Dietitians: The key to unlocking prevention and early intervention
Dietitians offer many of the solutions our health service needs. This manifesto outlines how politicians can support them to deliver the work that keeps people healthy and well for longer.
Northern Ireland’s health service has reached a pivotal moment.
Over 50% of the NI Executive budget is spent on health and social care, and yet the needs of the population are not being met. 55% of outpatients are waiting over a year for a first appointment, with some specialities seeing particularly high waits; at the start of 2026 over 32,000 people were waiting on a first appointment for gastroenterology.
Societal conditions are partly to blame for the rising need for health intervention. By 2024, around 1 in 5 households in Northern Ireland were experiencing food insecurity, and households in the most deprived areas were twice as likely to be food insecure than households in the least deprived areas. Children are at particular risk of living in a food insecure household, with one in three (32%) children in Northern Ireland growing up in food insecure households.
Deteriorating societal conditions, coupled with an ageing population means that the need for healthcare is likely to rise in years to come. And so, it is now widely accepted that we need to do things differently in order to deliver a health service which meets the needs of our population. We must shift our focus from treating illness, to creating wellbeing.
The launch of the Neighbourhood Model of Health and Wellbeing signals a shift towards a healthcare system centred on prevention and early intervention. We believe that dietitians are well-positioned to be leaders in this space.
Nutrition is one of the most powerful, evidence-based tools we have to prevent ill health and reduce health inequalities. Therefore, it is more important than ever that the dietetic workforce is empowered to deliver the greatest possible impact for patients, communities and the wider health service.
That’s why we’re calling on the next Northern Ireland government to tackle malnutrition with dietetic expertise, develop the dietetic workforce, invest in education and training.
Tackle malnutrition with dietetic expertise
Good nutrition helps to keep people well for longer. It allows our bodies to fight off infection, and helps us to get better, faster when we’re sick or injured. Tackling malnutrition requires a society wide approach, embedding healthy habits from a young age, and creating a food environment that supports people to make healthy choices.
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Update the Promoting Good Nutrition Strategy through a dietetic-led review and make nutrition one of the core foundations of Neighbourhood Model of Health and Wellbeing. Northern Ireland’s main strategy for managing malnutrition – the Promoting Good Nutrition Strategy – is now ten years out of date. It no longer reflects the most up to date dietetic guidance on malnutrition, and nor is it designed for the reality of today’s health service and population needs. By aligning best practice with a strong emphasis on prevention and early intervention, an updated strategy would have a significant impact across all aspects of the health service.
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Develop dietetic-led specialist services in areas of increasing demand by investing in advanced practice roles in gastroenterology, obesity and diabetes. Rising rates of obesity, diabetes and gastro conditions mean more people need specialist support. Investing in advanced practice dietetic roles in these services will help people receive treatment earlier, which can improve outcomes and reduce avoidable demand on the wider health service.
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Embed healthy nutrition habits from a young age by introducing universal free school meals in primary schools, supporting schools to adopt a ‘Whole School Food Approach’, and ensuring the Public Health Dietitians have the funding they need to deliver early years training. Poor nutrition in childhood can lead to avoidable disease and can increase the need for health interventions later in life. Universal free school meals play a role in helping children to embed healthy eating habits from an early age, and can help to reduce the prevalence of obesity in children.
Why this matters
Research indicates that malnutrition costs the UK more than £23 billion each year. In Northern Ireland it affects 5% of the population, and around 14% of people over 65. Malnutrition can significantly worsen health outcomes, whereas meeting people’s nutritional needs helps them stay well, independent, and out of hospital for longer.
Dietitians are qualified and regulated healthcare professionals with specialist expertise in nutrition and dietary health. They play a vital role in preventing, identifying and treating malnutrition, while also supporting people to manage long-term conditions and improve their health through nutrition.
By modernising Northern Ireland's approach to nutrition and malnutrition and supporting dietitians to use their expertise to shape food and nutrition policy, we can improve health, reduce pressure on health and social care services, and help more people to live healthier, more independent lives.
Develop the dietetic workforce
To meet the goals of the Health and Social Care NI Reset Plan, and the Neighbourhood Model of Health and Wellbeing, we need a strong and sustainable dietetic workforce. Long-term workforce planning, investment in modern ways of working, and fair reward for staff are essential to ensure patients can access timely, high-quality dietetic care.
How:
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Deliver a long-term allied health professions workforce strategy, backed by multi-year funding. This should prioritise retaining locally trained dietetic graduates and creating clear progression pathways for dietitians and dietetic support workers.
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Build the infrastructure that allows the dietetic workforce to work at the top of their profession by investing in digital upgrades, supporting the introduction of independent prescribing rights and investing in more dietetic-led services in primary care, including first contact dietitians. By supporting more dietitians to provide services in primary care, we can reduce the pressure on other medical professionals, and develop service models that allow patients to access specialist care faster, and closer to home.
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Guarantee fair pay for the dietetic workforce through pay parity with the rest of the UK, timely implementation of pay awards, and improved progression opportunities across all career stages. This includes addressing real-terms pay decline through above inflation pay rises and ending the cycle of late pay awards in Northern Ireland through multi-year budgeting.
Why this matters
Northern Ireland cannot improve health outcomes or shift towards prevention without the workforce needed to deliver it. Demand for dietetic services continues to grow as more people are living for longer, developing long-term conditions, and facing more complex nutritional needs.
Dietitians improve outcomes across the health service, but workforce shortages, limited career progression and outdated infrastructure mean individuals are not always able to access their expertise when they need it. Investing in the workforce will help retain skilled professionals, enable them to work at the top of their profession and expand access to dietetic-led services across primary and secondary care.
Supporting the move to independent prescribing rights will enable new dietetic-led models of care. For example, first contact dietitians in diabetes services could provide both specialist nutritional support and prescribe insulin where clinically appropriate - reducing pressure on GP appointments and helping patients access expert care more quickly.
Health Trusts near the border have repeatedly highlighted difficulties retaining dietitians as staff move to the Republic of Ireland, citing higher pay and more flexible working arrangements. Achieving pay parity with the rest of the UK and creating clear opportunities for career progression will help Northern Ireland recruit and retain the skilled workforce needed to meet future demand.
Invest in education and training
Education is the foundation of our future health service. By investing in infrastructure which allows more people to access the profession, specialise, and receive the support they need to flourish, we set the foundations for a future in which dietitians can meet growing demand, lead innovation and improve the health of the population.
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Introduce a dietetic apprenticeship to Northern Ireland. A Higher Level Apprenticeship would allow dietetic support workers to train to become registered dietitians, while continuing to work in the health service. Dietetic apprenticeships are already established in England and would create a more flexible and inclusive route into the profession, helping to grow and diversify the workforce.
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Ring-fence funding for accredited postgraduate training to ensure the dietetic workforce has the skills needed for the future of the health service. Dietitians need access to specialist training to meet the changing needs of the population and deliver the ambitions of the Neighbourhood Model of Health and Wellbeing. Dedicated funding will ensure Trusts have the advanced skills needed to develop new services, while enabling dietitians to progress throughout their careers.
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Guarantee one full-time equivalent, dietetic practice education post in every Trust, to ensure that all students receive the support they need. Practice educators provide practical and pastoral support to students. Some Trusts no longer have dedicated practice educators, with these responsibilities instead falling to clinical teams. Restoring dedicated practice education posts will improve the student experience, protect clinical time for patient care and help secure the future dietetic workforce.
Why this matters
Northern Ireland needs more dietitians to meet growing demand. Workforce reviews have consistently identified the need to expand the profession, but increased student numbers will require us to enhance our education and training infrastructure.
Many dietetic support workers in Northern Ireland have the experience and ambition to become registered dietitians, but the current route requires them to leave employment and return to full-time university study. For many, this is simply not a practical option. Introducing a Higher Level Apprenticeship would create a more flexible and inclusive pathway into the profession, helping to grow the workforce while retaining experienced staff within Health and Social Care.
Investing in postgraduate education and dedicated practice education posts will ensure the workforce has the specialist skills needed for the future, while providing students with the high-quality support they need to succeed. Together, these investments will strengthen the pipeline of future dietitians and help to ensure Northern Ireland has the workforce it needs to deliver safe, effective and sustainable care.