- Reference Number: HEY471/2026
- Departments: Nutrition Support
- Last Updated: 30 April 2026
Introduction
This leaflet has been produced to give you general information about your treatment. It will help you understand how Home Parenteral Support (HPS) works and answer most of your questions. It is not intended to replace the discussion between you and your doctor or specialist nurse but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the Hospital Intestinal failure Team caring for you.
What is Home Parenteral Nutrition (HPN)?
As you have been receiving Parenteral Nutrition treatment as an in-patient, a discussion will have taken place with your surgical team and yourself to explain the reason you may need to continue this treatment in the form of Home Parenteral Nutrition (HPN).
HPN is a treatment we continue to administer in your own home. This involves administering Parenteral Nutrition feed directly into your blood stream. The feed is given through a long term central venous catheter either through using a tunnelled line or a Peripherally Inserted Central Catheter (PICC) line using a special pump (These are explained later in this leaflet).
This nutrition is usually administered over a minimum of 12 to 14 hours during the night. Your feed and equipment are supplied by a commercial homecare company, but all other aspects of HPN are managed by the Hospital Intestinal Failure Service Team.
Why do I need Parenteral Nutrition?
Parenteral Nutrition is used when a person’s small bowel is not capable of absorbing enough food. This is called intestinal failure. It may be caused by a:
- Blockage of the intestine.
- Leak from a fistula or a false passage.
- Disordered movement of the small bowel.
- Shortened or otherwise damaged small bowel.
Intestinal failure may be temporary or permanent; your surgical team will discuss this with you.
HPS is also sometimes used to improve a person’s nutritional state prior to surgery. If you are not sure which of these applies to you, please ask your ward doctors or a member of the Hospital Intestinal Failure Team caring for you.
Can there be any complications or risks?
Serious problems are rare if the protocols and advice provided by the Intestinal Failure team are followed.
Dehydration can be a risk for some people (mainly people with high fluid losses) and will be monitored by the Intestinal Failure team.
As infection of the central line is a common complication, you will be trained to care for your line to reduce the risks. Your specialist nurse will discuss this further with you.
Blockage of a vein due to a clot (thrombosis) forming around the central line (thrombosis) is rare.
Both of these problems, however, require admission to hospital for treatment.
Bone disease and / or liver disease can occur over several years. You will receive ongoing monitoring.
What are the benefits?
The aim of HPS is to allow people with intestinal failure to go home and to live as normal a life as possible. Many people on HPS go out to work, look after a family, go on holiday and take part in sport and social activities like anyone else.
Are there any alternatives?
HPS is not usually considered if there is another way of keeping a person well nourished. If people cannot eat normally, a tube placed into the stomach or upper intestine is sometimes used for feeding. However, this does not usually work in people with intestinal failure.
How is Parenteral Nutrition given at home?
You will have either a Tunnelled central venous catheter or a Peripherally Inserted central Catheter (PICC) line inserted for HPS.
A tunnelled central venous catheter is a tube which is inserted into a large vein in the neck or shoulder. It is usually placed in theatre or the X-ray department using a local anaesthetic. The catheter is tunnelled under your skin for 2 to 4 inches and has a section outside the body with a small plastic clamp and a hub where feeds can be connected. Tunnelled catheters can have one external section (single lumen tubing) or two (double lumen tubing).
A PICC is a long thin flexible catheter that is inserted into a one of the veins in your upper arm. The tip of the PICC sits in the large vein above your heart, the other end of the PICC comes out of your arm and this is secured to your skin with a fixation device and clear adhesive dressing. A PICC can have one (single) or two (double) ends called lumens and the treatment you are having will determine how many lumens you require. Not everyone is suitable for a PICC your specialist nurse will assess and discuss your ongoing requirements with you.
When can I go home?
HPS usually takes several weeks to set up, this is because your hospital team need to try different types of Parenteral Nutrition regimes on you. Your team will explain the different bags they are using. The intestinal failure service carefully monitor your bloods, tailoring your unique prescription to your blood results.
It is straight forward in hospital to make changes to your prescription and administer additional fluids as required. But the process at home is more difficult and it takes a few weeks to make HPN prescription changes.
Whilst trialling your in-patient prescription, the nursing team will commence training your or someone close to you to safely administer your HPS and to care for your line.
They will also refer you to a commercial homecare company who will continue with training you at home. Your equipment order will be also completed by your specialist nurse. You will be provided with an estimated date of discharge. Your specialist nurse will explain everything to you and answer any additional questions you may have.
What support will there be for me at home?
Your specialist nurse will make arrangements for a nurse from the homecare company to visit you in hospital prior to discharge and will also arrange a home access visit with yourself or your carer before you are discharged home.
The homecare company will give you a 24-hour helpline telephone number for use out of hours if you have problems with any of the equipment or deliveries.
Contact details will be provided for members of the Hospital Intestinal Failure Team caring for you should you need to contact them.
Your General Practitioner (GP) will have details of the treatment you have received in hospital.
Your GP will monitor all other health concerns, including any non-nutrition or central venous access queries.
The Hospital Intestinal Failure Team caring for you will provide you with the following information just before you go home:
- Outpatient follow up arrangements: it is important that you attend these appointments regularly to ensure the team can continue to monitor you safely with your prescribed treatment.
- Arrangements for having repeat blood tests.
- Information about the Intestinal Failure Passport.
What information will people have about me?
Members of the Intestinal Failure team also hold their own records to enable them to look after you.
The homecare company need to know your name, address, telephone numbers and your GP’s contact details to be able to support you on discharge.
What happens if or when I do not need HPS any longer?
The Intestinal Failure team will continue to monitor you after your treatment has been discontinued.
The tunnelled line or PICC line are usually left in place for a few weeks after someone stops HPS, just in case there is a need to restart it.
Your homecare prescription and equipment are placed on hold with your homecare company. The Intestinal Failure team will arrange removal of the tunnelled or PICC line and equipment when it is certain that you no longer need HPS.
Where can I find out more about HPS?
Your Nurse will provide you with a copy of the ‘HPS Handbook for Patients,’ within the next few days. This will provide you with more information. Members of the Intestinal Failure team will answer any other questions you have.
PINNT: There is a patients’ organisation called ‘PINNT’ (Patients on Intravenous and Nasogastric Nutrition Therapy) which publishes a newsletter and other useful information. They can be contacted on:
PINNT,
PO Box 3126,
Christchurch,
Dorset,
BH23 2XS
E-mail: info@pinnt.com
Your specialist nurse will discuss the benefits of registering with this organisation and can help you to complete the registration form.
For further advice: if you require further advice on the issues contained in this leaflet, please do not hesitate to contact the nurse specialists on Tel: 07827 937025.
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
