22 Mar 2019

Andy Burman

Chief Executive, British Dietetic Association

Yesterday, three well-regarded think thanks, the Health Foundation, King’s Fund and Nuffield Trust, published Closing the Gap, a widely covered report regarding the NHS workforce in England. The report, which you can read here, comes ahead of a the expected publication of the NHS England Workforce Implementation Plan, which forms part of the wider Long Term Plan.

Closing the Gap makes a number of bold recommendations to government, and highlights some of the key challenges facing the healthcare workforce in England. As is typical in these cases, quite a lot of the focus is on doctors and in particular the nursing workforce. They call for action on staff recruitment and training, pay policy and actions to ensure the NHS is a good employer. They also consider international recruitment, the pressures facing social care and how to deal with shortages and pressures in Primary Care.

They are right to recognise the significant challenges to recruiting more GPs and nurses, and outline steps to try and fill those gaps. However, we would argue that in Allied Health Professionals (AHPs) the NHS has a quicker and more effective option to expand the primary care workforce. They make mention of physiotherapists and pharmacists, but take in the full range of AHPs who may well be better placed to provide support or assistance to a patient than a GP.

A significant proportion of conditions that GPs see on a daily basis are either partly or entirely determined by diet and lifestyle. Dietitians should be playing a core role in supporting GPs to manage patients with obesity, diabetes, IBS and more. Government needs to recognise the huge potential of dietitians and other currently smaller AHPs, who could be playing an even bigger part. Our Dietitians in Primary Care paper outlines this in more detail and our ongoing research project with the University of Plymouth will provide the evidence of both the health and financial benefits of primary care dietetics.

With regards to financial support, although the report focuses on nursing staff, dietitians and other AHPs have faced the same challenges in terms of cost of living since the government’s decision to withdraw bursaries. A grant of £5,200, as advocated by the report, should also be considered for AHP students who also spend significant time on clinical placements. It would be a positive step to ensure that such courses, some of which are struggling for numbers, are open everyone with the skills and desire, regardless of means.

The NHS’s success is based on its staff, so we welcome the report’s call for a “universal offer” to all staff to ensure fair treatment, fair pay and support for ongoing development and training. We also strongly agree that all health and care staff deserve guaranteed real terms pay increases, especially after many years of frozen and below inflation pay offers. Nobody who delivers our health and care services should be find themselves struggling financially, but we sadly know that this is the case.

I hope that these and many of the other very sensible suggestions included within this report will be included in the forthcoming workforce implementation plan as part of the NHS England Long Term Plan. The BDA has already provided feedback on the plan, and is providing input to other related pieces of work. We will also be doing so for the Workforce Implementation plan when it is released. Our team are also working on a document outlining how dietitians fit within the very many important policy priorities identified within the LTP.

You can find our more about the LTP and other areas of health policy in England and the rest of the UK on our website: https://www.bda.uk.com/professional/influencing/tools_information


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