1. The Role of Dietitians in Diabetes Care: BDA Diabetes Specialist Group Workforce Survey
Summary of findings
July 2016
Anita Beckwith
Clinical Lead Dietitian (Diabetes), King’s College Hospital
National DAFNE Educator, UK

2. 90 Respondent Profile 85.6% Diabetes Departments Represented 5.6% 2.2%
Consultant Paediatrician
Clinical & Operational Lead for Nutrition & Dietetics
Senior Specialist Dietitian
Diabetes Stroke Dietitian
Paediatric Diabetes Dietitian
Team Leader
85.6%
Diabetes Specialist Dietitian
Specialist Dietitian
Lead Diabetes Dietitian
Dietitian
6.7%
Highly Specialist Dietitian
Advanced Practitioner Dietitian
Associate Clinical Operational Lead
Senior Research Associate
Community Dietitian

3. Definitions
Dietitian: “Degree qualified expert in nutrition and dietetics who practises evidence based medicine and is registered with the HCPC. Only nutrition professionals to be regulated by law.”
Nutritionist: “A person who studies or is expert in nutrition.”

4. Surveyed Workforce by banding
554+
Total Staff
Numbers (H/C)

5. Areas of care and patient types covered

8. Patient numbers and education programmes
Others include:
BERTIE
KAREN
SADIE
ESTER
Carb Counting
57,000
Highly specialised Paediatrics: As few as 120 patients
As many as 57,000 diabetics in local area

10. DoH Criteria for Structured Education
Philosophy
A structured curriculum
Trained educators
Be quality assured
Be audited

11. Emergency Treatment Costs
Risk of DKA reduced by 61%
Risk of severe hypoglycaemia reduced by 72%
Costs of emergency treatments reduced by 64%
Elliott et al., Diab Med in press

13. #DAFNEplus Develop technologies Revise DAFNE curriculum
Review follow up pathway
Revise educator training
Cluster RCT

14. Caseload “Need more dietetic staff” “Capacity does not meet demand”
“Lack of funding and staff vacancies”
“Capacity does not meet demand”
“Struggling to cope… No time for service development and improvement”
“Unable to provide one to one support”
“Numbers and referrals increasing, also now receiving ‘prediabetes’ referrals”
“Long overbooked clinics or long waiting lists”
“Cover a massive geographical area… Only one specialist dietitian for high prevalence population”
“Chronic staffing shortages”

15. Comments
“We have always been under funded for diabetes dietitians in our area and therefore there are a lot of services that we do not provide due to lack of capacity.”
“I am very lucky to have highly-trained and experienced, hard-working individuals in my team. I only have one day a week to manage a changing and challenging service which I find insufficient.”
“We work very closely as a team helped by many of us (doctors, nurses and dietitian) sharing the same office.”
“I work very closely with the DSNs, we have a very supportive encouraging team, many of the professional boundaries are now greyed but there remains a tremendous respect for each others work.”

16. Comments continued…
“There is a chronic staff shortage… The gestational clinic and pump service is suffering due to lack of diabetes dietitians input. The NICE guidelines are not being met. This concerns me greatly.”
“Diabetes Dietitian is always under valued by the service despite a great contribution to the management of diabetes. Most clinical guidelines hardly mention the word dietitian, instead using words such as ‘professional with nutrition expertise’ which makes it a vague about the need to hire dietitian.”
“There resistance to improving IT and this hampers our ability to connect in a relevant way with older children. It also impacts negatively on time management.”
“Group education is important to address ever increasing caseload of patients. Weight management must be seen as an important pathway for all obese or overweight patients.”