Welsh Manifesto 2026

Dietitians: The Keys to Prevention and Early Intervention

Dietitians are qualified and regulated health professionals that assess, diagnose and treat dietary and nutritional problems at an individual and wider public health level. At the BDA we know the positive impact dietitians have in Wales as our country’s foremost experts on food and nutrition. In this Manifesto we will demonstrate they are the keys to the crucial areas for the future health of the nation: prevention and early intervention.

As people live longer, and expect more from our health system, demand needs to be managed by preventing ill health and addressing health issues before they escalate. Evidence shows that otherwise, society faces ever-mounting costs and pressure on health services. In Wales this is even more crucial that elsewhere in the UK due to high rates of poverty and food insecurity, health inequalities, and a growing proportion of the population over 65. For example, Nesta analysis suggests around one in three adults in Wales are living with obesity - leading to avoidable additional pressure expensive NHS services. Health inequalities have also been associated with additional costs £322 million per year to the Welsh NHS (2028-19). Additionally, significant rates of malnutrition impact on frailty across the Welsh health and social care systems. 

At the BDA we know dietitians and dietetic support workers have a play a pivotal role in, and have the potential to contribute even more, to prevention, early intervention and reconditioning. Evidence, such as the evaluation of the All Wales Diabetes Prevention Programme, has shown the improvement to care and cost saving that they deliver. That's why we're calling on the next Welsh Government to support them in doing so by taking action in three areas: supporting the dietetic workforce, investing in education and training and trusting dietitians on food policy. 

1. Support the Dietetic Workforce

Dietitians and dietetic support workers dedicate their professional lives to improving people's health through assessing, diagnosing and treating dietary and nutritional problems at an individual and wider public health level. The preventative action and early interventions they undertake saves the Welsh NHS a substantial amount. Sadly, this crucial workforce is not being supported to reach its key potential with staff left overstretched, demoralised and frustrated. At the same time, lack of digital infrastructure in Welsh health boards, with paper records often still in use, means that bureaucracy is currently time consuming and needlessly wasteful.

Dietitians’ and support workers’ pay has also been eroded due to high inflation beyond pay rises, which means salaries go less far year on year. This issue has not only had a negative impact on recruitment and retention but also demoralises our talented and hard-working workforce. As a trade union proud to represent dietitians and support workers across Wales, we think it is crucial this erosion is reversed, and the value of the dietetic workforce is recognised through restoration of fair pay.

Additionally, we believe that extending primary prescribing rights to qualified AHPs, especially dietitians, can hugely reduce administrative burden and cost. Weight and diabetes management GLP-1 drugs are seeing a surge in popularity. We believe that its important dietitians are empowered to oversee their appropriate use, alongside dietetic support and embedded within obesity services, so that their potential benefits are maximised and responsible use is promoted. Wales has also seen the introduction of programmes like the pioneering gluten free prescription payment card scheme. These, along with general free prescriptions, means extending prescribing rights could be even more impactful in Wales.

This is why we're calling on the next Welsh Government to:

• Address understaffing in dietetics departments through a long-term AHP workforce plan. This should include improving career planning for dietitians and dietetic support workers, so we have better retention and targeted recruitment.
• Commit to fair pay by fully funding workforce planning - addressing real-terms pay decline through above inflation pay rises and publishing a clear timeline for restoring NHS pay to competitive levels. 

• Improve efficiency of the dietetic workforce by investing in digital upgrades and exploring the expansion of primary prescribing rights, collaborating with and exerting pressure on the UK Government to explore how this could be achieved in Wales.

2. Invest in Education and Training

For dietitians and support workers to make a bigger impact going forward, we must invest in educating the next generation as well as upskilling workers. Currently people in Wales wishing to train in dietetics are limited in how they can study. Many feel a career in dietetics is out of reach for them either because they cannot access adequate maintenance loans/grants, because they do not have the right qualifications, or because they want to earn and remain where they live while they train.

The BDA believes this puts a huge limit on the number and range of talented people who can enter the profession – a huge loss to patients, Welsh taxpayers and the nation's health. This can be addressed by better supporting prospective students to study dietetics and by offering, and fully funding, alternative routes into the profession such as degree apprenticeships.

Similarly, opportunities for existing dietitians and support workers to upskill through training are severely limited, harming retention and limiting our skills base. A key issue is the lack of paid time to undertake training courses.

We're calling on the next Welsh Government to: 

• Improve access to dietetics university courses. This means maintaining funding for current places, ensuring access to adequate maintenance funding, making available part-time and other flexible study options and promoting science access courses.
• Undertake measures to make a career in dietetics more accessible by creating fully funded alternative routes into the profession such as degree apprenticeships. We’d also like to see improved careers planning for students or potential students interested in dietetics, in partnership with Careers Wales.
• Ensure dietitians and dietetic support workers have better access to CPD and training, including earmarked paid time to undertake these. 

3. Trust Dietitians on Food Policy

Dietitians are, by definition, qualified and regulated professionals. They are the experts on dietary health and nutrition, and they have an enormous potential to improve public health if we trust their expertise and priorities. Therefore, we think dietitians should be front and centre of food policy development, ensuring that we follow the science to improve public health.

The benefits of free school meal expansion to all primary pupils, a cause championed by dietitians, are already being realised in Wales, as well as those of schemes like Food and Fun and Nutrition Skills for Life. The BDA believes these are successes to be celebrated but further action is needed to make the most of them. We note with positivity that school food standards are being reviewed and a whole-school approach to healthy eating is being promoted. We would like to see this work continue in dialogue with public health dietitians. Further research is needed to monitor the impact of universal primary free school meals and we hope this will be adequately supported and followed by the Welsh Government. Secondary school is also a key developmental age for pupils in terms of attainment, prevention of ill health and health habit formation. We believe the further expansion of free school meals should be considered to reflect this.

The BDA also believes in a holistic and cross government approach to nutrition in Wales with public health dietitians at its core. We believe that fulfilling the Wellbeing of Future Generations Act means considering the dietary health impact of a wide range of policy areas and working to ensure future generations have access to healthy, sustainable diets. This is reflected in the latest Future Generations Commissioner’s Annual Report which called for a National Food Resilience Plan to improve this. We also note the increasing salience of the Marmot principles for improving health equality and the Welsh Government’s commitment to make Wales the first “Marmot Nation”. We were glad to see the Welsh Government’s recently published community food strategy and hope work will continue in this sphere along the lines of the Henry Dimbleby National Food Strategy report, which the BDA is campaigning for UK governments to adopt. We want nutrition, and public health dietitians, to play a central role in this work.

Therefore, we call on the next Welsh Government to:

• Explore options to further expand free school meals in secondary schools and improve food education in schools more generally through the whole-school approach. Outcomes of universal free school meals in primary schools should continue to be closely monitored. 
• Ensure involvement of public health dietitians in the development, design and, where appropriate, implementation of food policy and regulations. This should include the implementation of the recently published Community Food Strategy. 
• Ensure work across the public sector improves public nutrition and health equality, in line with the Wellbeing of Future Generations Act, the Marmot Principles and the National Food Strategy report. Create a National Food Resilience Plan, in partnership with dietitians, to achieve this through improving secure access to health and sustainable diets.

Read the Welsh Version Manifesto here

Watch our Wales Manifesto webinar here:

 Intro 

Part 2