Within the BDA Dietetic Career Framework and the BDA Roles and Responsibilities Guidance, we refer to two levels of practice relating to the dietetic support workforce; supportive and assistive. We also refer to assistive level with additional responsibilities.
The BDA do not see assistive level roles with additional responsibilities as sitting within a separate level of practice, we recognise that, specifically within the NHS, these roles may warrant a banding higher than that of band 4.
As an organisation, we are aware that whilst in their infancy and not widespread, these roles do exist and we want to recognise and acknowledge these to challenge the outdated narrative that the dietetic support workforce cannot progress in their careers, beyond band 4, without training to become a registered dietitian.
At present, research suggests that these roles are predominantly within the NHS in England, and they are usually band 5 on the Agenda for Change pay scale. They are not exclusive to the dietetic support workforce; these roles are being developed and are evolving within other AHP professions also.
More research is required, and the BDA are seeking further guidance from NHS England, and NHS bodies across the four nations to ensure these roles are clearly defined and appropriately governed. This is essential to assure the roles of registered dietitians.
At this time, the BDA considers assistive roles with additional responsibilities as roles which have been developed to meet additional leadership, facilitation of learning or research and evidence needs in a service, where the specific expertise of a registered professional is not required to meet these needs.
For example:
An assistant practitioner may lead a team of support staff with delegated management responsibilities.
or
An assistant practitioner may lead and publish a research project.
It is important to recognise that these roles do not allow members of the dietetic support workforce to perform at a higher level within the ‘Professional Practice’/’Clinical’ pillar. The scope in relation to nutrition and dietetic practice/clinical practice will remain within the assistive level, and the appropriate roles and responsibilities within the BDA Roles and Responsibilities guidance would apply.
When discussing any roles which relate to Agenda for Change pay scales, it is relevant to highlight that all NHS job roles will go through the NHS Job Evaluation process, to determine the appropriate pay banding.
Job evaluation is a process that seeks to objectively compare, for the purpose of pay, how demanding jobs are compared to each other. It does this by breaking jobs down into common components based on tasks, responsibilities, physical effort and working conditions, plus, the education required to work in a role. These components are called factors.
The NHS job evaluation scheme has thirteen factors including ‘Planning and Organisation’, 'Responsibility for Human Resources’ and ‘Physical Effort’. Each of these factors are assigned points, with some factors given more weight than others (because they are deemed to be more significant in determining how demanding a job is). The total points a job scores across all factors determines (compared to another role) how it is graded in the NHS.
It is important to recognise that the knowledge, training and experience factor carries the highest weighting within the scheme, and this is why roles that do not apply the depth and of knowledge of a registered dietitian tend not to score as highly within job evaluation, and as such, may not reach the threshold for a banding above band 4.
You can find out more information on job evaluation by visiting the Careers and Workforce FAQs webpage.