Dietitians are healthcare professionals that diagnose and treat diet and nutritional problems, both at an individual patient and wider public health level. Working in a variety of settings with patients of all ages, dietitians support changes to food intake to address diabetes, food allergies, coeliac disease and metabolic diseases. Dietitians also translate public health and scientific research on food, health and disease into practical guidance to enable people to make appropriate lifestyle and food choices.
Dietitians working within primary care networks would be included as essential members of the general practice team, and would support and enable patients to self-manage their conditions. They are trained in behaviour modification methods and motivational interviewing. The role can also provide primary care diabetic services that include dietary, lifestyle and medication modification, and in some cases is that as a result patients do not need to see their GP for insulin and antidiabetic agent modification. The Dietitian would act as a first contact role to make initial assessments and refer on to the GP according to red flags symptoms.
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Dietitians must be registered with the Health and Care Professions Council (HCPC). To register with the HCPC, completion of an approved degree in dietetics is required. This is usually a BSc (Hons) degree, although there are shortened postgraduate programmes available. A degree apprenticeship standard in dietetics has also been approved.
- Health Education England Primary care FCP training must be completed as the minimum threshold for entry to primary care and be supported by appropriate governance and indemnity.
- Health Education England primary care FCP training can begin 3-5 years postgraduate
- Advanced Dietitians can now train to become supplementary prescribers.
Supervision for Dietitians in Primary Care
Appropriate supervision will be required for all dietitians working in Primary Care.
Existing GP Tutors are able to supervise dieticians undertaking FCP and AP roles and do not need to attend additional training.
GPs who have completed the First Contact Practitioner Supervisor Development two day course can provide clinical supervision to dieticians undertaking FCP and AP roles.
Benefits to patients
- Receive advice on eating habits to help the patient improve their health and wellbeing
- Receive a tailored eating plan
- Receive support to manage conditions including diabetes, heart disease, being overweight and obesity, cancer, food allergies and intolerances
- Longer consultation times with dietitians leading to improved outcomes
Benefits to PCN’s
- Upskill other primary care professionals in nutrition
- Deliver more collaborative and coordinated nutrition care alongside their colleagues to benefit patient care
- Help to get patients better and keep them well
- Dietitians have the potential to reduce the demand on GP time by patients because their services are effective.
Benefits to the wider NHS
- Assist in reducing costly A&E attendances and avoidable hospital admissions by helping patients maintain their health and wellbeing through a healthy balanced diet
- Teach and inform the public and health professionals about diet and nutrition
- Work to ensure nutrition is included as a priority in patient care.
The role of the Dietitian could include the following activities:
- See patients with a wide range of different conditions via a range of different means e.g. one to one consultations, via email, telephone, virtual, domiciliary visits and visits to care homes
- See patients from primary care who self-refer with a predetermined and agreed range of symptoms and/ or conditions.
- Receive and respond to patient referrals from GPs, practice nurses, health visitors, district nurses, nursing home nurses, allied health professionals for example.
- Prescribe appropriately for management of long term conditions such as for diabetes, renal disease and pancreatic disease (if qualified to prescribe).
- Manage appropriate use of nutrition supplements and feeds, from commencement to review to discontinuation.
- Undertake health promotion activities such as/ and if appropriate, Health Checks.
- Utilising behaviour change skills and follow up patients when deemed necessary.
- May be involved in delivering patient education sessions (often jointly with other healthcare professionals) e.g. for diabetes, weight management.
- May be involved in delivering nutrition training for primary care and nursing home staff e.g. malnutrition screening, making an appropriate referral.