NHS Dietitian’s Unconventional Advice Sparks Review
A registered dietitian working with the National Health Service (NHS) has found herself under intense scrutiny following a series of unconventional and questionable recommendations made to patients. Aparna Srivastava, a locum dietitian, has faced a professional review after advising patients on a range of practices that have raised serious concerns about her clinical judgment and suitability for patient care.
Her tenure at an NHS healthcare practice in Hull, East Yorkshire, was relatively brief, lasting only four months before emails she sent to a colleague brought her methods to light and prompted an investigation into her fitness to practice.
A String of Baffling Recommendations
Ms. Srivastava’s advice to patients often lacked clear clinical justification and included some highly unusual suggestions. For instance, she reportedly advised one patient, identified as Patient A, to consume apple cider vinegar, specifically recommending only Bragg or Aspall brands. This patient was also instructed to drink eight glasses of tepid water daily and to chew each mouthful of food an astonishing 32 times before swallowing.
Perhaps one of the most striking recommendations was made to a 91-year-old Parkinson’s sufferer. This elderly patient was advised to try Sahaja Yoga, a practice founded in 1970 with the stated aim of achieving “thoughtless awareness and self-realisation by awakening inner Kundalini energy.”
Further dietary advice for this patient included incorporating root vegetables, drinking lemon ginger juice, Manuka honey, and black pepper in hot water each morning, consuming kefir daily, and using the grated rind of unwaxed lemons to combat a bad taste in the mouth. The professional panel reviewing the case noted that there was no documented clinical rationale for these recommendations, leaving fellow clinicians unable to understand the basis for such advice.
The panel heard that for another patient, Ms. Srivastava suggested drinking warm water upon rising and before meals. Additionally, she recommended listening to flute music by Pandit Hariprasad Chaurasia. When questioned, Ms. Srivastava explained that she suggested the music as a method for stress reduction. This was consistent with her advice to another patient, whom she recommended listening to Classic FM at night, both first thing in the evening and last thing before bed, also for stress relief.
The Health and Care Professions Tribunal Service (HCPTS) panel acknowledged that while recommending Classic FM without explanation or clinical reasoning fell below expected standards, it was not deemed serious enough to constitute professional misconduct due to the lack of clear risk of patient harm. However, the panel did find grounds for a lack of competence, citing these instances as examples of the dietitian providing non-standard advice without adequate explanation or clinical reasoning.
Concerns Over Cancer Advice and Gluten Intolerance
Further compounding concerns, Ms. Srivastava was found to have recommended pearl barley, a source of gluten, to a patient diagnosed with coeliac disease. Coeliac disease is a serious autoimmune condition where the consumption of gluten can lead to damage to the lining of the small intestine. She also reportedly advised fizzy drinks to patients whose conditions made them unsuitable for such beverages.
A significant turning point in the review came when Ms. Srivastava, in February 2018, emailed a colleague, referred to as Colleague C, with alarming claims about cancer treatment. In this email, she stated that cancer does not spread without sugar and would die on its own without it. She further asserted that consuming a whole lime in warm water was “1,000 times” more effective than chemotherapy and that three spoonfuls of organic or virgin coconut oil each morning could prevent cancer.
This alarming message prompted the colleague to report Ms. Srivastava to her superiors, initiating an inquiry. Ms. Srivastava’s defence was that she was merely relaying information to highlight bad advice about cancer treatment that she had received from a third party. However, this explanation was rejected by the healthcare practice.
The HCPTS panel heard that Ms. Srivastava admitted the content of the WhatsApp message was not good advice. She claimed to have informed Colleague C of her concerns about the spread of such advice among patients, which led to her forwarding the message. Colleague C, however, did not recall any prior conversation on the topic and understood the WhatsApp message to be Ms. Srivastava advocating for these nutritional approaches to cancer treatment.
Professional Consequences and Ongoing Review
The cumulative effect of these incidents led to Ms. Srivastava being subject to a two-year conditions of practice order from the HCPTS, focused on further training and supervision. Following the expiry of this order, she was suspended for six months. Most recently, she has been suspended for an additional six months while her professional standing continues to be reviewed. This ongoing review will determine the long-term implications for her ability to practice as a dietitian within the NHS.
