided by BCHC NHS Trust

Item Giving Sets

Code

Nutricia Homeward*

Infinity - Flocare Infinity ENPlus Pack Set - Flocare Infinity ENPlus Universal Set - Flocare Infinity ENPlus Mobile Set

95174 95179 95182

- Flocare Infinity Top Fill Reservoir with Integral Set – discontinued after Sept. 2015. Please order new separate Top Fill Reservoir and a separate giving set.
- Flocare Top Fill Reservoir

70139

Adult Requirements 1 per 24 hours

(Updated August 2016)
Paeds Requirements Comments

1 per 24 hours or 1 per feed

* If a tethered medicine port giving set is required please refer to Nutricia ancillary list

Flocare 800 - Flocare 800 ENPlus Pack Set - Flocare 800 ENPlus Universal Set, and Flocare Universal Pack Adaptor. Flocare Universal giving sets discontinued after Sept. 2015. Please order new Flocare Universal Pack Adaptor and a separate giving set as above.

95173 95173 and 70063

- Flocare 800 Top Fill Reservoir with Integral Set discontinued after Sept. 2015. Please order new separate Top Fill Reservoir and a separate giving set.

95173 and 70139

Enteral UK pH Indicator Sticks (plastic)

- pH 2-9 (100 sticks per pack)

88701

- pH 2-9 (25 sticks per pack) preferred choice for 97749 patients with BGT

Merck pH 2-9 (100 sticks per pack)

63786

- 1 box per month if patient has NG/NJ tube. - 1 box (25’s only) on first delivery only if patient has BGT

- 1-2 boxes per month if patient has NG/NJ tube. - 1 box (25’s only) on first delivery only if patient has BGT

Item NG Tubes

Code

Corflo Merck Long or Short Term NG Tubes (single patient use)
- CH6 56cm - CH6 92cm - CH8 56cm - CH8 91cm - CH8 109cm - CH8 140cm - CH10 92cm - CH12 92cm

63969 63970 63973 63977 63897 64137 63819 63950

Medicina Short Term - CH6 50cm - CH6 80cm - CH8 50cm - CH8 80cm

NG Tubes (single use)

63736 63763 63761 63768

Medicina Long Term - CH6 55cm - CH6 75cm - CH6 85cm - CH8 55cm - CH8 75cm - CH8 85cm

NG Tubes (single use)

63687 63751 63750 63688 63752 63689

ENFit Enteral Syringes for Non Bolus Patients

- Enteralok Female Luer Lock 60ml (ENFIT compliant 113807

from 01/06/2016)

(64349)

- Enteral UK Female Luer Lock 60ml (ENFIT compliant from 01/06/2016)

113831 (88717)

Adult Requirements
As required Maximum - 1 per month Minimum - 2 per year
1-2 per week
1 per month

Paeds Requirements
As required Maximum – 2 per month Minimum – 2 per year
1-2 per week (if more required please state clinical need in additional information box on Connect form) As required

Comments
Corflo can be used for up to 6 months and are re-passable (within manufacturer’s guidelines). The patient should always have 1 spare NG or replacement balloon gastrostomy at home and/or school. We do not provide spares for Day Centres or for respite – patient should take spare from home or school with them.
Medicina NG Tubes Short Term Tubes (up to 30 days)
Long Term Tubes Are single use, and can be left in place up to 60 days.

Please note: only one size of enteral syringe can be supplied
4 per month

Please note: only one size of enteral syringe can be supplied (4 per month up to max. of 1 per day according to clinical need) ENFit 10ml – 113805 (64308) 20ml – 113825 (64309) (if smaller syringe size required)

We will provide up to 20 syringes (of the same size) per month for use at school/college if problems identified by CCN, or Nutrition Nursing teams.

Item ENFit Enteral Syringes for Bolus Fed Patients

Code

- Enteralok 60ml Female Luer Lock (ENFIT compliant 113807

from 01/06/2016)

(64349)

- Enteral UK Female Luer Lock 60ml (ENFIT compliant from 01.06.2016

113831 (88717)

- Flocare Bolus Feeding Set – (paediatrics only)

89752 (40334)

- Bolus Adaptor (Freka)

64921

ENFit Enteral Syringes for NJ and Jejunostomy Tubes

- Enteralok 60ml Female Luer Lock (ENFIT compliant 113807

from 01/06/2016

(64349)

- Enteral UK Female Luer Lock 60ml (ENFIT compliant from 01/06/2016)

113831 (88717)

Adult Requirements Bolus fed: 3 per week to max. of 1 per day according to clinical need/home situation

Paeds Requirements 1 per day

Comment

1 per bag of feed (if required)
1 per day

1 per feed 1 per bag of feed (if required)
1 per day

Only to be used if bags of feed to be used as boluses

Syringe for Balloon Check
Terumo 5ml Luer Slip Syringe Terumo 10ml Luer Slip Syringe

63426 64857

Up to 8 per month Up to 8 per month

Up to 8 per month Up to 8 per month

Use an appropriate size syringe dependent on size of balloon.

Flocare Flexicontainers - 500ml - 1000ml
Balloon Gastrostomies Dependent on patient/type of tube used
PEG Ends, Clamps and Fixation Devices

40441 40455

1 per 24 hours

1 per 24 hours (water only) or 1 per feed

The patient should always have 1 spare NG or replacement balloon gastrostomy at home and/or school. We do not provide spares for Day Centres or for respite – patient should take spare from home or school with them.

Contact Department to send out to patient 0121 446 1131

Item Extension Sets
- Corflo Y extension sets - Freka extension sets
Extension Sets for Buttons - GBUK 12” Luer Lock with cap - GBUK 12” Luer Lock without cap
- CORFLO CUBBY Right Angle 24” Feeding Set Right Angle 12” Feeding Set
- MICKEY SECURLOK 12” Extension Sets (VYGON ONLY)

Code 63991 6381
64387 63823 63898 63929

Adult Requirements Maximum 2 per month
As per manufacturers guidelines 2 per month

Paeds Requirements Comment

GBUK and Corflo ancillaries should be requested on a HomewardConnections

As per manufacturers guidelines
2 per month, unless specified need for school use

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MicKey
buttons, ext. sets, and other MicKey items can only be ordered on a Vygon form.
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Items to be ordered in exceptional circumstances (on a named patient basis) The items below will only be authorised once the ordering practitioner has discussed it with a dietitian or nutrition nurse in the Birmingham Community Healthcare NHS Trust.  2 way Pack Adaptor  Statlocks/Skin fix-it discs  Farrell Valves  If a patient is transferred into Birmingham on a different enteral feeding system please contact us  Sterile Water – only if patient is immunocompromised as per documented evidence from GP/consultant, or patient’s on a named basis after
discussion with BCHC Nutrition Support Team.
Items not funded by the department  Syringes for medication : ADULTS - dispensing pharmacy should provide either a medicine spoon or syringe for liquid preparations under a
5ml dose. Medication should be mixed with water and given whenever possible in a 60ml syringe via tube. District Nursing team should be contacted to order appropriate syringes for medication measuring if required – contact number 0300 555 1919 CHILDREN - CCN’s supply – 0121 245 5775 (option 1)
 Dressings for wounds: on prescription from patient’s GP/patient’s District Nurse/Nurse Prescriber

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Ancillary Item List