5. Borderline Substances (ACBS)

Prescribing of borderline foods and dietary products should comply with the recommendations of the Advisory Committee on Borderline Substances (ACBS):

"Prescriptions for such products on FP10s are regarded as drugs for the treatment of specified conditions. Doctors should satisfy themselves that the products can safely be prescribed, that patients are adequately monitored and that, where necessary, expert hospital supervision is available."

In such cases, the prescriber must endorse the prescription with 'ACBS'. A complete list of conditions can be found in the BNF or Drug Tariff, Part XV. Most conditions can be included in the following categories:

  • Metabolic disorders
  • Liver disease
  • Dysphagia
  • Malnutrition (disease-related)
  • Renal Failure
  • Malabsorption states
  • Specific skin disorders
  • Gastrectomy
  • Inflammatory Bowel Disease.

There are several areas where prescriptions for dietary products do not comply with the above recommendations and responsibility lies with individuals GPs who may use their judgement to make exceptions to the above recommendations. This may occur following recommendations from a dietician or for a medical condition requiring nutritional support for a defined period of time. An example of the latter would be a patient having had maxillo-facial surgery, being discharged from hospital with a wired jaw and requiring nutritional support for six-eight weeks post-operation. Such a patient would be unlikely to receive adequate nutrition from a manageable volume of liquidised foodstuffs.



1. Enteral feeds (non-disease specific)

2. Nutritional supplements (non-disease specific)

3. Specialised formulas

4. Feed supplements

5. Feed additives

  • Feed thickeners and pre-thickened drinks

       Resources to support safer modification of food and drink 27           June 2018

  1. Instant Carobel powder (Cow & Gate Ltd)
  2. Nutilis® Clear (Nutricia Ltd) - subject to robost implementation plan - Oct / Nov 2018

6. Foods for special diets

7. Nutritional supplements for metabolic diseases




Last updated by: Dupe Fagbenro on 26-09-2018 10:13