Health Education England (HEE) with support from the BDA have produced a Roadmap to Practice for first contact dietitians (FCDs), this follows on from dietitians (along with other AHP colleagues) being added to the GP contract in 2020. Below is a summary of the main roadmap document.
1. What is a First Contact Dietitian?
A First Contact Dietitian (FCD) is a diagnostic clinician working in Primary Care at the top of their clinical scope of dietetic practice at level 7 (masters level). They are able to assess & manage undifferentiated and undiagnosed presentations in primary care settings.
FCD have not yet reached an advanced level in all four pillars of practice. With additional training, FCDs can build towards advanced practice. You should typically have five years post-preceptorship experience before starting primary care training to become an FCD.
2. What are the clinical/education requirements?
The Knowledge Skills and Attributes (KSA) section of the roadmap (Appendix 12.15) describes the required knowledge, skills and attributes dietitians need when moving into an FCD role. These have been developed to set the standard required for a dietitian working in this role.
Key clinical presentations that FCDs may manage are outlined in the roadmap (Appendix 12.16). Application of these will then be determined by the scope of the role of the FCD and the context in which they operate, and would be agreed between them and their employer.
3. What will training involve and how do I become a First Contact Dietitian?
Stage 1 is completed with a portfolio of evidence and verified before employment in Primary Care. Stage 2 is completed with a portfolio of evidence and verified once working in Primary Care.*
Stage 1 (to be completed prior to embarking in Primary Care) includes:
- Completing the HEE core online training MSK primary care programme & Personalised Care Institute modules: share decision making, core skills, personalised care & support planning). You may also find useful training and education available on the BDA website.
- Mapping against the FCP knowledge, skills and attributes capabilities (see roadmap appendix) by a taught HEI module or portfolio evidence.
Stage 2 involves:
- Evaluation of FCP knowledge, skills and attributes capabilities in practice (you will have a roadmap supervisor to support you with this). You’ll need to complete a non-medical prescribing course & master’s level advanced clinical assessment module.
*You will have access to a roadmap supervisor to support you through training. Contact your local Primary Care Training Hub to access a clinical supervisor.
4. Training and career progression
The ‘trainee’ FCD is advised to keep a folder mapped against the FCD knowledge, skills and attributes capabilities in anticipation of the HEE Centre for Advancing Practice ‘First Contact Practitioner (FCP) directory’ being launched.
Essential requirements for those training into FCD roles will be ongoing reflective practice, peer review, patient feedback, and the monitoring of personal wellbeing in order to provide an enriched learning experience. You can find templates to help you document CPD evidence within the appendices of the main roadmap.
5. How will the roles be supported/managed?
Following stage 1&2, once launched, FCD roles will be recognised by HEE The Centre for Advancing Practice who will provide a First Contact Practitioner (FCP) Directory to verify FCPs via the portfolio or taught FCP routes.
FCDs can continue building evidence towards Advanced Practitioner, should they wish to and there is a service need identified.
The Centre will also hold a directory of Advanced Practice Roadmap Supervisors (verified FCPs, Advanced Practitioners, Consultant Practitioners, or GPs) will be required to have completed an approved training programme to allow them to support clinicians in achieving both FCP and AP recognition.