Why Commission or Contract Dietetic Services?
Many dietitians are involved in highlighting and driving demand for nutrition and dietetic services across the UK, demonstrating why these services are so vital to the health of the nation, while coming in on an increasingly limited budget that stands fully accountable at all levels.
It is important to be able to clearly understand nutrition and dietetic services available and their positive impact. Dietitians can deliver this understanding and they can also produce powerful data on services, which may be in the form of a performance scorecard, and include areas such as:
- Number of referrals and sources of referrals - consultant/practice/locality;
- Proportion of inappropriate referrals;
- Demand versus capacity information;
- Length of waiting list and how this has changed/is changing/other variations during the year;
- Where is the service(s) provided and access and by hard to reach groups;
- Percentage of DNAs and cancellations and any evident/emerging trends;
- How is the service paid for? Is the service undertaking activities that it is not paid to do?;
- What do patients think about the service? It is important that patients are included in the design and evaluation of services. This could be through different methods including focus groups, face to face interviews, case studies, patient stories and questionnaires;
- Skill mix - who delivers what parts of the service?;
- What competencies are needed to deliver the outcomes? Is there a gap between the competencies of staff versus the services required to be delivered?;
- What competencies do the team have, how else could these competencies be used?;
- Multi-professional or agency working – how does the service contribute to care pathways?;
- How does the service contribute to healthcare standards, implementing NICE, and other, guidance, implementing NSFs or reducing demand in other parts of the system?;
- What areas of good practice, case studies are there that could help demonstrate the service provided to patients?;
- What else does the service do which supports patients or other professionals to deliver nutritional care but which is not face to face contact and how much time does is allocated to this?;
- Can the service generate income? And if so how, and by how much?
These are just some quick examples of where dietitians can demonstrate the value and impact of their work.
Impact of Dietetics:
So, what is it that dietitians deliver? What is the impact of nutrition and dietetic services on the ground, on the health of the nation, where patients are the number one priority?
This section highlights key information for those considering commissioning or contracting nutrition and dietetic services directly, or services that may involve the need for nutrition and dietetic services.
This information is designed to help nutrition and dietetic services give an overview and describe the impact they have demonstrated, and could, across different clinical specialities and patient groups.
- Food Service, Food Provision and Food Quality.
- Improving Health and Wellbeing by Tackling Malnutrition.
- Nutritional Screening, Assessment and Treatment.
- Enteral Feeding.
- Parenteral Nutrition.
- Home Enteral Tube Feeding (HETF).
- Oral Nutrition Supplements.
- Reduction in Length of Stay in Stroke Patients.
- Fractured Neck or Femur (NOF) patients.
- The Impact of Dietitians on Better Health Outcomes for those with Musculoskeletal Conditions.
- Patients with Long-Term Conditions to Have a Care Plan Incorporating Nutritional Needs.
- Spinal Cord Injury (SCI) Care.
- Pre-Conceptual Care and Pregnancy.
- Infants, Pre-School, and School-aged Children.
- The Impact of Dietetics in Public Health.
- The Effectiveness of Education and Training by Dietitians.
The Human Impact: Case Studies
The following, real people case studies, are drawn from the BDA member publication, Know Your Worth - Trust a Dietitian (case for nutrition and dietetic services), [review date 2015]. These human expereince accounts are representative of merely the tip of the iceberg when it comes to the impact dietitians make on the health of the individual, and nation, on a day-to-day basis:
- A Patient with Irritable Bowel Syndrome (IBS)
- A 65-year-old Widow with Weight Management Needs
- A Female Weight Management Group Setting (GP referral)
- An Education Programme Benefitting a Diabetes Patient
- A Patient with an Eating Disorder