Dietitians have played a key role in the immediate response to COVID-19, be that working in ICU, introducing innovative digital clinics or supporting public health. However, going forward, there will be a significant increase in demand for dietetic services to support people in the community. These services will support people’s recovery, rehabilitation and reablement, aimed at improving their nutrition and hydration status to improve health and wellbeing and speed recovery from other health issues, including COVID-19.
Those in need of support will fall into different categories:
- Those returning home after hospital treatment for COVID-19 (which may or may not have involved ventilation). Early evidence shows many will be malnourished and may have swallowing difficulties.
- Those who have other existing health conditions who may have not been able to access support, and may have deconditioned during isolation/lockdown.
- People who have developed new nutrition related conditions as a result of isolation/lockdown.
- Population level support to improve physical and mental health that may have been impacted by lockdown.
To meet the significant increase in demand, it is vital that health and care services plan for and put in place comprehensive and expanded community services that involve dietitians as part of the rehabilitation MDT. Governments must make sure that they provide the resources and funding to health and social care trusts, boards and partnerships to enable them to do this.
Longer term governments and healthcare services must look at how we can expand dietetic capacity and ensure more dietitians and other community healthcare professionals can be trained.
Chief Allied Health Professions Officers in all four nations have recognised the critical role dietitians and other AHPs will have in providing rehabilitation services during and after the COVID-19 pandemic. We need to build on this.
What is the BDA doing?
The BDA is championing the role of dietitians in community rehabilitation and reablement as a key part of the response to the next phase of COVID-19.
- Producing guidance and policy positions (see below) relevant to this topic to support members to provide community nutrition rehab and reablement.
- Building evidence around the needs and demand for dietetic services during and post-COVID.
- Pushing governments and national health services throughout the UK to recognise the vital role of dietitians in the response to COVID-19 and its aftermath.
- Working alongside other AHP bodies to lobby government and parliamentarians to introduce independent prescribing for dietitians. This adds another tool to community dietitians’ arsenal.
- Working alongside other AHP bodies on their Right to Rehab campaigns where appropriate.
- Supporting members to make use of digital solutions to meet the challenge of additional demand.
- Joining the Community Rehab Alliance alongside other AHPs and Charities with an interest in rehab.
What do we need members to do?
Members, especially those working in community services, will need to make sure the dietetic voice is heard as part of the post COVID-19 response.
- Ensure that your team are a part of the conversation about post-COVID discharge and community rehabilitation services. If you want advice on engaging your local leaders, read our influencing guidance.
- If you are a manager, please respond to our survey questions to help us build a picture of demand and service needs when they are circulated.
- Inform the BDA of what you and your service are doing that could be shared with other dietetic teams – get in touch firstname.lastname@example.org
- Gather data, especially on outcomes, to evidence the impact and importance of your services.
More information and useful links
- Nutrition and the Post-COVID discharge pathway - Policy Statement
- COVID-19 Clinical Guidance
- COVID-19 Community Guidance
- BDA Malnutrition Campaign
- Digital Tools: Rapid Implementation guidance
- Consultation responses
- Your COVID Recovery programme - developed with input from the BDA
- After-care needs of inpatients recovering from COVID-19 (NHS England)
- Intensive Care Society: Framework for assessing early rehabilitation needs following treatment in intensive care
- NHS RightCare Community Rehabilitation and Frailty toolkits (where malnutrition is identified as a key factor)
- CSP/RCOT Right to Rehab Campaign
- AHPF letter to Health Select Committee Chair Jeremy Hunt
- Rehabilitation: A Framework for Continuity and Recovery 2020-21 (Welsh Government)
- NHS Education for Scotland TURAS Learn COVID-19 site. A growing list of resources. Includes sections for people working in community settings, people’s homes and care homes, remote consulting and tools and apps.