Dietitian

How to access a Dietitian within a Primary Care Network

There are several ways to access a dietitian through DES in a PCN, these include:

• • A service level agreement with a local NHS trust dietetic department – this is likely to be the preferred option for most PCNs as training, profession-specific supervision and mentoring will already be in place, along with cover for annual leave, sickness and maternity leave. It also prevents potential duplication of services
• • Service contract with a freelance dietitian – working on a contractual basis
• • A dietitian employed directly by the PCN.

The HCPC requires that dietitians participate in training, supervision (continuing professional development and clinical) and mentoring. As local NHS trust dietetic departments have a structure in place to support this, this may be the preferable option for both the PCN practice and dietitian.

Information can be found at BDA Dietitians in Primary Care: A Guide to General Practice

How can Dietitians help with prevention, achieving QOFs and reducing costs?

Dietitians are able to support General Practice in multiple ways across multiple conditions. This can be either by working to prevent diseases from occurring, reducing costs to surgeries and assisting surgeries in achieving QOF.

Prevention

By working with patients, Dietitians can support those with prediabetes / Type 2 diabetes by referring them to relevant programmes. In addition, they can offer advice on diets, such as the Mediterranean diet, which may protect against dementia or other conditions. (1)(2)

Alongside this, Dietetic advice for IBS can reduce referrals to secondary care, reduce symptoms and improve the quality of life for patients. (3)

Reducing Costs

In some circumstances, Dietitians within General Practice can help to reduce the cost to surgeries and patients. One study showed how dietetic input not only improved improvements around weight, BMI and grip strength in frailty patients but also cost savings when reviewing oral nutritional supplements. (4)

Case Study – PCN Dietitians in Birmingham

In Birmingham, a case study was conducted to show the impact of Dietitians within General Practice. The following results were observed:

• Reduced inappropriate use of oral nutritional supplements and trained Primary Care and Care Home staff.
• In the first 12-15 months we have achieved:
  • >600 GP appointments saved
  • >£70,000 savings in inappropriate prescribing
  • Reduced waiting times: most patients get access to a PCN dietitian within 1 week.
• Very positive patient feedback: e.g. “Truly made a difference to my physical health and mental wellbeing”

Further results and information can be found here.