Primary Care across the UK
Primary care is facing challenges across the UK, and the English, Welsh, Scottish and Northern Irish Governments have all identified Primary Care as a priority.
- In England, in 2015 The Future Primary Care Workforce aimed to identify models of primary care to meet the future needs of the NHS. The Long Term Plan sets out a new model for primary care, with additional funding, expanded multidisciplinary teams and a wider range of support. The new GP Contract specifically includes a scheme to employ more AHPs, including dietitians, in primary care roles.
- In Wales, the Strategic Programme for Primary Care identifies the need for a multidisciplinary primary care workforce, making use of a wide range of professions according to prudent healthcare principles. It builds on the overall Healthier Wales strategy for health and social care in Wales.
- NHS Scotland and Healthcare Improvement Scotland identify the importance of using multidisciplinary teams in Primary Care to support GPs.
- The Northern Irish Government has developed a primary care multidisciplinary team project, aimed at expanding the roles in primary care to including AHPs acting as First Contact Practitioners.
The BDA believes that dietitians have a critical role to play in supporting primary care services for conditions relating to diet and nutrition. Excitingly, in England this was recognised in the GP contract in 2020, whereby dietitians are now specifically included within the Additional Roles Reimbursement Scheme. This means that GPs can get specific funding for dietetic posts in their services, but they will only do that if they are aware of the impact that a dietitian could have in their service.
The BDA believes dietitians can have a number of important impacts in primary care, these include:
- Enable patients to self-manage their conditions
- Reduce demand on GP time
- Make ‘prevention’ possible in primary care
- Manage medicines effectively and efficiently
- Manage ACBS products effectively and efficiently
- Reduce the need for expensive referrals to secondary care and the need for hospitalisation
- Utilise technology effectively
- Be part of the multidisciplinary primary care home team
The primary care leaflet provides an overview of the key roles that dietitians can play in the primary care setting.
The Primary Care Project
The BDA commissioned Plymouth University to undertake a research project to collect and evaluate data on the effectiveness of dietitians working in primary care. This was part funded by HEE and will give us a firm evidence basis on which to base our calls for more dietetic posts in primary care. The three phases to the project have now finished, and we are awaiting the final analysis and write up. The three phases were:
- Phase 1 - scoping review focusing on the effectiveness of dietitian-led care in primary care
- Phase 2 - an on-line survey of dietitians working in primary care
- Phase 3 - collecting observational data to evaluate how dietitians could work in primary care. This consisted of three models:
- Dietitians working as a First Contact Practitioner to treat frailty and malnutrition within the general practice setting.
- Dietitians working to enhance the multi-disciplinary team (MDT) within general practice.
- Paediatric allergy which is usually delivered through referral to secondary care.
HEE FCP and AP in Primary Care: Dietitian - A Roadmap to Practice
Health Education England (HEE) supported by the BDA is producing a roadmap for dietitians working in primary care. This is due to be published in July 2021, more information can be found on our First Contact Dietitian webpage
Across the Four Countries
We are linking in with a representative from each of our four countries to progress the primary care agenda.
BDA Dietetic Primary Care Discussion Forum
The BDA has created a Dietetic Primary Care Discussion Forum for all dietitians with an interest in these roles to join and share experiences, knowledge and recourses such as business cases and job descriptions. Please email us directly if you would like to be added to the forum.