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At a specialist paediatric centre, with 378 beds including a 31-bed paediatric intensive care unit, an expert Nutrition Support and Intestinal Failure Team (NSIFT) was established in 2014. This funded team was designed to oversee parenteral nutrition (PN) provision for all type 1 and 2 intestinal failure patients, with an aim to reduce PN wastage and increase PN standardisation. 1 NSIFT review approximately 400–450 patients per year. The hospital does not have an aseptic manufacturing unit, therefore all PN is procured from external suppliers with strict deadlines. PN is provided either as bespoke/compounded bags or standard bags.The aim of this project was to review if NSIFT have had a sustained impact on PN usage (bespoke versus standard) and PN wastage over the last 10 years.Data was collected from the pharmacy PN database from 2016 onwards, due to data record availability):Number of PN referralsBespoke versus standard PN numbers and costsPercentage of wasted PNNSIFT activityAverage number of PN referrals was:In 2016, average 26/monthIn 2020, average 39/monthIn 2024, average 32/month (23% increase in PN referrals)PN usageTotal PN provision (mean PN usage) was:In 2016, 756 bags/monthIn 2020, 603 bags/monthIn 2024, 568 bags/month (25% reduction in PN provision from 2016)Standard PN usage – see figure 1Of PN provided, percentage of standard PN was:In 2016, 14%In 2020, 31%In 2024, 35% (20% increase in standard PN usage since 2016)PN wastageIn 2016, 3% of PN was wastedIn 2020, 4% of PN was wastedIn 2024, 5% of PN was wastedNSIFT has had a continued positive impact on PN usage in the hospital. The team’s interventions have resulted in lower PN usage and, with higher patient numbers, this suggests that patients have shorter episodes on PN. Individualised patient care plans offer better patient outcomes, reduce length of stay in hospital and provide significant cost savings. NSIFT continue to look for quality improvement opportunities to optimise PN, including timely weaning off PN and using standard PN more proactively. Using clinical expertise, the team have increased the portfolio of standard bag available. Interventions by the team have results in a 20% increase in standard PN usage from 2016 to 2024, which has resulted in at least £200,000 cost saving.Abstract OC18 Figure 1Percentage of standard PN bags usedPN wastage is multifactorial, and there is still work to be done to achieve a sustained reduction in PN wastage. NSIFT are considering tools that can be implemented to support the appropriate prescribing of PN, including education and training to medica/surgery teams, tailoring support provided to teams and sharing the data collected to highlight the cost burden of wasted PN.Reference Butcher M, Johnson T, Chana G , et al. Sustained clinical and financial benefits of a nutrition support team. Frontline Gastroenterology 2021;12:A6-A7.