Suyin Chia is a registered dietitian who became frustrated with the lack of support and awareness of the role of dietitians within primary care. As a result, she co-founded the Primary Care Dietitians organisation and is now Chief Operating Officer. Here she explains the role of the primary care dietitian and how to get involved.
The Additional Roles Reimbursement Scheme (ARRS) is an initiative by the National Health Service (NHS) to support the expansion of the primary care workforce and improve patient care. The scheme was introduced in England in 2019.
Under the ARRS, dietitians in primary care are funded to take on additional roles and responsibilities, such as assessing and diagnosing patients, beyond their traditional scope of practice. This scheme recognises dietitians’ expertise in nutrition and dietary management, and the important role they play in delivering high-quality, holistic healthcare.
At Primary Care Dietitians (PCD), we promote the role of the primary care dietitian amongst PCNs and support our dietitians in becoming First Contact Dietitians. Currently, we have 50-strong team of dietitians supporting over 35 PCNs.
What is a primary care dietitian?
The primary care dietitian is usually an expert generalist, meaning they cover a range of conditions most seen in primary care. This includes diabetes, gastroenterology conditions (IBS or functional bowel disorders like chronic diarrhoea, chronic constipation), frailty and weight management. Dietitians working in primary care bring at least three years of post-graduate clinical dietetic experience.
Who do they see?
Primary care dietitians see a range of patients, including those with chronic disease, or presenting with symptoms that might be linked to diet, such as the sudden onset of weight loss or gain.
Another example of a use case of the primary care dietitian is to fill gaps in being provided in community. In a diabetes example, the community team can only see newly diagnosed patients with diabetes, or those with complex diabetes. A primary care dietitian can support the PCN and community by seeing patients with pre-diabetes, or those within 6 years of a diagnosis.
All dietitians in primary care should be embarking on the roadmap to becoming a First Contact Dietitian. These dietitians can see patients at first presentation, without having to go through the GP. One of the aims of upskilling dietitians to recognise red flags and manage clinical presentations is to reduce the workload and pressures faced not only by GPs, but also our colleagues in secondary care.
My experience of being a primary care dietitian
Before launching Primary Care Dietitians (PCD) as a company, my co-founder, Nusrat Kausar and I, were working in primary care.
We were both supporting patients with Type 2 Diabetes, but with different PCNs.
I absolutely loved it. I had the chance to meet patients who were motivated, in their own environment, with jobs, friends, and hectic schedules. It gave me the opportunity to talk about food, lifestyle change and the importance of health.
What I liked about it was the focus on prevention rather than cure. We were preventing complications of diabetes, supporting, and educating them along their journeys to make sustainable change. They didn’t have access to a dietitian previously as they didn’t ‘fit’ into a box of referral criteria. Now, patients presenting to primary care with dietary issues or chronic diseases requiring dietary input could be seen easily and quickly by a dietitian.
Dietitians in primary care is a growing need. Primary care dietitians contribute to building a more robust, holistic, and sustainable healthcare service. Making them accessible to the general population is also crucial for shifting our collective approach to health from treatment and cure to proactive prevention.
If you’d like to add a primary care dietitian to your PCN or find out how to fit a dietitian into your service, reach out to firstname.lastname@example.org from the Primary Care Dietitians team.
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