Concierge nutrition · UK
Home enteral nutrition, set up properly and looked after.
Tube feeding at home — NG, PEG, PEG-J or RIG — coordinated by a consultant gastroenterologist, a specialist dietician and a home enteral service that turns up on time.
Why patients choose us
- 01
A consultant-led decision, not a default
Whether a tube is the right step — NG, PEG, RIG or none — is a decision made with a gastroenterologist and dietician, not a discharge planner in a hurry.
- 02
The home service set up properly
Nutricia, Fresenius Kabi, Abbott or Nestlé — the right feed, the right pump, weekly deliveries, and a community dietician who actually calls back.
- 03
Independent, and free
We are paid by no feed company or home care provider, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private home enteral nutrition costs in the UK.
Indicative ranges across our partner clinics and home enteral providers. NHS provision via the ICB is free at point of use for eligible patients.
In short
A PEG in our network: £2,800–£4,800, then a home service from £450/month.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Gastroenterology + dietician assessment | £350–£650 | 60–90 min | Same visit |
| NG tube placement (fine-bore, pH-checked) | £250–£600 | 30 min | Same day |
| PEG insertion (day-case OGD-guided) | £2,800–£4,800 | Half-day | Same day |
| RIG insertion (radiologically guided) | £3,200–£5,500 | Half-day | Same day |
| PEG-J / jejunal extension | £3,400–£5,800 | Half-day | Same day |
| Home enteral feed service (monthly) | £450–£1,200/mo | Ongoing | Weekly delivery |
Prices vary by hospital, by which consultant places the tube, by feed formulation and by whether the home service is delivered privately or via an ICB-commissioned provider. We come back with a firm quote and funding route within one working day.
The problem
The right tube, the right feed, the right team at home.
Discharge from hospital with a feeding tube and no plan is the commonest reason home enteral nutrition goes wrong in the first month. We fix that before anyone leaves the ward.
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Not sure a tube is needed?
Sometimes it is not — a supplement, oral thickener or an SLT plan may do the job. We say so before you agree to a PEG.
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Worried about complications?
Refeeding, aspiration, blockages, buried bumper — real risks with proven playbooks. We build the plan around them.
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Want it looked after at home?
A named dietician, a home enteral provider that turns up, and a 24-hour helpline that actually picks up.
The journey
From enquiry to feed at home — what happens, in order.
One team from first message to the annual review — consultant, dietician, community nurse and home enteral provider.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Tube placement and set-up
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, swallow, weight loss, current feeding, and what has been offered so far.
- 02
Before
We come back with a recommendation
Within one working day: gastroenterologist and dietician review, the right tube and feed regime, an indicative price and route to funding.
- 03
Before
We arrange the assessment
Usually within one to two weeks. Swallow assessment (SLT), nutritional screening (MUST), and refeeding-risk stratification per NICE CG32.
- 04
On the day
Tube placement
NG at the bedside with pH-confirmed placement, PEG or RIG as a day-case in endoscopy or interventional radiology.
- 05
On the day
Home enteral service set-up
Pump, giving sets, feeds, syringes and cleaning kit delivered to your door. Two to three training sessions for you and family.
- 06
On the day
Home the same day (or next)
NG and PEG are usually day-case. First feeds are slow and monitored; you go home with written instructions and a 24-hour helpline.
- 07
After
Community follow-up and annual review
Community dietician and nurse team on call for problems. Annual dietetic review, tube changes at 3–6 months for balloon devices.
Typical set-up: 1–3 weeks from enquiry to first feed at home. Ongoing: annual review.
When it helps
When home enteral nutrition is the right step.
The situations we see most, plus the one red flag — refeeding risk — that means slow feeding and daily bloods, not a quick start.
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Dysphagia after stroke or MND
An unsafe swallow after stroke, motor neurone disease, Parkinson’s or advanced dementia — often the trigger for a PEG.
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Head & neck cancer treatment
Chemoradiotherapy for oropharyngeal cancers frequently needs a PEG or RIG in place before treatment starts.
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Cannot meet needs orally
Chronic illness, IBD flare, cystic fibrosis or cachexia where oral intake simply cannot keep up with what the body needs.
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Altered upper GI anatomy
After oesophagectomy or gastrectomy, or with severe reflux, a jejunostomy may be the safer route for feeding.
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Gastroparesis and dysmotility
Delayed gastric emptying — diabetic, post-viral or idiopathic — often needs post-pyloric (NJ or PEG-J) feeding.
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Paediatric — CF, CP, failure to thrive
Cystic fibrosis, cerebral palsy, severe reflux or infants failing to thrive — a low-profile button gastrostomy is usually the plan.
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Short-term nutritional support
A fine-bore NG for a few weeks bridges people through an acute illness without committing to a gastrostomy.
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Red flag: refeeding risk
Severely undernourished patients (BMI <16, negligible intake >10 days) need slow feed introduction, thiamine cover and daily bloods — per NICE CG32.
Tube options
A PEG is not the only route.
What each tube type actually involves — and which one fits which problem. Feeds run as continuous overnight pump, gravity bag, or bolus by syringe.
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Nasogastric (NG) — short-term
Fine-bore 8–12 Fr tube passed at the bedside. pH-checked placement (aspirate <5.5) per NHSPS. Usually for less than 4–6 weeks.
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Nasojejunal (NJ) — post-pyloric
Placed endoscopically or radiologically past the pylorus. Used for gastroparesis, pancreatitis or high aspiration risk.
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PEG — the workhorse
Percutaneous endoscopic gastrostomy. Day-case, 20–24 Fr, OGD-guided. The standard for long-term (>4–6 weeks) home enteral feeding.
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PEG-J or JET-PEG
A PEG with a jejunal extension threaded through it — for gastroparesis or when gastric feeding is not tolerated.
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RIG — radiologically inserted
Image-guided gastrostomy with T-fasteners. Used when an obstructing head & neck tumour prevents OGD access.
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Surgical gastrostomy / jejunostomy
A laparoscopic or open route when PEG is not feasible — adhesions, prior gastric surgery, unusual anatomy.
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Balloon-retained tube
A replacement gastrostomy tube held by a water-filled balloon. Swapped every 3–6 months by a trained nurse or carer at home.
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Low-profile (button) gastrostomy
A discreet skin-level device for children and paediatric transition — easier under clothes, kinder for body image.
Our vetted UK network
A small panel of gastroenterologists and dieticians, we picked them.
Consultant gastroenterologists, interventional radiologists and HEN-specialist dieticians across the UK. Not listed publicly — introductions are made privately, once we understand the case.
Selection criteria
How we choose every clinician and provider in our network.
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Consultant gastroenterologists and interventional radiologists, not trainees
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Specialist HEN dietician allocated for the life of the tube
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Commissioned home enteral feed provider (Nutricia, Fresenius Kabi, Abbott, Nestlé)
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24-hour community nurse helpline for blocked tubes, leaks and displacement
Safety and recovery
What to expect at home — honestly.
Home enteral nutrition is safe and life-changing when it is planned properly. The complications worth planning for are refeeding syndrome, aspiration, blocked tubes and the social adjustment.
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Refeeding syndrome is the biggest risk
Severely starved patients get dangerously low phosphate, potassium and magnesium when fed. Slow reintroduction, Pabrinex and daily bloods — NICE CG32.
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NG placement is a Never Event if wrong
The pH-aspirate rule (or CXR) is not optional. Feeding into the lungs from a misplaced NG tube is on the NHSPS Never Events list.
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Blockages — flush before and after
The commonest problem at home. 30 ml of water before and after every feed and every medication. Crushed tablets are usually not appropriate — ask the pharmacist.
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Stoma-site infection is the top PEG issue
Redness, discharge or pain around the PEG site is common in the first weeks — usually treated with topical or oral antibiotics.
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Buried bumper syndrome
The PEG’s internal disc can erode through the gastric mucosa if left too tight. Weekly rotation and gentle in-and-out movement prevent it.
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Aspiration pneumonia
Head of bed at 30–45° during and after feeds. For high-risk patients, jejunal feeding (NJ or PEG-J) reduces the risk.
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Diarrhoea and constipation
Feed rate, formulation, medication sorbitol, C. difficile — the dietician troubleshoots systematically rather than blaming the feed.
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Fluid balance matters as much as calories
Dehydration and fluid overload are both common. Water flushes are part of the prescription, not an afterthought.
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The social loss is real
Meal-times are social. Losing them — or eating alongside a pump — is a genuine adjustment for patients and families. It is worth naming.
Reading your feed regime
Your feeding plan in four parts. Read the last one first.
Whichever tube and feed you are on, the plan the dietician sends home keeps to the same shape.
A quiet reminder
Feed plans use dietetic shorthand — we translate it into a daily routine you can actually follow.
If you would like us to talk you through the plan before the community team takes over, just ask.
- 01 Regime
Feed, rate and route
The feed prescribed (polymeric, peptide, disease-specific), the daily volume, the rate in ml/hour and whether it runs overnight or as boluses.
- 02 Targets
Energy, protein and fluid targets
Daily kcal, protein grams and total fluid — including water flushes. Set by the dietician against your weight, activity and clinical goals.
- 03 Monitoring
Bloods, weight and tube checks
How often bloods (U&E, magnesium, phosphate, LFTs) are done, weight targets, and when the tube is next reviewed or replaced.
- 04 Plan
Escalation, weaning and review
Read this first: when to call the helpline, plans to wean back to oral intake if possible, and when the annual dietetic review is scheduled.
Recognised by major UK insurers
Cover for PEG or RIG insertion varies by insurer and by indication — the ongoing home enteral service is usually delivered via the NHS ICB regardless. We confirm the funding route before booking.
Frequently asked
Everything we get asked about home enteral nutrition.
Quick answers on tube choice, cost, NHS funding, complications and life at home with a PEG.
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What is home enteral nutrition (HEN)?
Feeding delivered into the gastrointestinal tract through a tube — nasogastric, nasojejunal, PEG, PEG-J, RIG or surgical — while the patient lives at home rather than in hospital. It is coordinated by a specialist dietician, a home enteral feed company and a community nurse team.
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Who needs a feeding tube at home?
Most commonly people with dysphagia after stroke, motor neurone disease, Parkinson’s, dementia or head & neck cancer; patients who cannot meet nutritional needs orally through chronic illness or cancer treatment; and children with cystic fibrosis, cerebral palsy or severe reflux.
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NG or PEG — which tube is right?
A nasogastric tube is used for short-term support, usually under four to six weeks. A PEG (percutaneous endoscopic gastrostomy) is the standard for longer-term feeding. A RIG is used when a head & neck tumour blocks endoscopic access, and a PEG-J when the stomach itself does not empty well.
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How much does home enteral nutrition cost privately in the UK?
Gastroenterology and dietician assessment is £350–£650. PEG insertion is £2,800–£4,800 as a day-case, RIG £3,200–£5,500. The ongoing home enteral service — pump, feeds, giving sets, dietician — is £450–£1,200 per month. NHS provision via the ICB is free at point of use.
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Is HEN paid for by the NHS?
Yes. Home enteral feeds, pumps, giving sets and community dietetic support are commissioned by Integrated Care Boards (ICBs) and delivered by companies such as Nutricia Homeward, Fresenius Kabi HomeCare, Abbott and Nestlé Health Science — free at the point of use for eligible patients.
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What are the biggest risks?
Refeeding syndrome in severely undernourished patients, aspiration pneumonia, tube blockage, PEG stoma-site infection and buried bumper syndrome. Refeeding is the one to fear most and is why NICE CG32 mandates slow reintroduction with thiamine cover.
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Can I still eat and drink with a feeding tube?
Often yes — many people with a PEG continue to eat safely for pleasure while getting the bulk of their nutrition through the tube. Whether it is safe depends on the swallow assessment done by the speech and language therapist.
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How long does a PEG last?
The original PEG can stay in for one to two years or more. When it is replaced it is usually swapped for a balloon-retained tube or a low-profile button, changed every three to six months by a trained community nurse or by carers at home.
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What happens if the tube blocks or falls out?
Blockages are usually cleared by flushing with warm water. A displaced NG tube is replaced and pH-checked before the next feed. A gastrostomy tube that falls out is a same-day problem — the stoma can close within hours, so the on-call community team or A&E should be contacted straight away.
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When should I call the helpline urgently?
A gastrostomy tube that has fallen out, heavy bleeding or leakage around the stoma, spreading redness, high fever, sudden breathlessness after a feed, or signs of refeeding syndrome (weakness, palpitations, confusion) — all reasons to call the 24-hour community team or A&E the same day.
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