Dietitians in primary care

Dietitians have a clear role to play in increasing capacity in across systems and improving outcomes, by placing dietetic advice at the front of pathways as shown by the work of Chloe Adams - a dietitian who worked at Birmingham Community Healthcare NHS Foundation Trust.

Recognising there was a lack of community-based support for people with gastrointestinal problems, Chloe designed and developed an early intervention dietetics service to enable rapid assessment and treatment for irritable bowel syndrome in the community.  Chloe explains:

“Initially I did an audit and it was noted that patients were often spending over 24 months within the service. It was noted often patients were referred in to secondary care for expensive invasive investigations costing in excess of £1000 per patient compared to under £100 for community-based care in line with the NICE guidelines.

"Within existing resources, I was supported to have additional training so I could focus specifically in this area, and the Trust facilitated a restructure of our clinics so that we could have more of a specialist focus. 

“Following the 18-month pilot, we noted that 90% of the patients were experiencing a symptom improvement of greater than 50%; 100% of patients that came into the service stopped taking their medication or were able to do reduce the medication saving around 92.7% on medication expenditure – around £2,500 a year.

Karen Watson, a local GP highlighted:

“Patients like the clinic because it's local, they're given time to discuss their issues, they feel that they're listened to and then the Low FODMAP Diet gives them real hope, and when followed correctly, it has a good impact on symptoms”.

Karen adds:

“Personally I've seen a drop in my secondary care referrals to gastroenterology because of this clinic.”

One patient said:

“It was lovely to sit down with somebody who when you explained the details to them, said “I can help”. And another said “Mentally and physically it's been fabulous”.

Finally, Chloe explains

“The impact that this service has had is it's actually helped to reduce the workload for general practitioners, it's taking pressure off secondary care services, reducing referrals so they can focus on those that really need acute treatment. And for the patients themselves, it's really helped to improve their quality of life.”

Chloe’s achievement in establishing this dietitian-led community gastroenterology service won her the HEE sponsored Chief Allied Health Professions Officer’s award in 2018 and since then Chloe has received mentoring and support from HEE to support her development in management and leadership. Chloe has recently been appointed as Policy Officer at the British Dietetic Association (BDA) where she is developing BDA policy to influence national dietetic practice across the UK.

HEE have developed a film featuring Chloe as part of its series of video case studies

Dietitians have a huge role to play in primary and community care settings. Hear about the timely and sustainable positive patient impact that  new roles have had in dietetic care pathways. People see the right person, in the right place, first time.

Take a look at our overview video on transforming dietetic services.

Find out more about an innovative new Dietetic led approach to treating Type 2 Diabetes in the community. This sustainable and empowering service enables people to understand and manage their own conditions and to access timely and quality clinical care in primary care settings

Take a look at our video on Transforming dietetic services, Eat Smart Think Active, Bedford Hospitals NHS Trust.

Hear about an early intervention dietetics service to enable rapid assessment and treatment for irritable bowel syndrome in the community. By following NICE guidelines, this service has demonstrated significant qualitative and quantitative improvements.

Take a look at our video on Transforming dietetic services – Irritable Bowel Syndrome, Birmingham Community Healthcare NHS Foundation Trust.

Irritable Bowel syndrome affects many people. In Somerset, the dietetics team have pioneered a new webinar approach to self-management to enable people from across the community to access clinical care in their own environment. #]

Take a look at our video on Transforming dietetic services - Irritable Bowel Syndrome, Somerset Partnership NHS Foundation Trust.