Dietician

Overview

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 (NHSE, 2024)

Scope of Practice

Job Responsibilities

Dietitians are able to support patients with a range of conditions. This range will include the following*:

Diabetes (which may include assessing levels of motivation to support identification of appropriateness for very low-calorie diet programmes)
Weight management
Frailty
Functional bowel disorders and Coeliac disease

*This list may be expanded to include other areas of practice, such as paediatrics, dependent on the dietitians’ training, experience and scope of practice.

Entry Requirements

BSc in or pre-reg MSc in Dietetics
3 – 5 years post graduate
Registered member of the Health and Care Professionals Council (HCPC)
Able to operate at an advanced level of practice

Training and Development

Mandatory

Please see above ‘Entry requirements’

Standard (on entry to Primary Care)

First Contact Practitioner (FCP) Recognition

FCP roles began with the development of the FCP Physiotherapist in 2014, in response to the shortage of GPs in Primary Care. FCP roles are designed to support GPs as part of an integrated care team and to optimise the patient care pathway by seeing the right person in the right place at the right time.

To create sustainability for multi-professional FCP roles, there is a need to build a clear national Primary Care training pathway for clinicians moving into FCP roles and then onto Advanced Practitioner roles. Therefore the NHSE ‘Roadmaps to Practice’ were published to support educational pathways for clinicians.

Please find below links to the Roadmap to Practice which will help service providers, managers and Dietitians themselves to identify what training, qualifications and competencies they should have to safely and effectively practice at first contact practitioner levels.

What is First Contact Practice (Dietitians BDA)

Dietitian: First Contact Practitioners and Advanced Practitioners in Primary Care: (Dietitian) A Roadmap to Practice

The Post registration professional Development Framework (BDA)

Working alongside the ‘First Contact Practitioners AND Advanced Practitioners in Primary care (Dietician); Roadmap to practice (link above), FCPs must have completed both stage 1 and Stage 2 of the Roadmap to gain recognised First Contact Practitioner MSK status.

The Dietitian can be seen as a ‘trainee FCP’ until full FCP recognition is gained.
At present there are 2 main educational pathways by which one can train to be a First Contact Dietitian:

Via an FCP portfolio completely.
Via portfolio with taught routes via HEI’s. (This may include supported portfolio option, where HEI supports clinician with portfolio completion)

There are two stages to First Contact Practitioner recognition:

Stage 1: Preferably, must be completed with a portfolio of evidence and verified before employment in Primary Care. The KSA must be completed prior to employment as a FCP or AP in Primary Care to assure patient safety. For clinicians already working in primary care this can be completed retrospectively
Stage 2: Is completed with a portfolio of evidence, including formal module completion and is verified in Primary Care. This is the recognition process of the application of the KSA in Stage 1 to clinical practice in Primary Care. Best practice is that this should be completed within 6 – 12 months for a full-time member of staff but this can be longer provided a completion date is agreed with the employer.
‘Trainee’ FCP’s are advised to keep a folder of evidence ready to submit in the final stages of their pathway.

The British Dietetic Association have suggested other courses (list accessed via link below) which may support dietitians to meet some of the capabilities outlined in the roadmap: Education and Training – British Dietetic Association (BDA)

Education providers

There are education providers across the UK that are successfully running Dietitian FCP taught modules. NHSE has also provided funding support for applicants to attend these modules. All the providers have committed to taking learners from outside the region that they are based.

Please see information and links below to each provider for further information. If you are looking to enquire about an FCP taught module, please contact the education provider directly to discuss your individual requirements.

Additional Training opportunities

Advanced Practice Recognition

Please see link to the SNEE TH Advanced Practice page for full information.

Supervision Requirements

Supervision is a process of professional learning and development that enables individuals to reflect on and develop their knowledge, skills and competence, through regular support from another professional.

Supervision can have different forms and functions and a number of terms are used to describe these. For this guidance we use the below terms and define them as follows:

Clinic/practice supervision: day-to-day support provided by a named/duty senior/more experienced clinician for issues arising in the practice.
Clinical/professional supervision: regular support from a named senior/experienced clinician/practitioner to promote high clinical standards and develop professional expertise.
Educational supervision: supports learning and enables learners to achieve proficiency.

Supervision Guidance for primary care network multidisciplinary teams (NHSE, 2023)

Clinical and Education supervisors have an integral role to support learners through the FCP Recognition process and to provide assurance that the practitioner has demonstrated the knowledge, skills and attributes required to work in a FCP role in primary care. One of their key roles is to review a learner’s portfolio of evidence and decide whether the individual has met the requirements of an appropriate FCP Roadmap.

For both the FCP Supported Portfolio and FCP Taught routes, Clinical and Education supervisors will work with an education provider, as part of the institution’s quality assurance processes, to support the learner to meet the appropriate level 7 learning outcomes of the applicable FCP Roadmap. Supervisors will sign-off the portfolio of evidence on successful completion.

The route to becoming a supervisor for FCP recognition and training has recently been updated. Please see the ‘NHSE First Contact Practice FAQ’s’ page here for the latest updates on the process.

For further information regarding the FCP Roadmap pathway and processes, please visit: Roadmaps to Practice

Funding

AFC Band 7/8a

100% of actual salary plus defined on costs covered via ARRS Scheme.

Training and development funding

Dietitians may be entitled to wider NHSE commissioned funding to support their training and development requirements. Please contact the training hub for more information on this.

Recruitment Information

Where a PCN employs or engages a Dietitian under the Additional Roles Reimbursement Scheme, the PCN must ensure that the Dietitian meets the ‘Minimum Role Requirements’ stipulated in Annex B of the Network DES

Please find various resources in this section to assist in the recruitment and embedding of the Dietitian role in General Practice.