- Managing patients suffering with COVID-19 who are presenting to primary care
- Meeting the backlog in long term condition care from the current and previous lockdowns
- Rising demand for care, and ageing population, increasing numbers of complex patients
- A workforce under increasing stress, major shortages insome areas
- Staff absence from those suffering from COVID-19 or self-isolating
A First Contact Dietitian sees the patient first and assesses undiagnosed presentations.
First Contact Dietitians
Changes to the GP contract 23/24 moves the focus to improving patient access and improving patient experience.
Our First Contact Dietitian frees up GP time by seeing patients at first contact. Our dietitians also provide holistic care for your patients.
- We will support your PCN with achieving goals, including the Investment Impact Fund (IIF)
- We also provide dietitians who can support with the Extended Hours Access and Enhanced Access
- We will find out your priorities and work with you to meet the needs of your demographic
- Malnutrition is estimated to affect over 3 million people in the UK
- It leads to increased GP visits, prescription costs and referrals to secondary care
- Involvement of a dietitian can lead to improved outcome measures, including weight, BMI, strength and nutritional status
- Changes to oral nutritional supplements resulted in projected annual cost savings of £15k
- Gastrointestinal conditions represent one in every 12 GP consultations, with IBS being the most prevalent
- Those with undiagnosed IBS visit their GPs ten times more frequently than matched patients
- Dietetic input in IBS has shown a 36% reduction in referrals to secondary care,reduction in symptoms for 70% of patients and improvements in quality of life for 74%of patients
- A systematic review of RCTs found that dietitians in primary care were effective at improving diabetes control, achieving reductions in weight and waist circumference as well as improving diet quality
- Supervision of patients using total diet replacement has been shown to be effective inachieving weight loss in primary care
- Diabetes prevention programmes that focus on lifestyle interventions are effective at reducing body weight and blood glucose levels. Programmes delivered by dietitians had greater weight loss outcomes
- Dietetic consultations for adults in primary care settings appear to be effective for improvement in diet quality and weight loss outcomes (eg, changes in weight and waist circumference)
- Dietitians can support patients with a variety of weight management approaches to help reduce weight, manage co-morbidities associated with overweight or obesity, and improve quality of life
- Their expertise can be shared across the multi-professional team to increase overall quality of care
What the Primary Care Dietitian can do for you
Enable patients to self-manage their conditions
- As the emphasis in health care is shifting from secondary to primary care, GPs are looking after more patients with complex and multiple conditions. These patients would previously have been cared for in hospital. Dietitians are integral to the treatment of these conditions and can help these patients manage their diseases at home
- Patients who are able to manage their own conditions at home are likely to experience better quality of life and satisfaction with the GP service
- Dietitians are trained in behaviour modification methods and motivational interviewing. Using these skills, dietitians enable patients to manage their own conditions and so have a significant impact on clinical outcomes e.g.obesity, cardiovascular disease and diabetes
Reduced demand on GP time
- Dietitians have the potential to reduce the demand on GP time by patients becausetheir services are effective
- Patients with undiagnosed IBS see GPs 10 times more frequently than matched patients and one in 12 GP consultation are for gastro symptoms – 46% of which were diagnosed as IBS (NICE, 2017). A new IBS pathway for a dietetic led gastro clinic hasdemonstrated that dietitians can reduce symptoms (and therefore reasons to seethe GP) in 70% of patients (Williams 2013).
- Advanced dietitians can now train to become supplementary prescribers. This means that dietitians can provide primary care diabetic services that include dietary, lifestyle and medication modification. As a result patients do not need to see theirGP for insulin and antidiabetic agent modification.
- Dietitians are effective at obesity management, and in a meta-analysis, have beenshown to achieve better weight loss than non-dietitians
- Focus on Undernutrition a dietetic programme in County Durham has shown that dietitian can reduce the incidence of pressure sores inpatients in nursing homes and in the community by treating malnutrition appropriately
Make ‘prevention’ possible in primary care
- Dietitians are currently involved in the NHS Making Every Contact Count initiative and so are using every opportunity to have healthy conversations with patients
- In primary care, dietitians can work with pregnant mothers; NICE recommend that evidence based dietary advice should be given to mothers by dietitians to improve their own and their children’s long term health. NICE further recommends that women with a BMI of 30+ should be offered a referral to a dietitian at the booking appointment
Reduce the need for expensive referrals to secondary care and the need for hospitalisation
- A primary care dietetic led clinic for patients with IBS demonstrated improvementsin overall symptoms and quality of life in 70% of their patients (Thompson 2000) as well as a 5% reduction in new outpatient slots in secondary care which equated to cost savings of £102,000 per annum