Dietetics in the UK Dr Fiona McCullough Associate professor of dietetics University of Nottingham

Dietetics at Nottingham

What is a dietitian? Dietitians are the only nutrition-related profession registered with the Health Professions Council. They are uniquely qualified by degree to translate scientific information about food into practical dietary advice. As well as providing impartial advice about nutrition and health, dietitians also advise about food related problems and treat disease and ill health.

Where do RDs work Many work in the National Health Service (NHS) and May work in one or more specialist areas, e.g. diabetes, children's health, cancer, whilst others work with people in the community, often visiting them in their own homes. They are a key part of the healthcare team. There are also a wide range of opportunities for dietitians outside the NHS such as the food industry, sports, scientific research, public health and journalism.

What is the difference between a dietitian and nutritionist? Dietetics- It is necessary to have a Health and Care Professions Council (HCPC) recognised degree in nutrition and dietetics to work as a dietitian and to be registered with the HCPC if working as a dietitian. The title dietitian is protected by law, anyone using the title must be registered with the HCPC.

Nutritionist Nutrition is the study of nutrients in food, how nutrients are used by the body, and the relationship between diet, health and disease. Most of the major food manufacturers and retailers employ nutritionists and food scientists but opportunities also arise in journalism, research and education. There are a variety of careers within the field of food science and technology. Many nutritionists hold a nutrition degree and are on the UK Voluntary Register of Nutritionists, but this is not a mandatory register. Further information about training to be a nutritionist can be found from the Association for Nutrition.

Dietitians are statutorily regulated, with a protected title and governed by an ethical code, to ensure that they always work to the highest standard. The title 'dietitian' can only be used by those appropriately trained professionals who have registered with the Health Care Professions Council and whose details are on the HCPC website.

Professional body support for dietitians The British Dietetic Association (BDA) is the only body in the UK representing the whole of the dietetic workforce. We are a trade union and professional body representing the professional, educational, public and workplace interests of our members. Founded in 1936, we are one of the oldest and most experienced dietetic organisations in the world.

International members £200/year Way to encourage sharing of nutrition and dietetic practice across the world. To be eligible for International Membership you should: have undertaken recognised education and training in nutrition and dietetics overseas not currently registered in the UK and are not practising in the UK be a full member of a dietetic association recognised by ICDA or EFAD or a member of a dietetic association which has similar aims to the BDA. If you are an International Member and obtain HCPC registration to work in the UK, you must transfer to the Full Member category. International Members cannot vote at the AGM, and professional indemnity insurance and Trade Union support is not included.

Under graduate dietetics Biochemistry Human Nutrition Human Physiology Diet Therapy Food Processing, Preservation and Food Hygiene Nutritional Medicine Healthcare: Systems and Management Structures Epidemiology and Public Health Genetics Research Methods Data Analysis Behavioural Studies Pharmacology Professional Practice Communication

Clinical placements Students will be required to undertake practical placements usually within the NHS and other health and care organisations which are organised by the university. Placements allow students, under supervision, to develop practical skills and apply knowledge in a work environment. Teaching is usually delivered over three to five days with contact hours a week. Placements are full- time and approximately 37 hours per week. The BDA holds responsibility for the curriculum which describes what is expected of a newly-qualified dietitian and provides the framework for universities to deliver programmes that are responsive to the demands of dietetic employment.

Accountability of Universities Health and Care Professions Council (hcpc) standards APPROVAL BODY Standards of Education and Teaching Standards of proficiency (2013) Standards of conduct, performance and ethics Standards for continuing professional development

Detailed curriculum The role of the BDA in education is to safeguard the role and identity of the dietitian. This includes articulating curriculum standards for education and training of dietitians, producing guidance for education providers and monitoring these standards. BDA owns the Curriculum Framework for the Pre-Registration Education and Training of Dietitians for the HCPC. The curriculum is the mechanism through which the Association describes a dietitian, and the accreditation process is thus the mechanism through which the profession ensures that the pre-registration education in each university is designed to meet the profession specific standards. Upon graduation, students should hold the core understanding, knowledge, skills and capabilities. Universities require BDA curriculum approval and annual accreditation

Drivers for Change  HCPC Standards of Proficiency (Dietitians)  The current and future NHS –Professionalism –Engagement of whole dietetic team –Changes in technological approaches  Potential threats to the profession –‘Know your Worth’ – Trust a Dietitian to Know about Nutrition

The 2013 Curriculum Four Key Sections  Background and Context  Knowledge underpinning informed, safe and effective practice  Graduate Capabilities  Roles and Responsibilities

Section 1: Background and Context Includes:  Aims and Purpose  Role and Scope of Practice  Educational Philosophy  BDA Expectations  Length and Structure of Programme  Curriculum Delivery  Framework overview

Consultation Feedback on Background and Context  Use of the word ‘normally’  Specification of Entry Level Criteria  Maximum Course Length  Final Placement Hours  Research Project  Support Worker Involvement in Student Placements  BDA Membership

Section 2: Knowledge Underpinning Informed, Safe and Effective Practice  Streamlined  Update of terminology  Logical order with level descriptors: –Extensive, critical, integrated and applied –Critical, Integrated and Applied –Broad

Knowledge Components 1.0Dietetics for prevention & treatment of disease 2.0Applied Nutrition and Food 3.0Food science, food skills and food systems management 4.0Health inequalities, Structure & Function of NHS, Social and Health Policy, Public Health and Public Health Nutrition 5.0Professional practice and leadership 6.0Nutritional sciences, physiology & biochemistry. Genetics.

Knowledge Components (pt 2) 7.0Immunology and Microbiology 8.0Clinical medicine, disease processes and pharmacology with respect to dietetic and nutrition interventions 9.0Psychology as applied to health 10.0Communication and educational methods 11.0Theories, concepts and principles of research and evidence informed practice 12.0Use of technology in relation to dietetic practice

Strengthening the Underpinning Knowledge  Professional practice and leadership  Consideration of medicines management  Record Keeping  Use of technology in relation to dietetic practice.  Service user centred care approach

Section 3: Graduate Capabilities  Mapped to four core areas of practice: – Dietetic Practice – Evidence Based Practice – Dietitians as a nutrition and dietetic resource – Leadership and Management  Lay foundations for a lifetime career  Advance the dietetic profession

Overarching Statement; Graduate Capabilities 1.1: Caseload Manages routine caseload as appropriate to the setting. Manages more complex cases with supervision Applies and develops their communication skills (initially developed in pre- registration education). a)recognise the need for effective self-management of workload and resources and practise accordingly; b)ensure safe case-load management; c)select and use the appropriate assessment techniques (SOP 14.4) / undertake the most appropriate method of dietary and nutritional assessment; d)assess the nutritional status of individuals and groups through interpretation of anthropometric measurements, biochemical, haematological and clinical chemistry test results; Capability Statements

Practice Placements ‘Every dietetic workplace should regard itself as a learning environment to support the initial education and training of Dietitians and so demonstrate commitment towards development of the Dietetic profession and the continuing professional development of Dietitians.’ BDA Pre-registration Curriculum Framework (2013)

Who?What?Why? BDA (Professional Body) Promoting of training & education Curriculum Standards Programme accreditation / annual monitoring Advancement of the science and practice of dietetics HCPC (PSRB)Regulating the profession – maintaining a register Setting standards for registrants, education and training, CPD etc Protection of the public HEIsProgramme provision Developing, managing and quality assuring academic and placement learning Produce the future dietetic workforce Practice Educators Providing students with the practical experience of dietetics: access to service users, facilities, supervision etc Ensure future dietetic workforce graduates with adequate practical experience and skills Dietetic Students Independent learning, engagement with programme Adherence to relevant codes of conduct Professionalism of future dietetic workforce

What is Nutrition? NUTRITION CLINICAL NUTRITION PUBLIC HEALTH NUTRITION BASIC NUTRITION Use of diet in treatment and prevention of disease Dietetics Monitoring trends in disease. Understanding how diet leads to poor health. Health promotion, health education. Understanding the basis of how diet controls the key processes within the body Biochemistry and metabolism. Genetics.

World inequalities in Nutrition

Teaching Facilities

Specialist Groups and Branches 21 clinical specialist groups including: Cardiac and Respiratory Diabetes Obesity Mental health Older people Sports nutrition Food allergy and intolerance Digestive disorders Nutrition for children and infants Local contacts Branch network offering access to dietitians across the country and excellent CPD

Reach Public Health England Nutrition Policy Team AHP Lead Departments of Health Meet health Ministers and civil servants Respond to consultations Change for Life FSA NICE Registered stakeholder Guideline development groups As leaders in nutrition, the BDA has a key role engaging with key organisations and stakeholders and influencing at a strategic level European Commission Lead member of EFAD ICDA Patient Groups Carers UK Macmillan Cancer Care The Media Broadcast, broadsheets, redtops, hard news, national, international, online Lobbying Groups CASH, Sustain Trade Unions Seat in the TUC Other medical bodies e.g. RCGP Partners e.g. Danone water, Nutricia, Abbott, etc. UK Parliaments Meeting with Parlimentarians, providing evidence to committees and inquiries HCPC PEN Education e.g National Association Practice Educators, HEE AHP Advisory Group AHP Bodies e.g AHPF, Council for AHP Research

Publicly Recognised 1: In the national press daily, regularly invited to interview on TV, approached by production companies to help create, shape and contribute. 2: Food Fact sheets accessed by 13,000 people per month including the public, dietitians and other healthcare professionals. 3: BDA campaigns lead to opportunities to shape debate via Party Conferences and TV shows. 4. Information standard accredited kite-mark of quality for our public facing information 5. BDA Policy statements

BDA National Campaign & Chairman’s Theme Trust a Dietitian is a British Dietetic Association (BDA) campaign which aims to equip members with tools and resources which highlights the work and worth of dietitians and the impact of the dietetic profession in the UK.

A New Website

Keeping in Touch

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Get Involved Write an article for Dietetics Today Contribute to our Trust a Dietitian campaign Become a Trade Union Representative and represent your department Join a BDA Specialist Group or BDA Branch committee Join a BDA Board or Council Become a Media Spokesperson Become a BDA Ambassador Contribute to PEN Contribute to BDA Food Fact Sheets Contribute to the dietetic evidence base by publishing in JHND Work with colleagues on a key facts sheet

To find out more… Visit: Telephone: Or for links on how to follow us via social media go to: dia

Advanced practitioner BDA guidance 2010 The BDA Dietetic Career Framework (British Dietetic Association, 2010) describes the capabilities required of dietetic practitioners along the career pathway from support worker to expert or consultant practitioner. The framework is built on the four pillars of practice as described by, for example, NHS Education Scotland (NES) and National Leadership and Innovation Agency for Healthcare (NLIAH). For advanced practice roles these are: Advanced Dietetic Practice. Research and evidence based practice. Leadership. Acting as an expert nutrition and dietetic resource and facilitating learning

Any Questions?