Environmental Sustainability in the UK Home Enterally Tube Fed Population: A Healthcare Professional Survey

This report presents findings from a survey conducted in April 2025 by BAPEN’s Malnutrition Action Group (MAG), the BAPEN Sustainability Specialist Interest Group, and the British Dietetic Association (BDA) Parenteral and Enteral Nutrition Group (PENG).

The survey gathered responses from 142 healthcare professionals (HCPs) working in Home Enteral Tube Feeding (HETF) across the four nations of the UK. The survey explored clinicians’ beliefs, barriers to sustainable practice, and key areas of waste within HETF pathways. The insights have informed recommendations for future collaboration with patients, carers, advocacy groups, and homecare companies to develop innovative, patient-centred, and environmentally sustainable enteral feeding services that maintain safety and wellbeing.

The NHS currently supports over 40,000 individuals with HETF in the UK who are unable to meet their nutritional needs orally. While guidelines exist for the safe administration of HETF and best practices have been explored, the environmental impact of HETF requires greater attention to meet the NHS’s Net Zero target by 2045.

Major contributors to HETF’s carbon footprint include hospital admissions, home visits, and the production, transport, and disposal of feeds and equipment. Additional environmental concerns involve significant plastic waste and the disposal of unused feed into sinks, which may contribute to eutrophication5 – a risk exacerbated by oversupply and incorrect deliveries.